Social Trust Profile Transitions and Health-Seeking Behavior: A Latent Transition Analysis of Three-Wave Panel Data...

Social trust is increasingly recognized as a psychosocial determinant of health service utilization, yet most studies treat trust as a unidimensional, static variable. This study examines how multidimensional trust configurations evolve over time and whether distinct profiles are associated with subsequent health-seeking behavior. Data were drawn from three waves (2018, 2020, 2022) of the China Family Panel Studies (N = 12,216). Latent profile analysis identified trust configurations based on four indicators (trust in neighbors, strangers, government officials, and doctors), and a three-wave latent transition analysis with partial measurement invariance modeled profile stability and change. Time-lagged logistic regressions and stayer-mover analyses examined associations with care-seeking. Three profiles emerged: Low Trust (31%), Higher Generalized Trust (36-42%), and Selective Institutional Trust (27-33%). All profiles showed moderate-to-high stability. Selective Institutional Trust was consistently associated with higher odds of care-seeking at the subsequent wave (adjusted OR = 1.30-1.35, p < 0.01), an association strongest among those who maintained this profile over time (OR = 1.47-1.48, p < 0.001). Higher Generalized Trust showed no significant association, and no profile was associated with facility-level choice. These findings indicate that the behavioral relevance of social trust for health-seeking is profile-specific rather than monotonic, underscoring the value of person-centered longitudinal approaches.