COVID-19 health practices and attitudes in the United States: the role of trust in healthcare

Aim Individual-level COVID-19 vaccination and related preventive health behaviors is politically polarized in the United States. We examined whether the current polarization in COVID-19 health behavior may be explained by differences in trust in healthcare, locus of control, or insurance status. Subject and methods Our sample includes 553 US adults recruited on Amazon MTurk. We assessed odds ratios of currently vaccinated, or willing to be vaccinated if unvaccinated using logistic regression. We assessed count of routine changes and positive attitudes toward facemasks using negative binomial regression. Results Trust in healthcare was found to be an important determinant of all COVID-19 related health behavior measured in our study. Further, the effects on COVID-related attitudes/behavior from trust in healthcare are large in magnitude. For instance, our results suggest that individuals at or above the upper quartile of trust in healthcare are around 20 percentage points more likely to be vaccinated than those at or below the lower quartile. Further, we find that the effect of trust in healthcare on adherence or endorsement of COVID-19 mitigation strategies is distinct from political affiliation, i.e., the effect on COVID-19 related health behavior is independent of the polarization across political party lines. Locus of control was not associated with adherence/attitude toward COVID-19 mitigation strategies. Insurance status was only found to be positively associated with odds of being vaccinated. Conclusion Our study highlights the importance of increasing trust in healthcare as a means to protect public health in the wake of major public health crises.