Every disease outbreak is a concern, but Covid-19, more popularly known as a coronavirus, might be especially deadly. This is not because of the genetic makeup or the incubation period of the virus. It is because the general public has lost confidence in the medical community. This trend has been especially acute among several religious groups, with Catholics experiencing one of the larger declines in trust.
Among Catholics, the share expressing confidence in medicine dipped to 42 percent in the most recent General Social Survey.
The General Social Survey has been asking about the public’s trust in a number of institutions since 1973, and the trend line for medicine should frighten those in the field of public health. In the 1970s, about 53 percent of U.S. citizens indicated that they had “a great deal” of confidence in medicine. By 2018, the last year for which we have data, that number had declined to 38 percent.
There are significant differences among religious traditions. For instance, in 1973 three in five evangelical Protestants (of all races) expressed “a great deal” of confidence in medicine, the highest of any Christian group. That support dropped in half, with just 30 percent expressing the same sentiment in 2018. For Catholics, the share expressing confidence started at 52 percent in 1973 and dipped to 42 percent in the most recent survey—perhaps a more modest decline because so many health-care facilities in the United States are Catholic-run. That 10-point decline is similar for mainline Protestants.
There has also been a tremendous decline of confidence in medicine among black Protestants, from just over half expressing “a great deal” of confidence in 1973 to only 28 percent saying the same in 2018. While there are many potential reasons for this, one could be the revelations of unethical medical testing on African-Americans in the past.
The only religious group to see an increase are Jews, who saw a six-point rise in confidence in the last 45 years. This may be because Jews in the United States are concentrated in the urban Northeast, where health care is more accessible.
It is not easy to pin down reasons for the broad-based decline in trust. One theory, that suspicion of science is linked to the conservative political ideology of many Christians, is contradicted by the fact that the religiously unaffiliated (whose politics often lean to the left) have also seen an eight-point drop in confidence during the last 45 years.
Another theory is that Americans have not lost confidence in medicine specifically but have adopted more skeptical views toward all types of societal institutions.
The General Social Survey also asks, “Generally speaking, would you say that most people can be trusted or that you can’t be too careful in dealing with people?” It is clear from this broader question that the American public is somewhat less likely to trust their fellow man today than they were in the 1970s. But the patterns here are not the same as for the question about trusting medicine. For instance, evangelical Protestants have long been wary of others in society, with just 44 percent of them saying that people can be trusted in 1972 and 30 percent in 2018. The decline among Catholics was similar, dropping from 48 percent to 34 percent over the same period. But even the religiously unaffiliated saw a drop of over 14 percentage points, with only 29 percent saying they could trust people in 2018.
One outlier is mainline Protestants; about 40 percent of this group still say that most people can be trusted. A possible explanation lies in theology. Most evangelical Protestants believe that the end of the world will begin as societies devolve into violence and sin, so they may be on the lookout for evidence that things are going downhill. Tellingly, a survey conducted last year by the advocacy group Prison Fellowship found that 81 percent of practicing evangelicals believed that the crime rate has risen in the prior 25 years, which is empirically false. (Sixty percent of all adults, 62 percent of practicing Catholics and 66 percent of mainline Protestants also held this erroneous belief.) Mainline theology, however, places very little emphasis on the book of Revelation and the end of time. In fact, the social gospel, which argues that Christianity can (and has) made the world a better place, is much more prominent in mainline churches.
A disease outbreak may become deadlier if people wait too long to go to the hospital—whether because they do not trust the medicine itself, do not trust they will be treated equitably or with dignity, or fear financial hardship.
To get a sense of how general distrust feeds into a lack of confidence in the medical community, I divided the survey respondents by whether they believed that people can be trusted or not. I calculated the shares of those who said that they had “a great deal” of confidence in medicine in both 1973 and 2018 for the four largest religious groups.
Looking at these two factors brings a sharper focus: Distrust of other people and a lack of confidence in medicine seem to be related. For both mainline Protestants and Catholics, there was no decline in confidence in medicine over the last four decades when the sample is restricted to just those who have a trustworthy view of society; the entirety of the decline was among those who say that people cannot be trusted. (Among Catholics in the latter group, those expressing confidence in medicine fell from 54 percent to 39 percent.)
But that pattern did not hold for evangelical Protestants. The share of this group expressing confidence in medicine fell sharply even among those who say that people can be trusted (from 72 percent to 37 percent). Evangelicals are outliers here, but there is no apparent theory that explains this. It merits further investigation.
This lack of confidence in the medical community sets the stage for a national disease outbreak that may become more widespread and deadlier if people wait too long to go to the hospital after noticing coronavirus symptoms—whether because they do not trust the medicine itself, do not trust they will be treated equitably or with dignity, or fear financial hardship.
But another possible accelerant is misinformation from medical authorities and political leaders, including a president who first described the Democrats’ treatment of the virus as a serious threat to be a “hoax.” At least one study has indicated people who distrust government are more likely to refuse medical vaccinations for themselves or their children. With trust in government at a 70-year low, the politicization of medicine is a growing danger.
Medical professionals and epidemiologists must not only stay out of political debate but also work to make sure they do not become political pawns. The possible Covid-19 pandemic requires the medical community to effectively communicate messages about public health and treatment of the sick. If handled correctly, the current coronavirus outbreak may also improve trust in medicine among the general public.
