Guiding Public Health Communications in a New Era: Dynamic Measures of Public Trust

Trust is essential for US public health agencies, and measuring it is a key strategy for communicators to understand audiences and tailor messages. However, major shifts in the political environment are limiting the utility of traditional, unidimensional trust measures, as trust levels no longer align cleanly with attitudes and behaviors.

To examine novel trust measures that may produce more insightful segments for public health communicators.

Nationally representative, probability-based survey (online/telephone).

A total of 3343 US adults, aged 18 years and older.

The survey measured (1) trust in public health agencies at the start of the Trump administration (a great deal, somewhat, not too much, not at all) and (2) anticipated changes in trust under new leadership (trust more, the same, or less).

Combining these measures yielded new public trust segments: Losing Trust (40%), Unchanged Trust (21%), Growing Trust (17%), Switching Trust (12%), and Never Trust (11%). Each segment had a distinct attitudinal profile. For example, those Losing Trust felt the most positive about past public health agencies (>85% agreement with positive statements) and were least likely to report feeling judged during COVID (24%), whereas those Switching Trust felt the most negative (>85% agreement with negative statements) and felt the most judged (59%). Other segments had more nuanced views. Further, although those Losing Trust and Switching Trust aligned clearly with political party (Democrat and Make America Great Again/Republican respectively), those with Unchanged and Never Trust shared perspectives across party lines.

Multidimensional, dynamic trust measures produce practical insights for communicators by revealing audience segments that have coherent attitudes about public health without relying on a partisan lens or common, media-based stereotypes. This new approach can enhance communication by showing variability and commonalities in attitudes and emotional response across segments and underscoring the value of empathy in communication.