Eroding Black Patient Trust in Health Info Imperils Cancer Outcomes

As the COVID-19 pandemic unfolded, an alarming trend in cancer outcomes has emerged—the trust of Black patients in government-provided cancer health information has plummeted by almost 50 percent, according to a recent study published in the Journal of Health Communication.

The COVID-19 pandemic coincided with a period of increased awareness of systemic racism and misinformation spread. This period, marked by heightened visibility of racial inequity such as the George Floyd murder and concerns over misinformation dissemination on media platforms, may have influenced public trust in health information concerning chronic diseases like cancer, researchers pointed out.

Given this backdrop, the study used responses from over 7,300 patients to evaluate whether there was a change in patient trust in cancer-related information from governmental, clinical, social, and community sources between 2018 and 2020. Additionally, researchers examined how these changes may have varied across different racial and ethnic groups.

In 2018, before the pandemic, Black respondents most trusted cancer information from family and friends; however, this group demonstrated the lowest level of overall trust during the pandemic. The odds of reporting high confidence in cancer information from family and friends plunged by 73 percent for Black patients. Even trust in cancer information from religious organizations and leaders before and during the pandemic took a hit, decreasing by 9 percent among Black respondents.

Also pre-pandemic, 37.6 percent of Black respondents demonstrated the highest trust in cancer information from government health agencies. Conversely, other non-Hispanic respondents showed the lowest confidence in government agencies, with only 15.70 percent expressing trust.

The pandemic, however, significantly impacted trust levels across both racial/ethnic groups. Trust in cancer information from government health agencies shifted based on respondents' race/ethnicity. Notably, during the pandemic, non-Hispanic Black individuals experienced a 53 percent decline in the odds of reporting a high degree of trust compared to before the emergence of COVID-19.

“Politically charged messaging around COVID-19 and heightened media attention to institutional racism and racial inequities may have intensified historically rooted distrust among non-Hispanic Black people,”  Erin Kobetz, senior study author and professor from the Miller School of Medicine at the University of Miami, said in a public statement.

 “The response to the pandemic continues to be highly politicized. Governmental agencies and leaders have provided guidance [eg, on mask-wearing and social distancing] that is at times inconsistent and contradictory to scientific consensus.” 

As the pandemic shifted views on trusted figures, survey participants indicated that doctors remained the most trusted cancer information source. Notably, trust in cancer information from doctors increased by nearly 3 percent during the pandemic compared to before.

The eroding trust in cancer information from authorities such as government health agencies highlights the need to closely monitor changes in access to cancer prevention services. This decline in trust may eventually worsen racial/ethnic disparities in cancer cases and deaths, according to the study's authors.

To counter these potential issues, leveraging the high trust in doctors among individuals could be a valuable approach.

Ensuring access to a doctor can facilitate effective communication of cancer screening and vaccination recommendations to all, irrespective of their background or ethnicity.

Moreover, Kobetz and colleagues stressed the importance of adopting health equity frameworks to direct community outreach and advocacy initiatives, guaranteeing that marginalized populations are not excluded from preventive care.

They also recommend strengthening relationships with community leaders to foster collaboration between healthcare systems and community organizations, ultimately promoting health equity.