Trust and Violence in Healthcare (2021-2022)


Health behavior relies on trust not only in the healthcare system and providers, but also in science and the channels through which scientific information is communicated. The COVID-19 pandemic is a crisis that humanity was not prepared for; however, what turned the infectious disease pandemic into an economic and social crisis was a global erosion of trust. 

Even prior to the COVID-19 pandemic, healthcare faced a crisis of trust with an alarming growth in cases of violence against healthcare workers globally. Asymmetry of information in healthcare is one of the most fundamental problems in the sector. Yet, the democratization of information with social media appears to have contributed to further distrust in the health system. 

Trust is a contributing factor to lack of adherence to vaccines or treatment, violence against the healthcare workforce and even systematic efforts to undermine credibility of scientific research. Understanding the extent of such violence against the workforce and its relation to the problem of trust is critical to identifying potential solutions to improving healthcare and health outcomes.

Project Description

This project aims to document the global incidence of violence in the workforce and its relation to trust in the health sector. The team will study how the availability and sources of scientific information influence trust, especially in the context of the democratization of information in which individuals are unable to discern whether new information is correct or incorrect.

The project team’s preliminary data and review of the literature will form the basis of larger research proposals to undertake a global collaboration to study the issue of trust in the context of healthcare. 

The team will scrape online news sources to document instances of reported violence against doctors, nurses and healthcare workers in the U.S., U.K., China and India. This will result in a new database of violence against the workforce documented over a 10-year period. 

Team members will review the literature on trust, drawing from economics, game theory, political science, sociology and psychology. A related part of this literature review will cover models of altruistic punishment, which describes how individuals might impose punishment (violence) against errant agents even at high cost to themselves. The year-long review of theory of trust and violence will lead to a summary research paper that identifies potential hypotheses that can be tested in the context of health, as well as areas in need of theoretical development.

Anticipated Outputs

External grants; descriptive paper; review paper


Summer 2021 – Spring 2022

  • Fall 2021: Submit IRB; continue literature review and data scraping
  • Spring 2022: Submit reports

This Team in the News

Interdisciplinary Researchers Discuss Faculty-Student Research

Meet the Members of the 2021-2022 Bass Connections Student Advisory Council


Image: Fight Against COVID-19 - Pourakarmika Personals, by Trinity Care Foundation, licensed under CC BY-NC-ND 2.0

Fight Against COVID-19.

Team Leaders

  • Marcos Vera Hernandez, Dept of Economics, University College London
  • Manoj Mohanan, Sanford School of Public Policy
  • Sean Sylvia, Dept. of Health Policy, UNC-Chapel Hill

/graduate Team Members

  • Julia Barlow, Bioethics and Sci Policy - AM

/undergraduate Team Members

  • Micah Hurewitz
  • Kevin Jiang
  • Katie Margolis
  • Dana Otera, Biology (AB)
  • Sydney Simmons, Psychology (BS), Neuroscience (AB2)
  • Luke Triplett
  • Abigail Ullendorff
  • Lisa Zhao, History (AB)

/zcommunity Team Members

  • Ibrahim Abubaker, Epidemiology and Global Health, University College London
  • Antonio Cabrales, Dept of Economics, Universidad Carlos III de Madrid