Social mistrust

The results were that income inequality was strongly associated with lack of social trust, and that states with high levels of social mistrust had higher age-adjusted rates of total mortality (level of social trust explained 18% of variance in total mortality, under their regression). Lower levels of social trust were associated with higher rates of most major causes of death, including coronary heart disease, malignant neoplasms, cerebrovascular disease, unintentional injury, and infant mortality. 

When Kawachi and co-workers carried out a path analysis, it indicated that the primary effect of income inequality on mortality is mediated by social capital (as measured by level of perceived fairness). Income inequality exerts a large indirect effect on overall mortality through the social capital variable. As income inequality increases, so does the level of social mistrust, which is in turn associated with increased mortality rates. 

Disconnection and rejection - the individual has an expectation that their needs for security, safety, stability, nurturance, empathy, acceptance and respect will not be met in a consistent manner. The typical early family dynamics involve cold, rejecting, withholding, lonely, explosive, unpredictable or abusive behaviour from others. The EMS in this domain are abandonment/instability (perceived instability or unreliability of personal support), mistrust/abuse (expectation that others will hurt, abuse, humiliate, lie, manipulate, cheat, etc.), emotional deprivation (perception that one s needs for emotional support will not be met), defectiveness/ shame (the feeling that one is defective, bad, unwanted, inferior, flawed or invalid in some important respect) and social isolation/alienation (the feeling that one is different from others and isolated from any social group). 

Housing finances social networks (mistrust, alienation, withdrawal )... 

Voutira, E., and Harrell-Bond, B. E. (1995) In Search of the Locus of Trust The Social World of the Refugee Camp. Pp. 207-24 in E. V. Daniel and J. C. Knudsen (eds.). Mistrusting Refugees. Berkeley University of California Press. 

All this said, these obstacles are perhaps insignificant when viewed in light of the current modus operand in which commercially driven clinical trials fall like dominos in the clinic—to the detriment of each company, to the detriment of the patients and with relatively litde communal learning. This approach has a potential social benefit as well making the drug discovery process more transparent to the public may increase public awareness of the complexity of drug development and lower public mistrust of the pharmaceutical industry. 

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