A major UK report has found that trust in healthcare and clinical research among Black communities is strong at a personal level but remains fragile overall, shaped by inequality, past experiences and inconsistent care.
The study, led by Prostate Cancer Research and supported by AstraZeneca, combined polling of more than 1,000 Black British adults with expert interviews and community workshops. It paints a mixed picture: while most respondents said they feel respected and listened to by healthcare professionals, nearly one in three reported avoiding care after a negative experience.
Researchers found that trust is often placed in individual clinicians rather than in the healthcare system itself. Many participants described good one-to-one care, but said wider issues, such as delayed diagnoses, poor communication and perceived bias, undermine confidence over time.
Historical and social factors also play a role. More than 80% of those surveyed said legacies such as slavery, colonialism and the Windrush scandal influence their trust in UK health institutions. Experts stressed that these factors, combined with ongoing inequalities in areas like housing and employment, contribute to poorer health outcomes.
Clear, culturally relevant communication emerged as a key driver of trust. Participants said they often rely more on family, community figures and social media than official sources for health information. Local trusted voices - such as faith leaders and community groups - were seen as more effective than national campaigns or celebrity endorsements.
The report also highlights underrepresentation of Black patients in clinical research and calls for more inclusive, community-led approaches. While many respondents said they would consider taking part in research, they wanted better information, transparency and reassurance about how their data would be used.
Professor Julian Barwell, Clinical Geneticist, Academic Champion and Honorary Professor in Cancer Studies at the Department of Genetics and Genome Biology at the University of Leicester, supported and contributed to the report.
Julian says: "The covid pandemic presented a magnified mirror to healthcare outcome inequities for certain communities underpinned and worsened by mistrust that has built-up over centuries across multiple socioeconomic, cultural, educational, and racial domains. In genomic medicine this involves access to testing, understanding of results but also appropriate personalised treatments.
Local voices and partnerships in healthcare can help improve equity in participation in research but we will also require informed and bold policy decision-makers to understand what drives equitable access to 21st century healthcare and take positive and sustainable action that impacts on every day clinical practice.
Professor Julian Barwell, contributor to the report
To address these challenges, the report recommends long-term partnerships with community organisations, culturally responsive training for healthcare professionals, and the creation of local “trust hubs” offering accessible advice and engagement outside traditional clinical settings.
Overall, the findings suggest that mistrust is not a barrier rooted in reluctance, but a response to lived experiences. Building lasting trust, the report concludes, will require sustained effort, transparency and genuine collaboration with communities.
Further links
- You can access the full report here (opens in a new tab).
- Black Health Legacy (opens in a new tab) is working in partnership with Black, Black African and Black Caribbean communities in the UK to create one of the most inclusive health research studies of its kind.
- Improving Black Health Outcomes (opens in a new tab) is an NIHR Bioresource health research programme focused on improving our knowledge and understanding of health conditions and their unique impacts on UK Black Communities.
- Ethnic Inequities In Genomics and Precision Medicine Report (NHS Race and Health Observatory) (opens in a new tab)
- Play Domino Talk Prostate (opens in a new tab) was a project led by the Centre for Ethnic Health Research in Leicester. It's aim was to promote awareness of prostate cancer among black men, ultimately to more men from ethnic minority communities to get screened for the condition.
- Black Maternal Mental Health Project (opens in a new tab)