COVID-19 pandemic significantly eroded American public’s trust in US public health institutions, assessment shows

Four discrete cross-sectional surveys of US adults from 2020–2024 reveal US adults reporting high confidence in the Centers for Disease Control and Prevention (CDC) dropped from 82% in February 2020 to a low of 56% in June 2022, according to a study published in PLOS Global Public Health by Amyn A. Malik and colleagues from UT Southwestern Medical Center, United States.

Surveys have shown the US public’s trust in public health entities has decreased since the COVID-19 pandemic reached the United States in 2020. This study is one of the first academic work to longitudinally assess US adults’ perception of health entities from 2020 to 2024.

From February 2020 to October 2024, the authors conducted four surveys of a census-matched sample of US adults (sample sizes were 718, 672, 856, and 828 respectively).

Surveys 1 and 2 asked questions on the COVID-19 pandemic, while surveys 3 and 4 asked questions around the 2022 and 2024 mpox outbreaks; all surveys also asked participants their perceptions of public health entities, who they thought should lead the US response to infectious disease outbreaks, and how they would rate their confidence in various public health entities.

The authors found a significant decline in mean confidence among US adults in health institutions, including the CDC, with respondents reporting high confidence in the CDC, dropping from 82% in February 2020 to a low of 56% in June 2022.

Reported high confidence in the National Institutes of Health (NIH), Department of Health and Human Services, state health departments, and professional medical organizations followed a similar pattern (dropping by 25%, 13%, 16%, and 26% respectively in the same time period).

Though confidence in their own doctor and local health departments also decreased in the early years of the pandemic, from February 2020 to June 2022, respondents’ confidence in their doctors and local health departments increased by 5% and 19%, respectively, from 2022 to 2024. High confidence in the White House increased from 29% in February 2020 to 39% by October 2024.

These results suggest local health entities, including personal doctors and local health departments, could play a key role in reestablishing trust in American public health institutions and interventions.

Co-author Hannah Melchinger adds, “Overall, Americans’ trust in public health entities has decreased since 2020—we need to take this decline seriously if we want to preserve the credibility of these entities and their public health recommendations.”

Senior Author Amyn A. Malik summarizes, “Even though overall trust in health care institutions has decreased, health care providers remain one of the most trusted sources of health information in the US. As trusted communicators, doctors, nurses, and other health care staff will play an essential role in rebuilding Americans’ confidence in their public health organizations.”