Beyond Financial Incentives: Social Trust and Community-Based Insurance Uptake

Most health insurance adoption studies (e.g., Adeniran et al., 2024) highlight financial barriers, but Nzowa et al. (2023) suggest that trust is a powerful but underexplored mediator of willingness to pay. This research would design and test interventions that build community-level trust—such as transparent claim processes, peer endorsements, or visible community health outcomes—and measure their effect on both enrollment and utilization. By conducting randomized controlled trials in communities with historically low insurance uptake, this work would challenge the assumption that only price or compulsion matter. It builds on, but goes beyond, current behavioral economics approaches that focus mainly on direct incentives or nudges (see Wheatley, 2024). If trust-based interventions are shown to be cost-effective, it could revolutionize strategies for expanding insurance coverage in developing contexts.

References:

1. Determinants of health insurance adoption among residents of Lagos, Nigeria: A cross-sectional survey. A. Adeniran, K. Wright, Adedayo Aderibigbe, Olufunsho Akinyemi, T. Fagbemi, Omoyeni Ayodeji, Abiola Adepase, E. Zamba, H. Abdur-Razzaq, Faith Oniyire, O. Ogboye, A. Abayomi (2024). Open Health.
2. Mediation effect of trust on willingness to pay for health insurance among co-operative members in Tanzania. Petro G. Nzowa, F. Nandonde, S. Seimu (2023). Future Business Journal.
3. Enhancing Public Health Strategies: The Role of Behavioral Economics in Health Interventions and Policy. Mary Christine Wheatley (2024). Premier Journal of Public Health.