Experts from AcademyHealth, the University of Chicago, Emory University, and Yale University discuss why trust in science has declined in recent years, what can be done to restore that trust, and how thoughtful and effective science communication can help.
How Trust in Science Has Shifted Since 2020
The vast majority of the American public—about 75%—believe that scientists are acting in the public’s best interests. This level of confidence is substantial but has fallen since the early days of the COVID-19 pandemic. More than half of Americans trust individual doctors and government health agencies, but these levels have also fallen slightly since January 2024. Additionally, discussions in the media and conversations among individuals and communities often reveal a persistent level of distrust despite these reported high levels of trust in clinicians and scientists.
On December 9, 2025, the National Academy of Medicine’s Health in the Headlines series hosted a discussion—moderated by Michael F. Cannon, Director of Health Policy Studies at the Cato Institute and a public health and health care scholar —that brought together science and health policy leaders to discuss the state of public trust in science and medicine, how trust is lost and earned, and how scientists and clinicians can communicate more authentically and effectively with the communities they serve.
This article explores four key takeaways for health science communication best practices, how effective strategies today may differ from those in the past, and why these changes are necessary to build and rebuild trust.
There Are Many Reasons for Distrust—And Don’t Assume You Know What They Are.
Aaron Carroll, President and CEO of AcademyHealth and a nationally recognized science communicator and health services researcher, began the conversation by defining three levels of personal resistance to change—or, in the context of this conversation, resistance to following health-related guidance:
- I don’t understand it.
- I don’t like it.
- I don’t like you.
Carroll noted that traditional science communication has often assumed that only the first level needs to be addressed, and that people simply need more facts to understand why they should change their behavior. However, in every situation, there is likely a large group of individuals who do understand the issue, but simply don’t like the guidance, don’t believe it’s necessary, or have competing priorities that place another behavior above the one being recommended. Historically, traditional science communication practices have ignored these people. When individuals are ignored or feel talked down to, they begin to lose trust, and without trust as a foundation, knowledge dissemination backfires. For example, if a parent expressed hesitancy about a vaccine to their child’s pediatrician, the pediatrician, historically, may have reached for a printout explaining the factual benefits of vaccination or a pamphlet from the state health department rather than having a conversation with the parent to understand the values or narrative behind their hesitancy. There is an urgent need to engage with people who don’t like the guidance or don’t like the messenger—but understand the information—because without their trust, knowledge dissemination not only doesn’t work, but will often make things worse.
When engaging with these groups, Venkat Narayan, Professor at Emory University and internationally recognized for his multidisciplinary work in diabetes and translational research, warned against assuming or generalizing ideas about individuals and their beliefs. Just because an individual holds one belief doesn’t necessarily mean that they hold other similar beliefs—or dissimilar beliefs—as well. Listening to the person, hearing their concerns, and trying to understand their motivations is more important to ultimately successful communication than conveying any data.
Scientists and clinicians understand that science, as a process, never ends. However, more than 30% of Americans believe that the scientific process produces “unchanging core principles and truths,” so when new data emerges that causes existing scientific or medical guidance to change, those changes can create substantial distrust. When communicating about science and medicine, experts should be clear about what is known—and what isn’t known, which may be uncomfortable at first. However, trust is also lost when scientists and clinicians speak with a level of surety that does not match the available evidence—so being honest about issues where the evidence is less robust—could help rebuild lost trust.
“The American public wants science communicated to them. It would be a failure for scientists and clinicians to not actively communicate in ways that are intelligible and respect people’s intelligence.”
– Venkat Narayan
Scientists and Clinicians Must Understand How Their Biases and Values Affect Their Work
Scientists and clinicians bring enormous zeal to their work, and this fervor has led to numerous breakthroughs and improved care for individuals and communities. However, Narayan acknowledged, this passion can also make them feel that anyone or anything—including new data—that disagrees with their work is standing in the way of their mission. This inflexibility can harden their scientific or medical beliefs and make individuals unwilling to accept or integrate new information or viewpoints into their work. Scientists and clinicians must understand—and check in—with the biases and values they bring to their work, in order to produce the most neutral research possible, identify the most impactful issues to study, and know which battles are not worth fighting.
“We need to learn, when seeking truth, to separate passion from what the data are saying.”
– Venkat Narayan
The Key to Effective Communication is Listening—Not Speaking
The panelists agreed that effective science communication begins with listening: not just looking for an opportunity to rebut or reply to what the person is saying but deep listening to truly understand the person’s perspective. By listening, a relationship with that person, in which the scientist or clinician has demonstrated that they are also worth listening to, begins to build. Listening conveys respect, and respect is the foundation that trust is built on.
