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Abstract Background Public trust is crucial during health crises, such as the COVID-19 pandemic, for the effective implementation of scientific and policy interventions. This study investigates factors contributing to the decline in trust in the health sector within the European Union during the pandemic. Methods Using the publicly available 2020–2022 Standard Eurobarometer dataset, we employed a "geography of trust" approach. We applied equal quantile mapping to visualise high and low trust countries and Local Spatial Autocorrelation (LISA) to identify statistically significant clusters. Using a series of one-way ANOVA, we found associations between socio-economic and other variables available in the same dataset with trust. Results Trust in health institutions and medical staff declined in 20 of 27 EU countries from 2020 to 2022. Clear geographical clusters of Western and Central Europe as the high-trust countries and Eastern Europe as the low-trust countries emerged through mapping. One-way ANOVA revealed that contrary to several studies, age, gender, and most demographics did not vary with trust, but trust was directly associated with the satisfaction with measures taken to fight the COVID-19 pandemic, and individual perceptions about their life and national affairs (p < 0.001). Conclusion High-trust Western European countries share characteristics in health systems, governance, and pandemic responses. Understanding this interplay could inform trust-building strategies. The persistent low trust in Eastern Europe may stem from slow government responses and requires nuanced approaches considering unique contexts. The decline in traditionally high-trust countries highlights challenges even in established social contexts. This study provides valuable insights for policymakers aiming to foster trust during health crises.
Yaddanapudi et al. (Fri,) studied this question.