Medical Mistrust in the Evangelical Community

The findings in this study from the Pew Research Foundation about evangelicals and their attitudes toward the COVID vaccine were stunning.

Among religious groups, atheists are the most likely to say they would get a vaccine or already received one dose, while White evangelical Protestants are the least likely. Nine-in-ten atheists said in February that they would definitely or probably get a vaccine or had already received one. Around eight-in-ten agnostics (80%) and Catholics (77%) said the same. The share was considerably smaller among Black Protestants (64%) and especially White evangelical Protestants (54%). Slightly under half of White evangelicals (45%) said they would definitely or probably not get a vaccine to prevent COVID-19. 

Religious affiliation often correlates with party affiliation, but even among Republicans, White evangelical Protestants stand out as less inclined to get a coronavirus vaccine.

Beliefs about the role of community health are strongly tied to intent to get a vaccine, including among religious groups. On balance, White evangelical Protestants are less inclined than people in other religious groups to think that community health effects should have a lot of sway in an individual’s decision to get a COVID-19 vaccine. More in this group say community health concerns should have only a little role or no role at all in individual decisions about getting a vaccine.

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One contributing factor to attitudes in the evangelical community regarding the vaccine may be an association with a public health response that was arbitrarily harsh in restricting church attendance in many regions of the country. Several churches in California rebranded themselves as strip clubs after strip clubs were allowed to operate while indoor worship was banned. Others have based their resistance upon unfounded rumors that stem cells of aborted children were used to create the vaccine. The Southern Baptist Conventionprominent Baptist ethicists and the Roman Catholic Church have addressed these concerns, with Pope Francis suggesting Catholics have a moral obligation to receive the vaccine.

The concept of “medical mistrust” has been widely discussed of late, especially in the context of addressing healthcare disparities within historically marginalized populations, especially the Black community. Expressions of medical mistrust in the evangelical community appear very similar to those observed in other minority groups.

Some of the characteristics of medical mistrust include:

  • Historic events fuel current mistrust. Example: The Tuskegee Experiment is a major source of mistrust in the Black community.
  • Minority patients might miss out on advances in care
  • Mistrust and past experiences delay routine care
  • Biases can lead to populations mistrusting healthcare providers
  • Work has to be done to actively win back trust 

One additional characteristic of the medical mistrust research involves a focus on “conspiracy theories” – a common concern in the evangelical community addressed in this interview by Russell Moore of the ERLC.

Evangelicals have been more skeptical than their fellow Americans of medicine and the medical community for a long time. This phenomenon is clearly present when Christians have mental health concerns. Christians with mental illness are more likely to seek help from a pastor than a psychiatrist. In the one study I found comparing medical mistrust in different Christian traditions, distrust of physicians was greater among evangelicals when compared to mainline Protestants, Catholics and Jews. 

Findings reveal that religiously active individuals have higher levels of trust in physicians. For example, individuals who attend religious services frequently (42% of the sample) are significantly more likely to trust their own physician (p < .05) and have higher levels of confidence in physicians in general (p < .01), compared to individuals who never attend. In addition, levels of trust vary by religious denomination with Mainline Protestants, Catholics, and Jews reporting more trust than Evangelical Protestants. For example, Mainline Protestants have more personal trust in their physicians (p < .01), general confidence in physicians (p <.05), and trust in the health care system (p < .05), compared to Evangelical Protestants.

One factor may be that Protestants are significantly underrepresented among the ranks of American physicians compared to their percentages in the general population. We know that patients treated by physicians from their ethnic or cultural background achieve better outcomes. In my broad specialty, Jewish psychiatrists outnumber Protestants, even though there were thirty times more Protestants than Jews in the U.S. population at the time of the study. 

In a New York Times article examining resistance to vaccination among evangelicals, Dr. Elaine Ecklund, Director of the Religion and Public Life Program at Rice University speculated on the role the exclusion of Christians from the medical and scientific communities has played in resistance to vaccination.

There are two parts to the problem, she said: The scientific community has not been as friendly toward evangelicals, and the religious community has not encouraged followers to pursue careers in science.

Distrust of scientists has become part of cultural identity, of what it means to be white and evangelical in America, she said.

For slightly different reasons, the distrust is sometimes shared by Asian, Hispanic and Black Christians, who are skeptical that hospitals and medical professionals will be sensitive to their concerns, Dr. Ecklund said.

“We are seeing some of the implications of the inequalities in science,” she said. “This is an enormous warning of the fact that we do not have a more diverse scientific work force, religiously and racially.”

The one study examining medical mistrust in the Christian community specifically focused on churchgoing Latinos. Increased participation in groups or ministries was associated with higher medical mistrust (the higher the number of groups or ministries, the higher the mistrust), even after adjusting for other religiosity variables and health care and sociodemographic covariates. In other words, attendees who did not participate in any groups or ministries mistrusted the health care system less than those that participated at any level. 

Medical mistrust within the evangelical community is only likely to grow going forward. The growing propensity of the medical profession to embrace causes antithetical to common evangelical beliefs is likely to deter young Christians from entering the field. The American Association of Medical Colleges is openly hostile to conscience rights for healthcare professionals. While medical schools (appropriately) recognize the need for patients from ethnic and sexual minorities to have physicians from their cultural background, the likelihood they’ll recognize the same need for evangelicals is nonexistent. The one paper on the impact of religious beliefs on medical school admission (published 25 years ago) described flagrant discrimination.

The perception of medical mistrust is already widespread in the disability community. Mistrust is only amplified when patients identify with two or more groups with substandard experiences of the medical profession. The individuals and families served by our ministries experience an enhanced risk of having treatment needs that are overlooked or ignored. Their experiences may be magnified by their identification with the Christian subculture.

From a disability ministry perspective, attitudes among churchgoers toward the vaccine are a big problem. Adults impacted by disability are three times more likely to have chronic medical conditions that increase vulnerability for serious medical complications from COVID-19. When large numbers of churchgoers choose not to vaccinate themselves, the fear and apprehension of returning to church among the most vulnerable is likely to persist. The failure of churchgoers to vaccinate and take other recommended precautions to reduce the risk of spreading virus contributes to the marginalization of persons with disabilities and their families. 

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, www.church4everychild.org was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
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