Decreasing trust in health institutions in EU during COVID-19: A Spatio-temporal analysis

BACKGROUND: Public trust is essential for easier acceptance of scientific, technological and policy interventions during crises. COVID-19 pandemic witnessed varied public responses to safety measures, highlighting the need for detailed public trust studies, especially in the health sector. Research shows considerable variation in trust in neighbouring regions to countries which is useful to understand in order to respond better to future pandemics. OBJECTIVES: To analyze public trust in health institutions within the EU, to identify spatial clusters of the same at the beginning of the COVID-19 pandemic to the present, and understand factors contributing to decreasing trust. METHODS: Data from the Standard Eurobarometer surveys between 2020 to 2022 was used to perform spatio-temporal analysis of trust in health institutions & medical staff. RESULTS: Data shows that trust in health institutions and medical staff decreased in most EU countries from 2020 to 2022. Mapping these values showed clear geographical clusters of varying trust. At the beginning of the COVID-19 pandemic, Eastern Europe (52-66%) trusted less in health institutions and medical staff compared to Central (66-85%) or Western Europe (85-97%). By 2022, although Eastern Europe maintained their tendency to not trust, the percentage of people who trusted health institutions reduced in Western and Central Europe. Interestingly, socio-demographic factors such as age, gender, education and income were found to not be associated with trust. However, several factors of perception such as life going in the right direction and difficulty in paying bills were identified to be significantly associated with trust. CONCLUSIONS: It is essential to understand the reasons for this decrease in trust, whether pandemic responses of health institutions or by policy is what contributed to this pattern. Understanding these changes can enable better policy responses towards supporting trust in health institutions. KEY MESSAGES: • There is clear geographical clustering of public trust in the EU - Eastern European countries tended to not trust health institutions during the pandemic. • Socio-demographics showed no significant association with public trust. Interestingly, factors of perception were significantly associated.