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How to Rebuild Trust in Public Health

This past year has been tumultuous but promising, given the trifecta of COVID-19, the flu, and respiratory syncytial virus (RSV) combined with unprecedented vaccine development and responses to other outbreaks. Despite recent medical advancements and more knowledge about infectious diseases, public health is under increased scrutiny. The spread of misinformation and disinformation has undermined our healthcare system’s ability to protect the population and deal adequately with public health threats. 

The start of a new year brings the potential to respond to these perceptions of mistrust and reinvigorate our approaches to messaging, education, and outreach. Understanding the sources of mistrust can help public health educators and officials rebuild and maintain credibility. 

Diminished Public Trust 

Many of us look back on 2022 as a year fraught with the continued spread of COVID-19 and an uptick of many serious diseases. Also, strains of mpox, formerly known as monkeypox, have challenged our medical resources and infected more than 30,000 people last year. Furthermore, the first known polio case in over a decade emerged last year, keeping health officials constantly alert. 

These continued health threats are increasing public skepticism of health educators and officials. A 2021 poll by the Robert Wood Johnson Foundation and the Harvard Chan School of Public Health revealed that 52% of people in the U.S. had a “great deal” or “quite a lot” of trust in the Centers for Disease Control and Prevention (CDC). Also, only 37% expressed similar sentiments about the Food and Drug Administration and the National Institutes of Health.


A Pew Research poll found that the number of people believing that public health officials were doing an excellent or good job dropped from 79% in March 2020 to 52% in May 2022. Federal agencies are not the only entities seeing decreased public trust. Less than half of Americans reported having a great deal of trust in their local and state health departments. 

Diminished trust in public health may increase vaccine hesitancy. In mid-October last year, the average daily count of people receiving a COVID booster shot was almost 613,000. By last December of 2022, that rate dropped below 250,000. Furthermore, a 2022 Kaiser Family Foundation survey shows that 71% of adults support vaccinating healthy children against diseases like mumps, measles, and rubella. This figure is down from 82% in 2019. 

As public health scrutiny has grown, so has the passing of state-level laws limiting health mandates, especially regarding COVID-19. Between January 2021 and May 2022, 185 laws throughout the U.S. were passed that hindered health protections like wearing masks or requiring vaccinations. Such legislation reduces the government’s ability to respond to health crises and diminishes the credibility of health officials. 

Misinformation, Disinformation, and Polarization 

Several factors can fuel public distrust, including pandemic fatigue. As more people grow weary of COVID-related news and continued safety measures, they may become less willing to continue the behaviors that help slow the spread of infection. Some people may also exhibit growing resentment and animosity toward public health educators and officials, often accusing them of having financial or political motives for their mandates and recommendations. 

Politicized perceptions of public health often give rise to misinformation and disinformation. Misinformation includes false, misleading, or inaccurate information. Although someone can intentionally spread misinformation, they may not realize that the content is not valid or accurate. Conversely, disinformation is misleading or fictitious content circulated with malicious intent. Health and safety usually suffer regardless of the purpose behind polarizing and false messages. 

Rebuilding Trust in Public Health 

Current negative and hostile attitudes toward public health may serve as a clarion call for experts to reexamine how they create and disseminate important health information. Regaining the public’s trust requires specific strategies, including maintaining consistency in messaging and outreach. When addressing public concerns, officials need to communicate with the public regularly and provide updates during emergencies, so that community members and stakeholders do not feel left in the dark. 

Communication must also be transparent. In addition to positive developments and added insights, officials should be willing to convey bad news or admit when they do not know something. Transparency can minimize perceptions of deception or conflicts of interest. 

Another key element of rebuilding public trust is crossing political divides. Communication should convey goodwill to all audiences, regardless of their political ideologies or worldviews. 

Public health experts and organizations that increase their public profile and accessibility can also help enhance public trust. Holding regular press conferences, updating data and trends, and posting on social media can give assurance to people who rely on timely and accurate health information to make everyday decisions. 

Research and materials for this article were compiled, written, and distributed on behalf of the National Public Health Information Coalition. The views and opinions expressed in this blog are those of the various authors. They do not necessarily reflect the official policy or position of the National Public Health Information Coalition or its members.