Not closing the gap. The social gradient in institutional trust from 2011–2019.

Public institutions need to focus on building trust with low socioeconomic groups. Moreover, reducing socioeconomic differences in the society is important to build trust, health, and wellbeing.

Background: Trust is described as the glue of healthy societies. However, levels of trust are not distributed evenly in the population, and socioeconomic status is an important determinant. Although Norway is among the countries with the highest levels of trust in public institutions, the increasing socioeconomic differences observed may threaten levels of institutional trust in the population, and more knowledge about the social gradient in levels of institutional trust over time is needed. Therefore, we aimed to investigate such differences in the general population between 2011 and 2019.
Method: A repeated cross-sectional study was conducted using data on the general population in Østfold county from 2011 (N=16673) and 2019 (N=15935). Level of education was used as an indicator of socioeconomical status, and differences in trust toward five public institutions (healthcare system, school system, labour and welfare administration (NAV), police, and municipal council) were investigated with Chi-square tests. Logbinomial regression analyses were used to examine potential changes in high trust over time. Gender and age were included in the analyses as control variables.
Results: A relatively high proportion of the general population reported high levels of trust to the health care system (2011: 71%; 2019:80%), police (2011: 73%; 2019:77%), and the school system (2011: 64%; 2019:66%), whereas a lower proportion reported high levels of trust to NAV (2011: 37%; 2019:41%) and the municipal council (2011: 45%; 2019:36%).. Both in 2011 and 2019 a clear social gradient in institutional trust was found for all institutions (p<0.05). Surprisingly, there was a reversed social gradient in trust to NAV in 2011, where lower education was associated with the highest level of trust. There was a significant increase in the level of trust in the health care system (low education:RR=1,10; middle:RR=1,12; high:RR=1.06) and a significant decrease in trust in the community council (low:RR=0,77; middle:RR=0,80; high:RR=0,83) in all educational groups from 2011 to 2019. No significant changes in trust to the school system and the police were revealed. The level of trust in NAV increased significantly in the two groups with highest education, while a non-significant decrease was shown in the low educational group.
Conclusions: Although the fairly high levels of institutional trust largely remained unchanged, the social gradient persisted or even widened. This is worrying as trust is an important factor in ensuring inclusion, social capital, democracy, and health and wellbeing. The lower levels of institutional trust found in low educational groups could also be of particular concern as these groups might be more dependent on the different parts of the welfare system.