Is trust in medical and public authorities and the media associated with COVID-19 related stress, perceptions, safety behaviors, inflammatory biomarkers and sleep quality among black adults?

Background: Mistrust of medical and public authorities and the media in the Black community may exacerbate their COVID-19 related stress, perceptions, safety behaviors, inflammatory biomarkers and poor sleep quality. We examined this hypothesis in a sample of underserved Black adults. Methods: Black adults (n=67) recruited from a clinical setting completed assessments of medical mistrust, trust in public authorities and the media as well as a scale to assess COVID-19 related stress, perceptions, and safety behaviors. Inflammation levels were measured using C-Reactive Protein levels derived from a blood assay. Sleep Quality was indicated using apnea hypopnea index (AHI) and REM generated by a home sleep assessment tool (Itamar WatchPAT200). The association between feelings of mistrust with COVID-19 related outcomes were examined using bivariate correlations. Results: The study sample were 66% female and had a mean age of 56.1 (SD=5.1) years. Overall, participants endorsed high levels of mistrust in medical and public authorities, high levels of COVID-related stress, and low engagement in safety behaviors (see Table 1). Higher levels of medical mistrust were associated with a lower belief that reducing the number of people met in a day (r= -.258;p<.05) and avoiding public transportation (r= -.259;p<.05), would reduce the risk of contracting COVID-19. Lower levels of trust in public authorities were associated with higher levels of AHI (r= -.312;p<.05), and less REM sleep (r= .444;p<.01). Lower levels of media trust were associated with higher levels of inflammation (CRP;r= -.368;p<.05) and AHI (r= -.413;p<.05). Discussion: Mistrust of medical, public authority, and media entities in the context of COVID- 19 was high in this small clinical sample. Higher levels of medical mistrust was particularly relevant to lower endorsement of important COVID-19 protective behaviors. Lower levels of trust in public authorities and media were more relevant to poorer sleep quality and greater inflammation. Rebuilding trust of these entities among under-resourced populations may be critical to forestalling the COVID-19 pandemic. Word Count: 347/400.