Trust and distrust in low‐income Michigan residents during the early Covid‐19 pandemic

A qualitative study

Bibliographic Data

ID19505985
AuthorsGavisha Waidyaratne (0000-0003-3886-4456, Department of Internal Medicine Ohio State University Wexner Medical Center Columbus Ohio USA), Eric Steinbrook (0000-0002-8948-4413, University of Michigan Medical School Ann Arbor Michigan USA), Shalini Roy (0000-0001-8053-1650, University of Cincinnati College of Medicine Cincinnati Ohio USA), Annabella Opoku (Department of Community Medicine and Population Health, College of Community Health Sciences University of Alabama Tuscaloosa Alabama USA), Kenneth Jaffe (0000-0002-5084-4100, Center for Bioethics and Social Sciences in Medicine University of Michigan Medical School Ann Arbor Michigan USA), Kaitlyn Jaffe, Susan Dorr Goold (0000-0002-0258-9774, Center for Bioethics and Social Sciences in Medicine and Department of Internal Medicine University of Michigan Medical School Ann Arbor Michigan USA, corresponding author)
Year2023
Volume26
Issue6
Pages2245-2251
Publication date2023-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.13826
PMID37452517
OpenAlexW4384401259
LanguageEN
Citations received1
References cited23

BACKGROUND: Trust and distrust have shaped health behaviour during the COVID-19 pandemic. Since the start of the pandemic, misinformation and polarization eroded trust across the United States. In states like Michigan, pandemic restrictions led to significant unrest. Michiganders also faced disproportionate morbidity and mortality from COVID-19 during this period. OBJECTIVE: The objective of this qualitative study was to understand the individual experiences of trust in low-income Michiganders during the early COVID-19 pandemic. PARTICIPANTS: Twenty-four participants at or below 200% of the federal poverty line who resided in Michigan were recruited for this study. APPROACH: Interviews were conducted during the winter of 2020 using a formal interview guide that addressed sources of information, perceptions of risk and exposure, protective behaviours and impacts of the pandemic at home, work and in receiving healthcare. RESULTS: Thematic analysis showed that themes of trust and distrust emerged in multiple facets of our participants' experiences, including in the context of information sources, the behaviours of others, health, financial security, employment and overall safety. Trust and distrust in low-income communities often stemmed from significant financial and economic vulnerabilities and instability in access to healthcare that was exacerbated in the pandemic. Furthermore, participant trust was shaped by internal (e.g., relationships with others) and external (e.g., source of information, social inequity) factors that influenced their perceptions and experiences during the pandemic. CONCLUSION: Trust has played an important role in many aspects of the experiences of low-income communities during the COVID-19 pandemic. This is important for clinicians to consider as COVID-19 becomes endemic, and trust continues to impact patients' approaches to vaccines, testing and treatment options. PATIENT OR PUBLIC CONTRIBUTION: This study was designed and conducted with the assistance and input of the members of the DECIDERS Steering Committee, a diverse statewide network of community members in Michigan. The DECIDERS team allows community members to have a voice in the design and conduct of health research, and collaborates with researchers to improve health across the state of Michigan

Disease · Distrust · Economic growth · Economics · Environmental health · Geography · Health care · Misinformation · Pandemic · Political science · Poverty · Public relations · Qualitative research · Socioeconomic status · Sociology · Thematic analysis · COVID-19 and Mental Health · COVID-19 epidemiological studies · Medicine · Psychology · Vaccine Coverage and Hesitancy

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