Black Americans’ trust in cancer information declined sharply during COVID-19 pandemic
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Key takeaways:
- Odds of reporting a high degree of trust in cancer information from government agencies declined more than 50% among Black Americans.
- Multiple factors may be responsible for the loss of trust.
The proportion of Black survey respondents who had a high degree of trust in cancer information from government agencies dropped sharply during the COVID-19 pandemic, according to study results published in Journal of Health Communication.
The findings showed an even steeper decline among Black individuals of trust in cancer information provided by friends and family members.
“We know from prior research that Black patients experience a disproportionate burden of morbidity and mortality from several cancers that are preventable and can be detected early through routine screening,” Jordan Baeker Bispo, PhD, MPH, principal scientist of cancer disparity research at American Cancer Society, told Healio. “Whether decreased trust in cancer information from government health agencies will have a long-term impact on access to cancer control measures like HPV vaccination and screening remains to be seen, but it will be important to monitor for new or widening disparities.”
Varying patterns of trust
Baeker Bispo and colleagues assessed data from 7,369 respondents to the annual U.S. Health Information National Trends Survey (HINTS), which asked respondents about their levels of trust in information about cancer from government health agencies, friends and family, religious leaders or charitable organizations. They compared responses from 2018 to those from during the pandemic in 2020 and evaluated differences relative to race/ethnicity.
Most of the survey respondents were non-Hispanic white (64%), aged over 45 years (60%) and had some college education (69%).
“When we looked at the overall population, the proportion of respondents who reported a high degree of trust in cancer information from doctors increased slightly, from 73.7% to 77.3%, whereas those who reported a high degree of trust in cancer information from government health agencies, family and friends, charitable organizations and religious organizations was stable,” Baeker Bispo said.
However, the study showed significant variation in patterns of trust before and during the pandemic across racial and ethnic groups.
“Among non-Hispanic Black survey respondents, for example, the proportion who reported a high degree of trust in cancer information from government health agencies actually decreased substantially, from 37.6% before the pandemic to 22.5% during the pandemic,” Baeker Bispo said.
The odds of reporting a high level of trust in cancer information from family and friends decreased 73% for this population, which also exhibited a 9% decline in trust of cancer information from religious leaders. Conversely, trust levels among all other racial/ethnic groups remained consistent between 2018 and 2020.
Rebuilding trust
Researchers could not attribute changing levels of trust in various sources of cancer information to any one cause, Baeker Bispo said.
“It is likely that multiple components of the social and historical climate surrounding the pandemic contributed to the temporal changes that we saw in our findings,” she told Healio. “For example, heightened attention to systemic racism and racial health inequities may have intensified historically rooted mistrust among the Black population.”
According to Baeker Bispo, the study is an important early indicator that the health care community may need to rebuild trust in cancer information among Black and ethnic minority individuals in the wake of COVID-19. She said it also serves as a reminder of the ongoing need for health care provider education around systemic racism.
“Our findings underscore the continued importance of eliminating inequitable access to trusted health care providers who counsel patients on preventive care services. They also emphasize the importance of adequate provider training on implicit biases and patient-centered communication so that preventive care recommendations are communicated effectively and equitably to all patients,” she said. “Adopting health equity frameworks to guide the outreach and engagement efforts of local health care systems, and strengthening partnerships between those systems and community-based organizations, may also be a critical strategy.”
References:
- Kobetz E, et al. J Health Comm. 2023;doi:10.1080/1081730.2022.2117439.
- Trust in cancer information declined among Black Americans during the pandemic (press release). Published March 16, 2023. Accessed March 16, 2023.
For more information:
Jordan Baeker Bispo, PhD, MPH, can be reached at jordan.baeker@cancer.org.
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