Does healthcare access affect trust in institutions? Empirical evidence in Canada during the COVID-19 pandemic.

Purpose: The paper investigates the determinants of citizens' trust in institutions, including banks and companies, during the COVID-19 pandemic in Canada.

Design/methodology/approach: We used a survey, conducted in 2020, with 36,851 respondents to identify what made some trust and others distrust institutions during the COVID-19 pandemic. Our methodology incorporated ordinary least squares and logit estimations.

Findings: Lack of healthcare access had a significant negative impact on people's trust in institutions. Consistent with life experience theory, we found that individuals facing healthcare barriers may distrust firms and banks. Sociodemographic variables, including gender, education and marital status, were likely to shape the effect of healthcare access problems on trust in institutions. Moreover, mental health issues stemming from healthcare access problems adversely affected trust in banks and firms, suggesting that people who had mental health problems during COVID-19 were more likely to lose trust in these institutions. The relationship between healthcare access and trust in banks and firms was more pronounced among men and highly educated people. The results were robust to the instrumental variable approach.

Practical implications: We showed that a link between trust in institutions and problems with healthcare access can inspire partnerships between Canadian institutional entities, typically banks and firms, and healthcare organizations. This would help strengthen long-term trust in these institutions.

Originality/value: The potential long-term economic consequences of COVID-19 created a crisis in the public's trust in institutions, typically firms and banks. This paper examined the relationship between healthcare access and trust in institutions, addressing the limited evidence on this topic.