Enhancing Trust in Healthcare Through Community Health Workers

Background: National surveys have noted a decline in trust with the US healthcare system among the public, which accelerated during the COVID-19 pandemic. The purpose of this project was to develop a compendium of interventions and logic model based on recent literature regarding strategies to improve trust within our healthcare system.
Methods: A literature review was conducted to elicit the current landscape of trust within the United States and interventions known to improve trust or satisfaction within a community. A compendium of interventions was created to help guide health systems along with a logic model focusing on community health workers, which has the most literature discussing its benefits.
Results: Several factors have led to the decrease in trust within US healthcare. They range from negative medical experiences, the commercialization of healthcare, and the perceived physician conflicts of interest with pharmaceutical companies leading to the disintegration of the patient-physician relationship. Consequently, overall trust in physicians and hospitals has suffered a steep 44% relative decline (from 71.5% in April 2020 to 40.1% in January 2024).
Conclusions: Overall, trust from the public towards governmental, scientific, and healthcare institutions has declined significantly, especially in the last few years. Community health workers offer one of the best chances for health systems to increase the community’s trust in the services they provide.
Public Health Implications: Distrust in healthcare systems is a major issue that harms patients and the systems that support them alike. On an individual level, distrust is associated with worse self-reported health, while individuals who have higher trust in healthcare are more likely to engage in preventive care and have better health outcomes. Repairing the broken trust in our healthcare system is essential to increase the effectiveness of future public health initiatives.
Data Source: PubMed search for publications related to trust in medicine