How Attributes of Place Threaten Community Trust in the American South: Opportunities for Improving Pandemic-Related Communication

Lauren A. Cafferty, Lillie D. Williamson, La Kesha N. Anderson, Samantha R. Jones, Justin X. Moore, Reginald D. Benson, Ebony B. Whisenant, Candace Clinton, Nikeshia La Shaundra Lawson, Christy J.W. Ledford

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Trust and mistrust influence the utilization of health services, the quality of overall healthcare, and the prevalence of health disparities. Trust has significant bearing on how communities, and the individuals within them, perceive health information and recommendations. The People and Places Framework is utilized to answer what attributes of place threaten community trust in public health and medical recommendations. Augusta-Richmond County is ranked among the least healthy counties in Georgia despite being home to the best healthcare-to-residence ratios and a vast array of healthcare services. Semi-structured interviews were conducted with 31 neighborhood residents. Data were analyzed using the Sort & Sift, Think & Shift method. Threats to community trust were identified within four local-level attributes of place: availability of products and services, social structures, physical structures, and cultural and media messages. We found a broader web of services, policies, and institutions, beyond interactions with health care, that influence the trust placed in health officials and institutions. Participants spoke to both a potential lack of trust (e.g. needs not being met, as through lack of access to services) and mistrust (e.g. negative motives, such as profit seeking or experimentation). Across the four attributes of place, residents expressed opportunities to build trust. Our findings highlight the importance of examining trust at the community level, providing insight into an array of factors that impact trust at a local level, and extend the work on trust and its related constructs (e.g. mistrust). Implications for improving pandemic-related communication through community relationship building are presented.

Original languageEnglish
Pages (from-to)67-75
Number of pages9
JournalJournal of Health Communication
Issue numbersup1
StatePublished - 2023

Bibliographical note

Funding Information:
This project is funded through a Patient-Centered Outreach Research Institute (PCORI) Eugene Washington PCORI Engagement Award (EASC-COVID-00249) The authors thank Alejandra Garcia Rychtarikova, Hailie Hayes, Eunice Lee, and Courtney Roberts for their support in data collection; Amelia Vu and Faith Elliot for their support in community outreach events; Rev Dr Charles Goodman, Rev Isaiah Lineberry, and Corey Rogers for their wisdom, insight, and historical expertise in the development of this project; Kim Thompson and Zachary Cooper for their advocacy of the project in their clinical spaces; and Traci Greene, the coordinator of the Co-Researcher Activation Network (CRANE). We also thank all of our neighbors who shared their time and experiences with us through this project.

Publisher Copyright:
© 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.

ASJC Scopus subject areas

  • Health(social science)
  • Communication
  • Public Health, Environmental and Occupational Health
  • Library and Information Sciences


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