Political ideology linked with trust in public health agencies for cancer information

Conservative political views correlated with a lower likelihood of having trust in cancer information disseminated by government health agencies vs. those who have liberal views, according to a study published in JAMA Network Open.

“This finding has significant implications, impacting various aspects of cancer prevention and treatment,” Sanjay Shete, PhD, professor of biostatistics and epidemiology and section chief of behavioral and social statistics at The University of Texas MD Anderson Cancer Center, told Healio. “First is the potential impact on adherence to cancer prevention practices, including compliance with cancer screening guidelines. Second, with lower levels of trust in information from health agencies, conservatives may face challenges in making well-informed decisions about their treatment, which could impact their overall health care experience and outcomes.”

A challenge to informed decision-making

Accumulating research suggests that political ideology is a “key determinant of health behaviors” that can arise to the level of public importance, according to Shete.

Sanjay Shete

“For the current study, we decided to investigate political viewpoints and trust in government agencies as sources of cancer information, given that prior studies show that government agencies such as the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration are witnessing declines in trust within the general U.S. population, including along the lines of individuals’ political viewpoints,” he said.

Shete and colleagues assessed data from the NCI Health Information National Trends survey (HINTS) 5 Cycle 4 — a nationally representative, publicly available survey of U.S. adults conducted from Feb. 24 through June 15, 2020. The researchers evaluated the data between Jan. 30 and April 5, 2023.

The researchers designated level of trust in government health agencies as a source of cancer information as the study’s outcome of interest, with political ideology specified as the exposure variable. Of the survey respondents, more than 90% answered specific questions on political viewpoint and trust in cancer information provided by government health agencies.

The investigators used multivariable logistic regression analysis to evaluate political ideology and trust in various sources of cancer information. They adjusted the analysis for sex, race/ethnicity, educational attainment, household income, having a regular health care provider, the presence of comorbidity, and rural-urban residence.

The overall study sample consisted of 3,254 respondents (1,794 women; 1,965 white, 396 Black/African American, 499 Hispanic and 249 other); 2,895 resided in urban areas.

Of the respondents, 78.1% reported having some or a lot of trust in government health agencies as a source of cancer information. In terms of political ideology, 37.2% of respondents identified as being politically moderate, 29.5% as liberal and 33.3% as conservative.

The adjusted logistic regression models revealed an association between conservative viewpoints and lower odds of having some or a lot of trust in government health agencies as a source of cancer information vs. having liberal views (adjusted OR = 0.46; 95% CI, 0.3-0.71) or having moderate political ideologies (adjusted OR = 0.69; 95% CI, 0.5-0.94).

An ‘urgent need’ for interventions

The adjusted analysis examined for significant differences by race/ethnicity or residency (urban vs. rural) in levels of trust in cancer information from government health agencies.

“We thought that our study may find differences by race/ethnicity and residency,” Shete said. “We were glad to note that there were no such differences in trust in information about cancer from government agencies by race/ethnicity or urban/rural status.”

The researchers noted that these findings echo those of a previous study that identified an association between policy liberalism and enhanced trust in and adherence to the guidelines of the CDC and WHO during the COVID-19 pandemic.

“The lower trust observed among conservatives aligns with prior research indicating that conservatives tend to be more skeptical of government institutions,” Shete told Healio. “This skepticism may stem from ideological differences, such as a preference for limited government intervention and a belief in personal responsibility for health care decisions.”

Shete discussed the need for more focused approaches to effective communication across political ideologies, with a goal of instilling confidence in government agencies as sources of cancer information.

“Interventional strategies are needed to rebuild trust in government health agencies, including tailoring health communications to resonate with individuals across the political spectrum,” he said. “While our study findings point to an urgent need for the development of population-based interventions aimed at trust-building, oncologists have a role to play in educating their patients to trust information from government health agencies, which are often credible, evidence-based and practice-informing.”

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