Individual perceptions of equity in the context of institutional and interpersonal trust in medicine by the older
Research Article
How to Cite
Galkin K.A. Individual perceptions of equity in the context of institutional and interpersonal trust in medicine by the older. Science. Culture. Society. 2025. Vol. 31. No. 1. P. 59-70. DOI: https://doi.org/10.19181/nko.2025.31.1.5 (in Russ.).
Abstract
The article examines individual perceptions of older people about fairness in the health care system through the prism of institutional and interpersonal trust. The empirical base of the study includes 40 semi-structured interviews with residents of St. Petersburg and rural areas of the Republic of Karelia aged 66-85. The results obtained allowed us to identify markers within the framework of the analysis of institutional and interpersonal trust that characterise similarities and differences in attitudes to the health care system among the considered category of citizens. The common markers of institutional trust for all respondents are the availability of modern equipment and competent staff. Older people in rural areas show significant distrust in local medicine, preferring ambulance services as a more reliable channel for receiving quality medical care. Attitudes towards the status of and trust in medical institutions vary significantly depending on the place of residence. Common interpersonal markers of trust include the presence of interactions and contacts with doctors and minimisation of bureaucratised communication. The integration of medical workers into the rural community and neighbourly help, which mitigated distrust in rural medicine and its possible problems, also proved to be important for rural residents. The study showed that individual perceptions of fairness were quite strongly influenced by trust in health care, and lack of trust affected older people's understanding of fairness. The close relationship between objective characteristics of medical care and subjective perception of its fairness requires the development of differentiated approaches to improving the health care system, taking into account regional peculiarities.
Keywords:
health, medicine, older people, justice in medicine, trust in medicine
References
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24. Kuchenkova A. V. Interpersonal trust in Russian society. Sociological Studies. 2016;(1):26–36. (In Russ.).
25. Hupcey J. E., Miller J. Community dwelling adults’ perception of interpersonal trust vs. trust in health care providers. Journal of Clinical Nursing. 2006;15(9):1132–1139. DOI 10.1111/j.1365-2702.2006.01386.x.
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28. Natalier K., Willis K. Taking responsibility or averting risk? A socio-cultural approach to risk and trust in private health insurance decisions. Health, Risk & Society. 2008;10(4):399–411. DOI 10.1080/13698570802167413.
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30. Talbert N., Wong N. In whom we trust: the effect of trust, subjective norms, and socioeconomic status on attitudes and COVID-19 vaccination intentions. Health Communication. 2025:1–14. DOI 10.1080/10410236.2025.2456995.
31. Torkhova E.L. Analysis of digital transformation of health care institutions in St. Petersburg. Ekonomika i biznes: teoriya i praktika. 2020;(7):230–233. (In Russ.). DOI 10.24411/2411-0450-2020-10628.
32. Kadnikova T. G. Some aspects of the implementation of the state program in the sphere of public health in the example of the republic of Karelia. Vektor ekonomiki. 2017;(11):28. (In Russ.).
2. Rusinova N. L., Panova L. V., Burmykina O. N. The predictors of consumers' satisfaction of primary health care services. Sociology of Medicine. 2006;(2):24–31. (In Russ.).
3. Rojo-Pérez F., Fernández-Mayoralas G., Rodríguez-Rodríguez V. Active ageing and quality of life: A systematized literature review. In: Rojo-Pérez F., Fernández-Mayoralas G. (eds) Handbook of active ageing and quality of life: From concepts to applications. Cham: Springer; 2021. P. 63–96. DOI 10.1007/978-3-030-58031-5_4.
4. Vyalykh N. A. Differentiation mechanisms of medical care consumption in Russia: a methodological turn in contemporary sociological research. Tomsk State University Journal of Philosophy, Sociology and Political Science. 2018;(45):122–137. (In Russ.). DOI 10.17223/1998863X/45/13.
5. Galkin K. A. features of social inequalities in the health of older people in Russia and Europe: research review. Nomothetika: Philosophy. Sociology. Law. 2022;47(1):14–22. (In Russ.). DOI 10.52575/2712-746X-2022-47-1-14-22.
6. Estlund D. Human Nature and the Limits (if Any) of Political Philosophy. Philosophy & Public Affairs. 2011;39(3):207–237. DOI 10.1111/j.1088-4963.2011.01207.x.
7. Haslanger S. Resisting Reality: Social Construction and Social Critique. Oxford: Oxford University Press; 2012. DOI 10.1093/acprof:oso/9780199892631.001.0001. EDN UUVIMX.
8. Poortinga W., Bird N., Hallingberg B. [et al.]. The role of perceived public and private green space in subjective health and wellbeing during and after the first peak of the COVID-19 outbreak. Landscape and Urban Planning. 2021;211:104092. DOI 10.1016/j.landurbplan.2021.104092. EDN VQIRVO.
9. Ugur Z. B. How does inequality hamper subjective well-being? The role of fairness. Social Indicators Research. 2021;158(2):377–407. DOI 10.1007/s11205-021-02711-w. EDN HYOIDL.
10. Klabbers G., Bosma H., Kempen G.I.J.M. [et al.]. Do psychosocial profiles predict self-rated health, morbidity and mortality in late middle-aged and older people? Journal of Behavioral Medicine. 2014;37(3):357–368. DOI 10.1007/s10865-013-9493-x. EDN SRYNOD.
