Introduction
Exploring medical mistrust: from clinic to community

m.schmidt-sane@ids.ac.uk
Abstract
This introduction to the special issue, Exploring Medical Mistrust: From Clinic to Community, provides a conceptual framing of ‘medical mistrust’ from a critical social science lens. This special issue explores and unpacks the complex temporal, social and scalar relationships which are intertwined with contemporary manifestations of mistrust in medicine. We ask what social science and humanities disciplines can offer in relation to wider understandings of the processes driving resistance to and refusal of medical interventions, including but also beyond vaccines. We distil insights derived from diverse spaces of medical encounter, ambivalence and resistance that serve as arenas which generate mistrust. We bring this analysis to deepen an understanding of the frictions and affective relations which exist between vertical and horizontal relations which constitute health systems.
Keywords
medical mistrustsocial scienceanthropologyCOVID-19trustCopyright statement © The author(s) 2023. This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License
Cite this article Schmidt-Sane with Storer, Ripoll, Hrynick (2023), ‘Exploring medical mistrust: from clinic to community’, Journal of the British Academy, 11(6): 001 https://doi.org/10.5871/jba/011s6.001

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The Middle East and North Africa (MENA) region has been traditionally characterised by young population demographics but is currently experiencing fast transitions into ageing societies. The region has strong narratives of respect and high regard towards the elderly that are embedded in cultural norms. However, such narratives appear to have limited practical applications as they contradict the experiences of older people. The experiences of older women and men are likely to be impacted by existing gender differentials across the life course including marriage patterns, societal expectations and access to opportunities. The COVID-19 pandemic and associated infection control restrictions have impacted the lives of older people globally, including in the Middle East. In this article, I reflect on the intersectionality of gender and ageing perception in the MENA region, drawing on qualitative data collected as part of the Middle East and North Africa Research on Ageing Healthy (MENARAH) Network between 2020 and 2022.
Uncertainties about COVID-19 vaccines and variants have been linked to vaccination refusal on a significant scale. To optimise public health communication on vaccination and inform vaccination policy, it is necessary to understand the substantive nature of these uncertainties. Our study, using a corpus of texts from 324 UK citizens, examines these uncertainties. The results suggest that major public uncertainties regarding COVID-19 vaccines are expressed in terms of: (1) concerns about the safety of the vaccines; (2) concerns about the effectiveness of the vaccines; (3) perceived lack of trustworthiness and/or competence of actors in the vaccination process; (4) concerns about the logistics of the vaccination roll-out; and (5) uncertainty about the longer-term need for vaccines and social consequences. Public uncertainties regarding COVID-19 are complex and will continue to evolve. Policy responses must be informed by an understanding of the factors that instigate and maintain uncertainties in individuals and the wider society.

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