Investigators have found that Black individuals’ trust in information provided by the government on cancer fell by almost 50% during the COVID-19 pandemic, according to a new study published by Bispo et al in the Journal of Health Communication.
The investigators stressed the need to assess whether this mistrust has persisted beyond the pandemic and whether it could potentially cause an upsurge in late-stage diagnoses as a result of a lack of adherence to cancer prevention measures, such as routine screenings and human papillomavirus (HPV) vaccinations.
The COVID-19 pandemic emerged during an era of heightened attention to systemic racism and the spread of misinformation via social media. Just 2 months after the pandemic was declared, George Floyd—a Black individual living in Minneapolis, Minnesota—was murdered by a police officer, which sparked widespread #BlackLivesMatter protests. As the pandemic unfolded, experts publicized that more Black and ethnic minority individuals than White individuals were being hospitalized with the COVID-19 infection and dying from the disease, and misinformation about the reasons for this proliferated on social media. Against this backdrop, there was also inconsistent COVID-19 advice from politicians.
“Politically charged messaging around [the] COVID-19 [pandemic] and heightened media attention to institutional racism and racial inequities may have intensified historically rooted distrust among non-Hispanic Black [individuals],” explained senior study author Erin Kobetz, PhD, MPH, Associate Director of Population Sciences and Cancer Disparity and the John K. and Judy H. Schulte Senior Endowed Chair in Cancer Research at the Sylvester Comprehensive Cancer Center, as well as Professor of Medicine and Public Health Sciences and Vice Provost for Research at the Miller School of Medicine at the University of Miami.
Health Information National Trends Survey
The annual U.S. Health Information National Trends Survey aims to get an annual snapshot of cancer-related knowledge, attitudes, and information seeking across adults aged 18 years and older in the United States. In the new study, participants completed a survey asking about their trust in information about cancer from government health agencies, physicians, friends and family, and religious leaders or charitable organizations. Among those who participated, 64% were non-Hispanic White, 60% were aged over 45 years, and 69% had received at least some college education.
Study Methods and Results
In the new report, investigators included data on 7,369 individuals who participated in the annual survey and compared responses from before the pandemic in 2018 and during the pandemic in 2020. They then examined whether trust in cancer information varied according to the participants’ race/ethnicity.
Overall, survey respondents noted that they trusted cancer information from physicians—a figure that increased by about 3% between 2018 and 2020. However, trust in cancer information from government health agencies varied significantly according to the respondents’ race/ethnicity, with a 53% decline in the odds of reporting a high degree of trust among non-Hispanic Black individuals between 2018 and 2020. Further, the odds of reporting a high degree of trust in cancer information from family and friends as well as religious leaders also plummeted by 73% and 9%, respectively, among Black individuals. In contrast, for all other racial/ethnic groups, trust levels remained stable between 2018 and 2020.
“The response to the pandemic continues to be highly politicized. Governmental agencies and leaders have provided guidance on mask-wearing and social distancing that [was] at times inconsistent and contradictory to scientific consensus,” emphasized Dr. Kobetz.
The investigators suggested that this contradictory advice may have undermined individuals’ willingness to stick to policies and recommendations designed to stop the COVID-19 infection from spreading. At the same time, other research has shown that the greater cancer incidence and mortality among Black individuals compared with White individuals has worsened as health-care systems and resources were stretched during the pandemic.
“This study is significant because it provides early insight into the actions we may need to take to rebuild trust in health information as a means to advance health equity in spite of the societal shifts that have accompanied the COVID-19 pandemic,” highlighted Dr. Kobetz.
The investigators underscored that because of the loss of trust in cancer information from authorities like government health agencies, it will be important to monitor for changing patterns in the use of cancer prevention services. Declining rates of routine screenings and HPV vaccinations among Black individuals could further exacerbate racial/ethnic disparities in cancer cases and mortality.
However, the investigators noted the potential to head off these problems by capitalizing on the study’s findings that trust in physicians may have remained high among non-Hispanic Black individuals. This highlights the importance of all patients having access to a physician so that recommendations for cancer screenings and vaccinations are communicated effectively—regardless of the patients’ background or ethnicity.
The investigators also recommended training physicians on implicit racial/ethnic biases and improving patient-centered communication with those who tend to have less contact with health-care providers in an effort to nurture trust and improve the use of cancer prevention services. They added that organizations should also adopt health equity frameworks to guide their community outreach as well as advocacy work, so that marginalized populations are not left behind in preventative care. The investigators concluded that bolstering partnerships between health-care systems and community organizations may also help make patient care more equitable.
Disclosure: For full disclosures of the study authors, visit tandfonline.com.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.