Trust In Governments And Health Workers Low Globally, Influencing Attitudes Toward Health Information, Vaccines

Abstract

Trust, particularly during emergencies, is essential for effective health care delivery and health policy implementation. We used data from the 2018 Wellcome Global Monitor survey (comprising nationally representative samples from 144 countries) to examine levels and correlates of trust in governments and health workers and attitudes toward vaccines. Only one-quarter of respondents globally expressed a lot of trust in their government (trust was more common among people with less schooling, those living in rural areas, those who were financially comfortable, and those who were older), and fewer than half of respondents globally said that they trust doctors and nurses a lot. People's trust in these institutions was correlated with trust in health or medical advice from them, and with more positive attitudes toward vaccines. Vaccine enthusiasm varied substantially across regions, with safety being the most common concern. Policy makers should understand that the public may have varying levels of trust in different institutions and actors. Although much attention is paid to crafting public health messages, it may be equally important, especially during a pandemic, to identify appropriate, trusted messengers to deliver those messages more effectively to different target populations.

Exhibit 2:

Trust in national government and health care workers, by region Chart displays predicted regional averages from fully adjusted models. Includes individual-level covariates (gender, age, age-squared, education category, rural/urban residence, household income quintile, living comfortably on current income) and country-level covariates (income classification, above- or below-median governance score based on factor analysis incorporating Government Effectiveness Index (World Bank), Rule of Law Index (World Justice Project, and Corruption Perceptions Index (Transparency International), and above- or below-median health system score based on factor analysis incorporating Healthcare Access and Quality Index (Institute for Health Metrics and Evaluation), health system responsiveness and measles vaccine coverage (World Health Organization)) with individual-level survey weights. Bars represent 95% confidence interval on each regional estimated value.

Exhibit 4:

Relationships between institutional trust and trusted sources of health advice Results are predicted margins from logistic regression models with individual-level survey weights that include: age, age-squared, education category, rural/urban residence, household income quintile, regional fixed effects, country-level covariates (income classification, above- or below-median governance score, and above- or below-median health system score). ** p<0.05, ***p<0.01, ****p<0.001