Nearly half of Americans don’t trust CDC and FDA — that’s a problem

As we (hopefully) see the light at the end of the COVID-19 pandemic tunnel, America appears to have a major problem. In a new survey released this week by the Harvard TH Chan School of Public Health and the Robert Wood Johnson Foundation, we found that America has a trust gap when it comes to public health. 

We found that most Americans want to spend substantially more money on public health at the federal level and have a very high level of appreciation for the field. But at the same time, the public has extraordinarily low levels of trust in the institutions that lead this field and in the current performance of the public health system.

In the middle of this public health crisis, we found that nearly half of Americans do not have high trust in the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA) or other major public health organizations when it comes to recommendations they make to improve health. And among Republicans, trust is even lower — only about a quarter say they have high trust in the CDC (27 percent), FDA (26 percent), or their state health departments (22 percent). 

Beyond trust, only about one-third of Americans (34 percent) give positive ratings to the nation’s current system for protecting the public from health threats and preventing illness, down from 43 percent in 2009. We found 65 percent of Americans rate the nation’s public health system as fair or poor, which is concerning in the middle of a pandemic. At the same time, Americans have increased their approval rating of the U.S. medical care system during the COVID-19 pandemic, and physicians and nurses remain as the highest sources of trust for information to improve health. 

We documented these low levels of trust a year into the COVID-19 pandemic, a time period when Americans collectively discovered it is significantly better to stay out of the ICU and take measures to prevent getting COVID-19 rather than be treated for it. Expanded interest in preventing illnesses has benefits for the field of public health, as a large majority of Americans believe the activities of public health agencies are very important to the nation’s health, and there is broad support for substantially increased federal funding in public health. 

However, low levels of trust are related to how Americans are interpreting what is going on with the COVID-19 pandemic, how it affects their everyday lives and what the science is actually saying about the state of the outbreak.

Low levels of trust and political polarization have made moving ahead on these critical issues extremely difficult. When looking at these polarized views around public health, it is important to recognize that part of this situation reflects the overall trends in American life, where political parties are divided on many issues, and a large share of the public doesn’t trust the media as a reliable source of information, irrespective of what the facts may be.

In our poll, about one-third of Americans (32 percent) said they think the information provided by their state health departments about the health of people in their state is unreliable, which is a problem if agencies expect a large share of people to change their health behaviors based on information provided by state health departments.

And the implications for the future are clear — you cannot improve the public health system, even with more funding, until you find a way for the public to trust these institutions and the people who lead them.

Restoring public trust will be very difficult. But as we see the light at the end of the COVID-19 pandemic tunnel, we need a way to make sure that in the future, these issues are not polarized by partisan politics.

To do this, we believe that it’s going to require a series of bipartisan committees and commissions at the federal, state and local levels to examine the performance of their public health agencies, and how they interacted with the public during this pandemic. Specifically, these activities have to reach out to the broader public to understand their views on why they have become so distrustful.

Again, we recognize that this will be very difficult to accomplish, but there is a need for public agencies and media organizations to more carefully examine how they interpret the science, particularly when it is changing over time, and how to present it to their audiences so it is seen as credible.

Robert Blendon, ScD, is a professor of Health Policy and Political Analysis, emeritus, at the Harvard TH Chan School of Public Health and is the Executive director of the Harvard Opinion Research Program.

Mary Findling, Ph.D., is the assistant director of the Harvard Opinion Research Program at the Harvard TH Chan School of Public Health.