# Health Perceptions and Trust in Healthcare After COVID-19: An Exploratory Cross-Sectional Survey from Romania

## TL;DR

This study explores how the COVID-19 pandemic affected health perceptions and trust in healthcare in Romania, finding significant declines in trust and perceived life expectancy.

## Contribution

The study provides novel insights into post-pandemic health perceptions and trust in a Romanian context with limited prior research.

## Key findings

- 31.9% of participants reported increased stress and anxiety during the pandemic.
- 75.6% of participants showed decreased trust in the healthcare system.
- Perceived life expectancy decline was associated with lower education and inconsistent healthcare behavior.

## Abstract

Background: This study is particularly relevant to the Romanian context, where relatively few empirical investigations have examined post-pandemic health perceptions and levels of trust in public institutions. The purpose of this study is to investigate the long-term impact of the COVID-19 pandemic on health perceptions and trust in the healthcare system by examining key socioeconomic and epidemiological factors. Methods: A cross-sectional online survey was conducted among Romanian adults (N = 423), between March and April 2025. Demographic data, lifestyle habits, mental health, and access to healthcare were assessed. Statistical analyses included both bivariate (chi-square test) and multivariable logistic regression models to identify independent associations. Results: 31.9% of participants reported increased stress and anxiety during the pandemic. Decreased trust in the healthcare system (75.6%) and a perceived reduction in life expectancy (74.3%) were also noted as a consequence of the COVID-19 pandemic. Perceived life expectancy decline was linked to lower education and inconsistent healthcare behavior. Conclusion: In our sample, the perception of decreased life expectancy reflects not only epidemiological realities but also emotional and social responses to crises. Individuals’ trust, behavior, and shared vision of the future have also been challenged during the COVID-19 pandemic.