The inequality of trust – and why addressing this issue is crucial to a meaningful recovery from COVID-19
What has the pandemic taught us about public trust in governance and the factors that erode trustworthiness? These are important questions if the UK is to shape a strategy for recovery and future preparedness that is both effective and inclusive
Joanna Chataway and Molly Morgan Jones
Coping with COVID-19 has required enormous sacrifice from the UK population. People have died alone, leaving their families and those who loved them with terrible and enduring pain and guilt. Broad swathes of the population have been asked to be absent from work, in many cases leaving themselves and their workplaces in vulnerable positions.
There are, of course, many more examples of how COVID-19 has forced people to take decisions that have left them emotionally and materially damaged. These sacrifices – and the public’s compliance with often rapidly-introduced policies – have been fundamental to governments’ ability to tackle the pandemic.
So why do people comply with guidance and laws that require this level of sacrifice? And importantly, what factors are most likely to erode this public trust – whether in relation to vaccine uptake, or strategies to help the recovery of those communities hardest-hit by the pandemic?
A vital ingredient for society
Two reports in which this blog’s authors were involved explored these questions from different angles. A report completed under the auspices of the Areas of Research Initiative (ARI) on Trust in Public Institutions highlighted the critical role that trust plays in ensuring compliance with policy. However, the British Academy’s COVID Decade report found that low and unstable levels of public trust in governance are likely to be one of the more significant long-term societal impacts of COVID-19.
One thing made clear by both reports is that trust is a vital ingredient for society. In the ARI report, the role of compliance is closely examined. Compliance is related to a sense of purpose and the widespread feeling that, from a number of different angles, compliance is ‘the right thing to do’.
In 2020, for example, panel survey research from the Winton Centre For Risk and Evidence Communication showed that, during the first weeks of lockdown in the UK, high levels of compliance appeared to be largely driven by a sense that: (i) it was right to comply to ‘save lives and protect the NHS’; (ii) it was normative to do so; and (iii) it was also a legal requirement.
Crucially, the ARI report highlighted evidence that the law seemed to play a role not through the traditional levers of deterrence and legitimacy, but through its perceived ‘coordination function’: making lockdown a legal requirement clarified to people what they should be doing and why – namely, to save lives and protect the NHS.
Light-touch police enforcement in the early phase of lockdown seems to have been (i) possible because of the high levels of normative compliance, and (ii) successful because police legitimacy, and trust in the police, was not damaged by heavy-handed enforcement. Trust is connected to institutions – in this case, the police – being perceived as both effective and trustworthy.
However, the ARI report goes on to suggest that during the pandemic, the identified reduction in public trust levels was likely linked to the UK public’s perception of government competence and effectiveness – and a declining sense of perceived equity and fairness among policy decisions.
The link between trust and trustworthiness
The philosopher Onora O’Neill, and many others, have pointed to the close relationship between trust and trustworthiness. The crucial point is that trust will be more evident when there are high degrees of trustworthiness. Evidenced review by the ARI report suggests that ‘trust is a multi-dimensional and multi-layered phenomenon, but to achieve trust, an institution must be trustworthy’.
It makes intuitive sense that communities who feel let down by institutions, and for whom institutions are not perceived as being trustworthy, will have had less trust in COVID-19 policy interventions. People of different ethnicities and cultural backgrounds have varying levels of trust towards public institutions, and that has impacted on the way that COVID-19 policy has been received.
In a recent BMJ article, Razai et al report findings from the UK Household Longitudinal Study which asked 12,035 participants in November 2020: ‘How likely or unlikely would you be to take the vaccine?’ While overall, 18% of all respondents were hesitant, this contrasts with significantly higher levels of hesitancy in people of Black ethnicity (72%), South Asians of Pakistani and Bangladeshi heritage (both 42%), and mixed ethnicities (32%).
The article also reports that UK data (as of 11 March 2021) show ‘lower vaccination rates in Black African and Black Caribbean (58.8% and 68.7%, respectively), Bangladeshi (72.7%), and Pakistani (74%) ethnic groups compared with White British (91.3%), and lower vaccination rates in people who live in more deprived areas (most deprived 87%, least deprived 92.1%)’.
