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

Student Opportunities

Ideally, this team will include 3-5 graduate students and 4-6 undergraduate students. Students of all disciplines are encouraged to apply. Students should have some background in quantitative social sciences and programming, with keen interests in empirical research methods, organizational skills and theory. 

Graduate students will have the unique opportunity to be involved in a large multicountry project, and those with longer-term interests in the topic will be able to build in their own research ideas as well.

Students will be organized into two subteams based on the project aims. Empirical and theory teams will help with division of responsibilities. Students will have the opportunity to participate in a year-long effort to develop the research agenda and an opportunity to collaborate with and be mentored by leading researchers at other global institutions. In addition to learning the process of conducting such searches, students will also learn the process of developing and publishing research manuscripts.

The subteams will meet every week, with both subteams providing updates on work conducted during the week and seeking advice on next steps. In addition, each team will have separate meetings with team leaders to receive technical feedback on their work. 

One graduate student will serve as a project manager, ideally a Ph.D. student from a social science department. The project manager should have knowledge of (or willingness to learn) software to write scripts for scraping.

In the optional summer component, team leaders anticipate two weeks of work for the project manager in order to help the team get started in advance prior to the fall semester, and two weeks of work for up to two master’s students and two undergraduate students to get started on the review and scraping.


Summer 2021 – Spring 2022

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


Academic credit available for fall and spring semesters; summer funding available


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