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Poll Finds Public Health Has A Trust Problem

May 12, 2021
Originally published on May 13, 2021 11:10 am

"I don't trust them — I don't," says Sandra Wallace. She's 60 and owns a construction company in Arizona. To her, the Centers for Disease Control and Prevention's guidance has been inconsistent.

"It's all over the board," she says. "They say one thing one minute and then turn around and say another the next minute."

Wallace was one of the respondents in a poll published Thursday by the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. The survey of 1,305 people was conducted from mid-February to mid-March of this year. The foundation funds coverage of health and health care on NPR.

Overall, the poll found that only 52% of Americans have a great deal of trust in CDC. Other health agencies were even lower — only 37% of Americans said they had a lot of trust in the National Institutes of Health or the Food and Drug Administration.

"We're in a period of distrust of government in general," notes Robert Blendon, emeritus professor at the Harvard Chan School, who oversaw the survey. "If we substituted the FBI for the CDC, it would not do a lot better."

The poll found that trust isn't just a problem for federal health agencies. State health departments have the trust of 41% of Americans, and local health departments only did slightly better at 44%.

Trust in public health during a pandemic is incredibly high stakes. Public health measures — like mask wearing and business restrictions — can't work as intended to contain a pandemic if the community doesn't believe they're based on reliable information.

If that trust is not there, people won't agree "to change their lives, take preventive [measures], take vaccines," Blendon says.

The mistrust is not really surprising. There have been plenty of missteps throughout in the past year, due to everything from political interference, to incomplete information, to confusing messaging.

One person who's frustrated by all this is the senior senator from Maine, Susan Collins.

"I used to have the utmost respect for the guidance from the CDC," she told CDC Director Rochelle Walensky at a congressional hearing this week. "I always considered the CDC to be the gold standard. I don't anymore." Collins cited issues with CDC's guidance on school reopening, mask-wearing and summer camps.

Walensky aggressively defended her agency and its guidance, point by point. On summer camp guidance, for instance, Walensky described her 16-year-old son counting down the days to camp this year, until she told him he couldn't go. "I want our kids back in camp," she said. "The camp guidance is intended to get our kids to camp and allow them to stay there."

Walensky was appointed by Democratic President Biden and Collins is a Republican. The political divide that has been a hallmark of the coronavirus pandemic was evident in the results of this poll — 27% of Republicans greatly trust CDC, compared to 76% of Democrats.

This poll doesn't dig into the reasons why respondents don't trust public health agencies, or what could be done to regain their trust. But, Blendon says, that's critical for health officials to figure out — both as a means to navigate the country through the end of this pandemic, and to prepare for the next one.

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RACHEL MARTIN, HOST:

OK, Americans know what public health is, and they think it's important. They think it should be well funded. But they don't trust what public health groups are telling them. This is the result of a new poll from the Harvard T.H. Chan School of Public Health and the Robert Wood Johnson Foundation, which we should note is an NPR funder. NPR health policy reporter Selena Simmons-Duffin has more.

SELENA SIMMONS-DUFFIN, BYLINE: Public health has a problem.

SANDRA WALLACE: I don't trust them. I don't.

SIMMONS-DUFFIN: That's Sandra Wallace in Arizona, one of the respondents to the survey.

WALLACE: It's all over the board, right? They say one thing one minute and you turn around and say another the next minute.

SIMMONS-DUFFIN: Wallace has company. Overall, the poll found that only 52% of Americans have a lot of trust in the Centers for Disease Control and Prevention. Other health agencies were even lower. Only 37% of Americans said they had a great deal of trust in the National Institutes of Health, same for the Food and Drug Administration.

ROBERT BLENDON: We're in a period of distrust of government in general. If we substituted the FBI for the CDC, it would not do a lot better.

SIMMONS-DUFFIN: That's Robert Blendon, emeritus professor at the Harvard Chan School, who oversaw the survey. So there's a context of mistrust in government. And maybe you're thinking this is just about public health at the federal level. Maybe people are more likely to really trust their local or state health department.

BLENDON: And even then, the state is 41% and a third said they don't trust the data from the state health department.

SIMMONS-DUFFIN: Trust in public health during a pandemic is incredibly high stakes. Public health measures and restrictions can't work if the community doesn't believe they're reliable and defies them. Without that trust...

BLENDON: You can't ask people to change their lives, take preventions, take vaccines.

SIMMONS-DUFFIN: That's true for Wallace, the survey respondent.

WALLACE: As far as the vaccination, I'm not going to get it, not until it's been approved.

SIMMONS-DUFFIN: When a vaccine has full FDA approval, she says she'll get it. This mistrust is not really surprising. There have been plenty of missteps throughout the year due to everything from political interference to incomplete information to shoddy messaging. One person who's frustrated by all of this is Maine Senator Susan Collins.

(SOUNDBITE OF ARCHIVED RECORDING)

SUSAN COLLINS: I used to have the utmost respect for the guidance from the CDC. I always considered the CDC to be the gold standard. I don't anymore.

SIMMONS-DUFFIN: That was Collins confronting CDC Director Rochelle Walensky at a congressional hearing earlier this week. She cited CDC's guidance on school reopening, mask wearing and summer camps. Walensky aggressively defended her agency and its guidance point by point.

(SOUNDBITE OF ARCHIVED RECORDING)

ROCHELLE WALENSKY: For our school guidance, we did that with 50 different stakeholders - over 50 actually. I personally engaged with both parents and teachers.

SIMMONS-DUFFIN: Walenskey was appointed by Democratic President Joe Biden. Collins is a Republican. The political divide that has defined this pandemic response was in full evidence in the results of this poll - 27% of Republicans greatly trust CDC compared to 76% of Democrats. Blendon from Harvard says that's concerning.

BLENDON: I don't ever remember other epidemics which were so politicized where party leaders had different views of what it is.

SIMMONS-DUFFIN: This poll doesn't dig into the reasons why respondents don't trust public health agencies or what could be done to regain their trust. That's critical for health officials to figure out, Blendon says, both as a means to navigate the country through the end of this pandemic and to prepare for the next one. Selena Simmons-Duffin, NPR News.

(SOUNDBITE OF NORTHCAPE'S "STATIC THEME") Transcript provided by NPR, Copyright NPR.