The authors make the link between lack of trust and vaccine hesitancy, and suggest that ‘trust is eroded by systemic racism and discrimination’. The tragedy is that those who are least well served by institutions, and for whom institutions are experienced as untrustworthy, are made more vulnerable.
A vicious cycle seems possible: minority groups and other discriminated-against populations are more likely to be hesitant about government health advice; they are likely to suffer more as a result; and this may lead to a further decline in trust. We may be seeing evidence of this with the rapid spread of the B.1.617.2 variant in areas of the country with higher levels of vaccine hesitancy.
The importance of community and local interventions
Razai et al note that GPs and primary care health practitioners are more likely to be trusted by the communities they serve because of the relationships that have built up over time. And both the ARI and British Academy reports note that as trust in central government has declined during the pandemic, the opposite is true of sentiment towards local government.
Notably, according to the British Academy, people across Britain continued to regard local unity as gaining ground faster (23%) than national unity (10%), and local division to be growing much less (26%) than national division (78%). In other words, although the national picture has often been one of division, there is a valuable foundation of unity within local communities.
Low levels of government trust have worrying implications for people’s commitment to following government guidelines, and for how effectively central and local government structures work together to achieve common goals. History provides many examples of this, which is important to reflect on because public health crises leave a legacy that can impact upon the next such crisis. For instance, the denting of public trust over BSE impacted confidence around MMR vaccination; and lingering concerns about MMR are likely to contribute to hesitancy around vaccination against COVID-19.
Trust, once undermined, can be hard to win back – especially if elements of a new crisis emulate previous ones. Lack of trust in government is likely to lead to poor take-up of public health interventions.
On the other hand, public trust can be enhanced through effective communication, and by working through, and with, broker agencies such as voluntary organisations that may be more trusted, especially among ‘hard to reach’ groups.
Cooperation and solidarity are vital ingredients of social cohesion and our collective capacity to achieve shared goals. Preventing and repairing social fractures is not just desirable but essential for a prosperous and successful future. Building and consolidating relationships and collaborations between central and local governments could significantly help with cohesion and trust, and should be a priority of any pandemic recovery strategy.
Recommendations for building trust on the basis of trustworthiness
In addition to the importance of working with local communities and trusted actors, the ARI report draws on a broad body of literature to offer advice on building trust on the basis of trustworthiness.
Some of that advice relates to the importance of demonstrating trustworthiness through ‘intelligent openness’: allowing information to be accessible, understandable, usable and assessable. This means, in practice, making all data and information used in decision-making open and easily understood by the public, with all necessary references to enable anyone who is interested to check the sources and quality of the evidence, and the integrity of the decision-making process. This constitutes good ‘evidence communication’ – very different from narrative-driven ‘comms’ that lead a reader to a conclusion rather than leaving it open for them to judge for themselves.
People typically judge the reliability of evidence on who they hear it from, its consistency with what they have heard elsewhere and experienced themselves, and from other quality cues such as the level of detail. Ensuring consistent messages from other trusted sources, and explaining/anticipating potential changes of policy that might make things seem inconsistent, is important.
Dominic Cummings’ recent House of Commons Select Committee testimony was a blistering personal account of ineffectiveness and dishonesty in COVID-19 policymaking. An honest and open attempt to review policy in order to assess how multiple mistakes could have been averted is crucial to learning how to improve future crisis responses. We owe that assessment to all those who have made such enormous sacrifices during the pandemic.
However, can testimonies such as that of Cummings play any positive role in rebuilding trust and increasing a sense of trustworthiness in our governing institutions? Based on the work of the British Academy and the Areas of Research Interest group, it isn’t obvious. Indeed, the opposite seems more likely, with blame and trust in public institutions being further eroded. That may well leave us all more vulnerable, because policy interventions will be made less effective as a result.
Professor Joanna Chataway is Head of Department for Science, Technology, Engineering and Public Policy (STEaPP) at University College London, and Principal Investigator of IPPO. Dr Molly Morgan Jones is Director of Policy at The British Academy.
- IPPO is hosting a major Action On Inequalities event on Tuesday 15th June (10am-1pm). To find out more about this event and register to take part, click here