Institutional Distrust among African Americans and Building Trustworthiness in the COVID-19 Response: Implications for Ethical Public Health Practice

African Americans are disproportionately affected by COVID-19-related disease and mortality due to long-standing social, political, economic, environmental injustice; COVID-19 inequities exacerbated institutional distrust. In the absence of trust, public health authorities have not adequately fulfilled their professional ethical obligations protect American communities from negative effects COVID-19. As distrust is shaped individual collective experiences untrustworthiness, we propose a paradigm shift increasing trust among trustworthiness medical institutions/systems throughout United States. This narrative review extends literature describing how social determinants contribute demonstrating develops over time reinforced through systems injustice. Additionally, illustrate consequences for provide recommendations building practice.