Medical mistrust: Why representation matters

How does trust — or the lack of it — shape who gets care, and what outcomes they experience?In this episode of Econ To Go, Neale Mahoney sits down with Stanford physician-economist and MacArthur Fellow Marcella Alsan to explore how trust and representation shape the U.S. health care system. Her research shows that historical events like the Tuskegee Syphilis Study continue to affect healthcare use and health outcomes today, and that trust isn’t abstract, it’s measurable. The conversation also highlights how trust can be built, how underrepresentation in clinical trials can influence both physician behavior and patient trust, and other key themes, including:(01:33) The mistrust problem(06:50) Representation as remedy (12:18) Clinical trials and trust in data (24:04) Eroding trust across the systemEcon To Go brings Stanford economics into your everyday life — served with a side of coffee. Hosted by economist and director of the Stanford Institute for Economic Policy Research (SIEPR), Neale Mahoney, the show takes you on a walk across campus with leading thinkers as they unpack the ideas shaping our economy, public policy, and daily lives. Smart, curious, and conversational — it’s Stanford economics, to go.The Stanford Institute for Economic Policy Research is a nonpartisan research center that brings together scholars, policymakers, and industry leaders to solve pressing economic challenges and inform better public policy.Never miss an episode. Subscribe to Econ To Go on Spotify, Apple Podcasts, Amazon, YouTube, or wherever you get your podcasts. Plus follow SIEPR on LinkedIn or X/Twitter for episode updates and research highlights, or explore more at siepr.stanford.edu.Today’s guest, Marcella Alsan, is a physician-economist at Stanford University, the Thomas J. Davis, Jr. Faculty Scholar at the Stanford Institute for Economic Policy Research, and a MacArthur Fellow whose research focuses on health disparities, trust in medicine, and the role of institutions in shaping health outcomes. To learn more about her work, explore her bio and these links:Tuskegee and the Health of Black MenDoes Diversity Matter for Health? Experimental Evidence from OaklandRepresentation and Extrapolation: Evidence from Clinical Trials* | The Quarterly Journal of Economics | Oxford Academic