# US survey across 20 waves links trust in CDC and physicians to protective behavior in COVID-19

- Published: 2026-11-06 18:42 UTC
- Section: Life & Health › Medicine
- Tags: institutional trust, protective behavior, mask wearing, COVID-19 survey, compartmental models, contact matrices, trust in CDC, public health agencies, epidemic modeling
- URL: https://realtech.media/news/rt-b9bf39e938ceac8edb878f8e_us_survey_across/

**Authors analysed 20 waves of a national US survey from the COVID-19 pandemic and propose adding institutional trust as a stratifying variable in compartmental transmission models.**

![US survey across 20 waves links trust in CDC and physicians to protective behavior in COVID-19](https://sgzwpqqelzmajkcubgkl.supabase.co/storage/v1/object/public/rt-media/2026/11/791c5c001fc01d36.jpg)
*Tadeáš Bednarz, Wikimedia Commons, CC BY-SA 4.0*

Researchers analysed 20 waves of a national survey conducted throughout the COVID-19 pandemic in the United States. According to a paper in Proceedings of the National Academy of Sciences, institutional trust, particularly trust in public health agencies, physicians and hospitals, is a dominant predictor of the adoption of protective behaviors [1].

## Trust compared with demographics

For mask wearing during periods of strongest pandemic activity, institutional trust explains more behavioral variance across population groups than age, income, education and partisan affiliation combined [1]. In unadjusted analyses, the difference in protective behavior adoption between individuals with the highest and lowest trust in the CDC was four- to six-fold larger than the corresponding differences by age, income or educational attainment [1]. It also exceeded the difference between Democratic and Republican respondents.

The association was specific to institutions: it weakened for trust in banks. It was also specific to behaviors: trust in the CDC was associated with protective behaviors but not with visiting a doctor [1]. The authors interpret this as trust modifying voluntary compliance with public health recommendations rather than access to or use of healthcare.

## Implications for transmission models

Compartmental models of infectious disease transmission parameterize interactions between population groups mainly through contact matrices stratified by demographic variables such as age, gender or socioeconomic status. The authors note that such characteristics are easy to measure but may inadequately capture the social and psychological forces that govern protective behaviors.

They conclude that compartmental models would be substantially improved by incorporating institutional trust as a stratifying variable [1]. The paper also offers a trust-integrated mathematical modeling framework and recommendations for the data infrastructure needed to implement it.

## Sources

1. [Proceedings of the National Academy of Sciences](https://doi.org/10.1073/pnas.2622260123)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-b9bf39e938ceac8edb878f8e_us_survey_across/