Unpacking Trust and Loneliness: A Quantitative Analysis of Health Discussions Among Mexican American Adults in the United States

Health policies contributing to or reinforcing loneliness create unintended consequences, including increased feelings of mistrust. Much research has focused on individual feelings loneliness and social trust. However, the relationship between various forms of loneliness, a key driver of health outcomes in the United States, and institutional trust (i.e., trust in systems such as healthcare, community, religious, media, and government institutions) remains understudied. A better understanding about the relationship between loneliness and institutional trust can help social workers, policy actors, and healthcare providers to work to enhance trust and decrease loneliness, thus supporting treatment adherence, increasing safety and well-being, and leading to better health outcomes.

A community-recruited sample (N = 933) of adults along the U.S.-Mexico border, completed individual surveys collecting cross-sectional data in a public health study on behaviors and perceptions of health and wellbeing. The NIH-funded South Texas Community Engagement Alliance (CEAL) Team collected data from 2022-23. Participants were adults aged 18 and older who were English- or Spanish-speaking and expressed hesitancy about being vaccinated for COVID. Loneliness was measured using the UCLA-3, which asks participants if they felt lonely hardly ever, some of the time, or often with scores ranging from 3 (low) to 9 (high). Participants were asked about trust, and responses were recoded as a binary variable with 0 if respondents selected no trust, does not apply, or I don’t know. All responses endorsing trust were coded as 1. Seven domains of institutional trust were measured: medical doctors, faith leader, mass media, government (i.e., federal, state, and local levels), and community agencies. To examine the relationship between various domains of loneliness (i.e., social connectedness, relational connectedness, and social isolation) and institutional trust, analysis embraced binary logistic regression to determine the odds that loneliness predicted trust.

Participants’ mean age was 41 (SD = 14.39). Over half were college educated (n = 52.8%), self-identified with Mexican-origin (n = 98.7%) and almost three quarters identified as women (n = 72.3%). Loneliness was significantly associated with decreased institutional trust. Social isolation was significantly associated with no trust in medical doctors (OR = 0.46, 95% CI [0.22, 0.97], p = .04). Social connectedness was also significantly associated with no trust in community agencies (OR = 0.58, 95% CI [0.35, 0.97], p = .03). Among the other models, the results suggest that the predictors included in the model did not meaningfully explain variation in the outcome.

These findings further support the loneliness’ role as a potential driver of health outcomes and raise important considerations for providers working to improve treatment adherence and vaccine hesitancy. Further research is needed for which variables contribute to institutional mistrust and to identify protective factors that can alleviate the loneliness’ negative effects. Practice implications include encouraging healthcare providers to actively screen for loneliness and assess patients’ intentions to follow through with treatment recommendations with understanding that trust may be one more barrier to treatment utilization. Policy implications highlight assessing and changing policies that may unintentionally contribute to social isolation and loneliness (e.g., isolation and quarantine practices).