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NRC Health Study Finds Trust in Local Hospitals and Health Systems Increased During the Pandemic

National Research Corporation
National Research Corporation

Trust in individual healthcare providers depends largely on patients’ language preferences

U.S. counties where provider trust is highest and lowest are politically mixed

LINCOLN, Neb., Nov. 01, 2022 (GLOBE NEWSWIRE) -- NRC Health, the leading partner in building Human Understanding through personalized healthcare solutions and data-driven insights, released findings from its national Market Insights study that reveal that people trust local hospitals and health systems far more than they trust federal, state, and local government to handle the COVID-19 pandemic. NRC Health also found through its experience surveys that patients’ language preferences are a strong predictor of trust in individual healthcare providers and that, in terms of political environment, trust in providers is not reliably related to political party.


With the midterm elections on the horizon, a patient’s political environment—e.g., the percentage of Democratic (“blue”) or Republican (“red”) votes during the 2020 presidential election at the county level—is a timely and relevant component of analysis, because there is a pervasive narrative that trust is at least partly a function of one’s political stance. But NRC Health’s data indicates that trust in providers is not a political issue.

“While it may be tempting—especially during an election cycle—to paint everything with a red or blue brush, it’s too simplistic when it comes to trust in providers,” says Gregory Makoul, PhD MS, Chief Transformation Officer at NRC Health. “Trust in the context of patient-provider relationships is a function of understanding and addressing what matters to patients as unique individuals. As we look to the future, healthcare leaders and providers can build trust and loyalty through Human Understanding, especially when trust in government and other institutions is waning.”

Language preference is a strong predictor of trust in individual providers
NRC Health works directly with health systems across the nation to collect feedback from their patients, usually within 48 hours of a clinical encounter. NRC Health’s experience surveys gauge multiple factors, including the level of trust that people have in their doctors and other providers responsible for their care.

Findings from a random sample of 1 million surveys collected since March 2020 showed that language preference is a strong predictor of trust: People who prefer English are 29% more likely to say that they “definitely trust” their provider, even when controlling for age, sex, race, marital status, county-level income, and political context.

“Our analysis highlights the importance of building trust by bridging interpersonal barriers, especially when it comes to language preference,” says Dr. Makoul. “This is an issue of equitable and effective care, not politics.”

At the county level, trust in individual providers is mixed
To assess aggregated results at the county level, NRC Health combined its experience-survey data with county-level voting and Claritas demographic data. NRC Health had provider trust data and patient-level demographic data for 3029 of the 3243 U.S. counties (or county equivalents). Two trust-related questions were combined to maximize the number of respondents and the representativeness of the sample from a national perspective.

Of the 20 counties with patients reporting the lowest level of trust in healthcare providers, 17 voted predominantly red, while three voted predominantly blue. Interestingly, among the 20 counties with patients reporting the highest level of trust, 17 represented red and 3 represented blue as well.

“Red counties outnumbered blue counties by almost five to one overall, so counties where trust was extremely high or low followed the overall voting pattern,” says William England, PhD, Strategic Analyst at NRC Health. “If high or low provider trust was more prevalent among members of a particular political party, we’d have expected to see a significant difference in the voting patterns at the extremes.”

Trust in local healthcare is on the rise nationally
The pandemic challenged the healthcare industry dramatically, but even in light of unprecedented circumstances, trust in hospitals and healthcare systems rose significantly during the pandemic.

More specifically, based on responses from 682,217 consumers from across the country between April 2020 and August 2022, NRC Health found that the proportion of people reporting trust in their local hospitals and health systems increased from 20.7% to 35.8%. In contrast, the proportion who trust the federal government to handle the pandemic declined from 10.6% in April 2020 to below 10% in every subsequent month until rebounding in May 2022 and reaching 13.2% in August 2022. Trust in state government dropped from 13.8% to 7.2%, while trust in local government hovered in the 5% range during the study period.

NRC Health will be releasing its annual Trends Report early next year, offering an in-depth analysis of trends and predictions in the healthcare industry.

About NRC Health
For more than 40 years, NRC Health has led the charge to personalize healthcare and support organizations in their understanding of each unique individual. NRC Health’s commitment to Human Understanding™ helps leading healthcare systems get to know each person they serve not as point-in-time insights, but as an ongoing relationship. Guided by its uniquely empathic heritage, NRC Health’s patient-focused approach, unmatched market research, and emphasis on consumer preferences are transforming the healthcare experience, creating strong outcomes for patients and entire healthcare systems.

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