Why The Public Health Message Has Failed: Rebuilding Trust in Public Health and Medicine Amid Declining Confidence in Science

Source: Udow-Phillips, M., Smyser, J., & Bagdasarian, N. (2025). Rebuilding trust in public health and medicine in a time of declining trust in science. Journal of hospital medicine, 20(7), 787–790. https://doi.org/10.1002/jhm.70086

Public trust in health and medical professionals has declined since the COVID-19 pandemic, fueled by inconsistent messaging and the rapid spread of misinformation on social media. Initiatives like Michigan’s Health Communications Initiative (MHCI) offer a model for restoring confidence by leveraging trusted messengers, community partnerships, and evidence-based communication strategies to deliver timely and accurate public health information.

The Decline of Trust in Public Health and Medicine

Since the onset of COVID-19, public trust in health professionals has seen a dramatic drop. At the start of the pandemic, 71.5% of adults reported considerable trust in physicians and hospitals, which fell to 40.1% by January 2024. Multiple factors contributed:

• Inconsistent messaging from federal, state, and local public health authorities.

• Conflicting recommendations regarding preventive measures, testing, and vaccination.

• The rise of social media, which accelerated the spread of unverified and often erroneous health information.

This erosion of trust is not just a perception problem—it directly impacts public health outcomes, as seen in recent measles outbreaks in Texas. Communities with higher vaccine exemptions experienced preventable illness and even death, highlighting the real-world consequences of misinformation and declining trust.

Michigan: A Case Study in Restoring Public Health Confidence

Michigan provides a striking example of how states can rebuild public trust in the wake of compounded crises:

1. The Flint Water Crisis (2014): Decades of systemic neglect culminated in widespread lead exposure, severely undermining trust in governmental and public health institutions.

2. COVID-19 Pandemic: The pandemic amplified distrust, especially in socially vulnerable communities like Flint, exposing the critical need for reliable public health communication.

In response, Michigan launched the Michigan Health Communications Initiative (MHCI) in 2025. This initiative aims to:

• Provide timely, evidence-based public health information.

• Partner with community-based organizations and trusted local messengers.

• Target critical health topics, including vaccines, mental health, contraception, STIs, and gun violence prevention.

• Use robust evaluation frameworks to track the effectiveness of health messaging.

Trusted Messengers: A Key Strategy for Public Health

The MHCI leverages the trusted messenger approach, empowering local organizations and individuals to deliver accurate information directly to their communities. This approach is grounded in behavioral science and social change frameworks like the Collective Impact model, which emphasizes:

• Collaboration across sectors and organizations.

• Timely, relevant communication based on near real-time data.

• Community empowerment, enabling local voices to disseminate health information.

By using trusted intermediaries, public health messages are more likely to be received, understood, and acted upon, helping counter misinformation and build long-term confidence.

Lessons for States and Local Governments

The decline in federal public health communication capacity makes state and local leadership even more crucial. Key takeaways include:

1. Leverage Local Networks: Partnering with schools, nonprofits, and community leaders enhances credibility.

2. Monitor Misinformation: Use data-driven tools to track trending health narratives and identify gaps in knowledge.

3. Provide Actionable Information: Citizens need clear, fact-based guidance to make informed decisions about health.

4. Sustain Engagement: Trust is rebuilt over time through consistent, reliable communication.

Conclusion: Rebuilding Trust Is Possible

Restoring public confidence in medicine and public health is essential for the nation’s health, especially amid ongoing misinformation. Initiatives like Michigan’s MHCI show that states can lead the way, leveraging local partnerships and trusted messengers to deliver accurate, timely, and evidence-based information.

In a landscape where trust is at a generational low, public health must meet communities where they are, providing the tools and guidance necessary for informed health choices. By empowering trusted messengers, states and local organizations can reclaim their critical role in safeguarding public health.

Author: R.E. Hengsterman, MSN, MA, M.E., RN

Registered nurse, night-shift administrator, and author of The Shift Worker’s Paradox

Nursewhowrites.com

For educational purposes only. Not medical advice.