11. Barlow J, Singh D, Bayer S, Curry R. A systematic review of the benefits of home telecare for frail elderly people and those with long-term conditions. Journal of Telemedicine and Telecare. 2007;13(4):172–179. DOI 10.1258/135763307780908058.
12. Luo W., Yao J., Mitchell R. [et al.]. Locating emergency medical services to reduce urban-rural inequalities. Socio-Economic Planning Sciences. 2022;84:101416. DOI 10.1016/j.seps.2022.101416. EDN ONNZNH.
13. Marmot M. Social justice, epidemiology and health inequalities. European Journal of Epidemiology. 2017;32(7):537–546. DOI 10.1007/s10654-017-0286-3. EDN IXWKFQ.
14. Arcaya M. C., Arcaya A. L., Subramanian S. V. Inequalities in health: definitions, concepts, and theories. Global Health Action. 2015;8(1):27106. DOI 10.3402/gha.v8.27106.
15. Saveleva Zh. V., Mukharyamova L. M., Kuznetsova I. B. Social justice in healthcare in the experiences and judgments of Russians. Universe of Russia. 2018;27(3):154–179. (In Russ.). DOI 10.17323/1811-038X-2018-27-3-154-179.
16. Cookson R., Dolan P. Principles of justice in health care rationing. Journal of Medical Ethics. 2000;26(5):323–329. DOI 10.1136/jme.26.5.323. EDN EPUCJH.
17. Sen A. Social justice and the distribution of income. In: Handbook of income distribution. 2000;1:59–85. DOI 10.1016/S1574-0056(00)80004-4.
18. Oliver A., Mossialos E. Equity of access to health care: outlining the foundations for action. Journal of Epidemiology & Community Health. 2004;58(8):655–658. DOI 10.1136/jech.2003.017731.
19. Dover D. C., Belon A. P. The health equity measurement framework: a comprehensive model to measure social inequities in health. International Journal for Equity in Health. 2019;18(1):1–12. DOI 10.1186/s12939-019-0935-0. EDN XTXWNQ.
20. Temnitsky А. L. The phenomenon of justice in the labour remuneration of medical workers. Universe of Russia. 2017;26(3):64–89. (In Russ.). DOI 10.17323/1811-038X-2017-26-3-64-89.
21. Kosharnaya G. B. Institutional and interpersonal trust in the process of consolidation of the Russian society. Vlast’. 2015;(9):125–129. (In Russ.).
22. Kaasa A., Andriani L. Determinants of institutional trust: the role of cultural context. Journal of Institutional Economics. 2022;18(1):45–65. DOI 10.1017/s1744137421000199. EDN IBCXQY.
23. Bornstein B. H., Tomkins A. J. Institutional trust: an introduction. In: Bornstein B., Tomkins A. (eds) Motivating cooperation and compliance with authority. Nebraska symposium on motivation. Cham: Springer; 2015. P. 1-11. DOI 10.1007/978-3-319-16151-8_1.
24. Kuchenkova A. V. Interpersonal trust in Russian society. Sociological Studies. 2016;(1):26–36. (In Russ.).
25. Hupcey J. E., Miller J. Community dwelling adults’ perception of interpersonal trust vs. trust in health care providers. Journal of Clinical Nursing. 2006;15(9):1132–1139. DOI 10.1111/j.1365-2702.2006.01386.x.
26. Temkina A., Rivkin-Fish M. Creating health care consumers: The negotiation of un/official payments, power and trust in Russian maternity care. Social Theory & Health. 2020;18(4):340–357. DOI 10.1057/s41285-019-00110-3. EDN MBGPKH.
27. Zdravomyslova E. A., Temkina A. А. ‘I don't trust doctors’, but... Overcoming mistrust in reproductive medicine. In: Health and trust: gender approach to reproductive medicine. St. Petersburg: EU SPb; 2009. P. 179–210. (In Russ.).
28. Natalier K., Willis K. Taking responsibility or averting risk? A socio-cultural approach to risk and trust in private health insurance decisions. Health, Risk & Society. 2008;10(4):399–411. DOI 10.1080/13698570802167413.
29. Holt-Lunstad J., Uchino B. N. Social ambivalence and disease (SAD): a theoretical model aimed at understanding the health implications of ambivalent relationships. Perspectives on Psychological Science. 2019;14(6):941–966. DOI 10.1177/1745691619861392.
30. Talbert N., Wong N. In whom we trust: the effect of trust, subjective norms, and socioeconomic status on attitudes and COVID-19 vaccination intentions. Health Communication. 2025:1–14. DOI 10.1080/10410236.2025.2456995.
31. Torkhova E.L. Analysis of digital transformation of health care institutions in St. Petersburg. Ekonomika i biznes: teoriya i praktika. 2020;(7):230–233. (In Russ.). DOI 10.24411/2411-0450-2020-10628.
32. Kadnikova T. G. Some aspects of the implementation of the state program in the sphere of public health in the example of the republic of Karelia. Vektor ekonomiki. 2017;(11):28. (In Russ.).
Article
Received: 21.01.2025
Accepted: 28.03.2025
Citation Formats
Other cite formats:
APA
Galkin, K. A. (2025). Individual perceptions of equity in the context of institutional and interpersonal trust in medicine by the older. Science. Culture. Society, 31(1), 59-70. https://doi.org/10.19181/nko.2025.31.1.5
Section
Research of socio-cultural processes in civil society
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