Confidence in Crisis? Understanding Trust in Government and Public Attitudes Toward Mandatory State Health Powers

Abstract

In response to the possibility of a bioterror attack using smallpox, many states have updated and revised their current public health laws in line with the Model Act, which would effectively give states the right to invoke mandatory state health powers, such as quarantine or vaccine. Previous studies have supported the importance of allying with the public in creating and implementing effective bioterror response policies. Historical case studies and recent research suggest that when the public is not supportive of government health policies, they may be less willing to comply. In this study we analyze a recent survey to determine the effects of a set of variables, including aspects of trust in government that have been found in previous studies to influence public opposition to compulsory government health policies, on opinions about compulsory vaccination and quarantine.

Predicting Response to Reassurances and Uncertainties in Bioterrorism Communications for Urban Populations in New York and California

“…These findings are compatible with previous research that has shown fairness beliefs and trust to be especially important to individual decision making and interpretation of events under conditions of uncertainty. 74,75 The significant association between values or preexisting risk beliefs and reactions to uncertainty messages in this research is noteworthy given that the 2 samples reflected different cultural and ethnic backgrounds, social histories, and geographic locations. Moreover, participants responded to actual past messages from leaders and public health officials that had been constructed based on in-place risk/crisis communication plans thought to reflect best practices at the time of the 2001 anthrax episode.…”

“…[38][39][40] As a significant act unfolds, some ongoing uncertainties would have been predicted; others will become apparent only as the event develops. [6][7][8][9]58,59,70,87 Distrust of government actions and decisions will be high in some communities, moderate in others, 11,17,23,28,75 and preexisting social and environmental vulnerabilities to extreme events will contribute to an unequal potential for loss. 6,50,89 During this dynamic phase, skilled communications about decontamination strategies, protection of public health, cleanup, restoration, and reoccupancy will be essential to support efforts to protect public health and maintain/restore public confidence within a context of disturbing events.…”

“…The communication process is more likely to succeed if leaders and risk communicators have figured out how to have different groups hear what is intended, but also if the process facilitates how well leaders hear and act on the information needs, concerns, and priorities of affected populations during an extreme risk event. 22,75,80 It may be more productive to think beyond typical sociodemographic profiles of populations most vulnerable to communication failures during a mass contamination event and consider the context or psychosocial environment of risk in terms of high or low trust individuals and in reference to likely preexisting values and risk perceptions. 81,82 Building an Updated Risk Communication Response Plan…”

Public Trust in Government Administrators

“…For public administration specifically, trust affects programmatic performance because it is associated with the delegation of administrative authority (Marlowe 2004;Metlay 1999), excessive oversight and an over-reliance on formal rules and procedures (Ruscio 1996), and public cooperation and compliance with laws and regulations (Marien and Hooghe 2011;Scholz and Lubell 1998;Taylor-Clark, Blendon, Zaslavsky, and Benson 2005). The link between low trust, excessive micromanagement, and reduced performance is at the base of past bureaucratic reform efforts, such as the Winter Commission (National Commission on the State and Local Public Service 1993) and the National Partnership for Reinventing Government (National Performance Review 1993).…”

“…For example, trust has been linked with adherence to public health guidelines, such as participation in vaccination programs (Larson and Heymann 2010;Quinn et al 2009;Sankar, Schairer, and Coffin 2003) and compliance with evacuation orders during natural disasters (Feldheim and Wang 2003-4;Taylor-Clark et al 2005). Lack of trust in regulatory agencies charged with the disposal of radioactive waste is the most significant obstacle that a successful radioactive waste management policy must overcome (Clark County 2003;Office of Technology Assessment 1982).…”