March 7, 2023 – The political wars over public health recommendations to combat the COVID-19 pandemic have had a direct impact on trust in public health agencies similar to the CDC and FDA, in line with a survey conducted by Harvard researchers.
The study, published on March 6 in the diary Health mattersfound that folks who had little or no trust on this and other federal, state, and native public health agencies believed that agency decisions were inconsistent, politically influenced, and never based on science.
Of those respondents who had quite a lot of trust in these agencies, only half said that the nice job of fighting the pandemic was a primary reason for that trust. Instead, their trust in federal health agencies was based totally on their belief that these institutions follow science in developing their policies. People who trusted state and native agencies cited their direct, compassionate care.
The telephone survey, conducted in February 2022, surveyed 4,208 U.S. adults. The authors say their study is the primary to look at the attitudes that promote or undermine trust in public health authorities.
To put the info on trust in public health into perspective, information from doctors and nurses received the best levels of trust of all survey categories. Fifty-four percent of respondents said they trust doctors, and 48 percent trust nurses. These professionals top the list in almost every survey because they're perceived as professionally competent and compassionate, says lead study creator Dr. Gillian SteelFisher, senior scientist and associate director of world polling on the Harvard Opinion Research Center.
Scientists (44%) and pharmacists (40%) were also relatively trusted. The CDC (37%) and the National Institutes of Health (33%) got here next on the list. About 1 / 4 of respondents trusted their local and state health departments. For details about COVID-19, 42% of respondents trusted the CDC and a few third of them trusted state or local health departments.
Political influence suspected
Among the explanations given for low trust in public health agencies, essentially the most ceaselessly cited was perceived political influence on their recommendations and policies. About three-quarters of respondents with low trust in agencies cited this as a think about their attitudes. At least half of respondents cited private sector influence on agencies' recommendations and policies. This was cited more ceaselessly for the CDC than for other agencies (60% CDC vs. 53% state agencies and 48% local agencies). Too many conflicting recommendations was one more reason for low trust (73% for the CDC vs. 61% state agencies and 58% local agencies).
According to the study, the “policy-influenced” view could also be related to cases throughout the pandemic “in which the legal authority of authorities to prevent and control the spread of COVID-19 was transferred to elected officials.”
Without giving specific examples, SteelFisher says, “People want to see that an agency is using science, that it's making rational, logical, science-based decisions. It's not that some people say, 'I don't believe in science.' It's that what they consider to be scientific is different. [from what they’re hearing]and they are afraid that they will not know the truth.”
Health authorities need a “clear allocation of responsibilities” and should give clear recommendations to elected officials rather than allowing themselves to be pressured by them or others to “go in a certain direction.”
Media plays an important role
The news media and certain websites have contributed to this confusion by highlighting these controversies or spreading misinformation, she says.
“The measures surrounding COVID have been discussed within the media as being politically motivated,” she says. “Media coverage of the influence of politics reinforces this concern.”
The problem is not that people are not paying enough attention to the news surrounding COVID-19, she says. They have [plenty] of information, but the question is how much high-quality information is included in their mix.
“Clickbait headlines can encourage that attitude, and the algorithms behind people's news sources can push them in a certain direction. That contributes to a distorted portrayal of what's happening.”
The survey results also showed that many people were concerned about corporate influence on health policy, she says.
“This just isn't nearly COVID; it's a broader concern about drug and vaccine development. People need to know that there's an independent body making well-informed decisions and giving advice that's in the perfect health interests of the general public. People fear there's something else behind the recommendations and that results in a lack of trust.”
Agencies need to gain more public trust
Trust in the statements of public health authorities is critical to gaining public support in the fight against pandemics and other health emergencies, the study said. GillFisher pointed to the controversy over the CDC's changing recommendations on wearing masks. She noted that at the beginning of the crisis, much was unknown about how the COVID-19 virus is transmitted; as a result, there have been some well-publicized changes in the agency's recommendations on whether and where masks should be worn and what types of masks should be worn.
This should be taken for granted in a public health emergency where the scientific evidence is constantly changing, she said. But when public trust is lacking, “there may be an inappropriate perception that policy is inconsistent,” she noted. That's also difficult for the media landscape, and there are outlets that take advantage of that as well.”
How it goes on
The paper incorporates some recommendations on how health authorities can construct public trust in the longer term. These include the next:
- Make it clear that the communication of scientific information to authorities and the general public comes from health authorities, not elected officials.
- Explain how agency decisions are based on science, in order that changes in policy or recommendations will not be seen as contradictory but relatively as a response to latest evidence.
- Adapt your communications approaches to specific segments of the general public based on their trust levels.
- Use the influence of doctors and nurses, who're more trusted than government agencies, to speak public health messages to your patients.
The time is true to implement these strategies before the subsequent pandemic, says SteelFisher. “Everyone is exhausted right now, so it's hard to think about it. But it's the right time and we've learned some lessons.”