Conceptualizing and Measuring Trust, Mistrust, and Distrust: Implications for Advancing Health Equity and Building Trustworthiness.

Jennifer Richmond, Andrew Anderson, Jennifer Cunningham-Erves, Sachiko Ozawa, Consuelo H Wilkins
Author Information
  1. Jennifer Richmond: Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
  2. Andrew Anderson: Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
  3. Jennifer Cunningham-Erves: Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  4. Sachiko Ozawa: Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA.
  5. Consuelo H Wilkins: Division of Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; email: Consuelo.H.Wilkins@vumc.org.

Abstract

Trust is vital to public confidence in health and science, yet there is no consensus on the most useful way to conceptualize, define, measure, or intervene on trust and its related constructs (e.g., mistrust, distrust, and trustworthiness). In this review, we synthesize literature from this wide-ranging field that has conceptual roots in racism, marginalization, and other forms of oppression. We summarize key definitions and conceptual frameworks and offer guidance to scholars aiming to measure these constructs. We also review how trust-related constructs are associated with health outcomes, describe interventions in this field, and provide recommendations for building trust and institutional trustworthiness and advancing health equity. We ultimately call for future efforts to focus on improving the trustworthiness of public health professionals, scientists, health care providers, and systems instead of aiming to increase trust in these entities as they currently exist and behave.

Keywords

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Grants

  1. P20 AG068082/NIA NIH HHS
  2. L60 CA264691/NCI NIH HHS
  3. K99 CA277366/NCI NIH HHS
  4. T32 HS026122/AHRQ HHS
  5. U19 AG065188/NIA NIH HHS
  6. R00 CA277366/NCI NIH HHS
  7. P30 CA068485/NCI NIH HHS
  8. U24 TR001579/NCATS NIH HHS
  9. P50 MD017347/NIMHD NIH HHS

MeSH Term

Trust
Humans
Health Equity
Racism

Word Cloud

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