Listening also helps to build relationships with people who disagree—and these relationships are vital in beginning to rebuild trust and change the trajectory of public opinion about science and health.
“Building a relationship with people is more important as the initial step than convincing them that you’re right.”
– Harold Pollack
Disagreement Isn’t Bad—It May Be the Most Important Catalyst for Rebuilding Trust
The panelists agreed that living with, interacting with, and trying to understand individuals who disagree with you is critical to rebuilding trust—and emphasized that scientists and clinicians should actively try to disrupt their own echo chambers. Carroll stated that scientists and clinicians shouldn’t end relationships when people disagree with them or don’t do what they say—because the goal is trust, not “winning.”
Harold Pollack, Professor at the University of Chicago and researcher focused on improving services for individuals at the boundaries of the behavioral health and criminal justice systems, illustrated the benefit of relationships between individuals who disagree through the example of PEPFAR—the U.S. President’s Emergency Plan for AIDS Relief, which was mobilized by a collaboration between public health professionals and evangelical Christians and worked at every level of the health system to combat HIV and AIDS by providing prevention services, care, and treatment. Since HIV and AIDS emerged as a disease that primarily infected gay men—and evangelical Christians generally believe that homosexuality is a sin—the partnership between public health officials and evangelical Christians to jointly advocate for and support a program focused on caring for people with HIV and AIDS was a surprising one. However, evangelical Christians focused on how the program would care for vulnerable children and public health professionals focused on attempting to eradicate a communicable disease—and the resulting program saved more than 25 million lives since 2003. If, despite their deep differences, this improbable relationship had not existed, those lives would have been lost.
“It’s important to acknowledge that people are hearing conflicting evidence and are concerned about their families and communities. Don’t dismiss what people are observing with their own eyes and ears.”
– Megan Ranney
You Might Not be the Correct Messenger
Megan Ranney, Dean of the Yale School of Public Health and leading advocate for innovative approaches to public health, acknowledged that she and her co-panelists are likely not the best messengers for many science and health topics, noting that the best messenger is often someone who belongs to the community most impacted by the topic. As science and medicine slowly becomes more diverse—racially, ethnically, and across gender, socioeconomic status, and geographic location—trainees could be excellent liaisons for such communication, but scientists and clinicians also need to be open to partnerships with impacted communities. Identifying appropriate messengers is critical because an important goal of effective science communication is helping individuals understand the risks and benefits of an approach or intervention. A trusted messenger can contextualize scientific data with local value systems—which often drive individual risk and benefit calculations—much more adeptly than an outsider.
What scientists and clinicians say may also be less important than what they actually do. Ranney emphasized the value of showing up for the individuals and communities that scientists and clinicians are in partnership with. Showing up—again and again and again—can build trust in equal, and perhaps greater measures, than anything a person communicates verbally.
Beyond ensuring the correct messenger, the panelists also agreed that there are huge differences in how communication succeeds in different situations and audiences. There is no single way to communicate—effective methods depend on the situation, audience, topic, and other variables. However, Carroll emphasized that the best way to communicate science is just to go talk to people. He stated that too many people are searching for the perfect soundbite that will suddenly convince everyone to change their minds—and that such perfect descriptions don’t exist. Building trust can’t be scaled up—it is built through individual relationships over time.
“I resist the idea that we need to come up with pithy phrases to explain things. Some science is complicated, and we need more than a soundbite to answer the questions in ways that completely explain the issue and build trust.”
– Aaron Carroll
Rebuilding Public Trust in Science Is Slow and Hard
Panelists cautioned that this work, albeit crucial, will be lengthy and challenging. People have been looking for answers and frustrated with the information they have been given for a long time. Rebuilding trust is done by building and maintaining relationships, and relationships are not built in days or weeks—they require months and years of sustained effort to grow.
Pollack noted that one of the ways that you show people respect is that you are honest with them—and being completely honest is often hard. He encouraged scientists and clinicians to pursue honesty in their work even when their findings might be unpalatable—and consequently, for scientists outside of the published work to be more accepting of findings that might contradict their own. Being a trusted messenger means that people know you are going to give them a straight answer—not that you are going to strategically respond with data that only serves your own ends. Despite these challenges, panelists encouraged scientists and clinicians to stay in the work, roll up their sleeves, and actually talk to the people around them.
“There is no quick fix for solving this problem of trust. Even all of us together cannot flip a switch and change people’s trust of health information overnight.”
– Megan Ranney
Watch a recording of the full discussion about science communication and rebuilding trust below.
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Disclaimer
Statements, recommendations, and opinions expressed in the webinar and this document are those of individual presenters and participants. These views are not necessarily endorsed or verified by the National Academy of Medicine or the National Academies of Sciences, Engineering, and Medicine and should not be construed as reflecting any group consensus.
