Quick Take: How Can Public Health Rebuild Trust?

Lack of trust in public health institutions existed long before COVID-19, but the pandemic exposed deep fault lines in the public’s faith in global and national health leadership. In the face of widespread vaccine skepticism and vocal politicization of public health responses, how can health leaders lead?

Jack Leslie, a visiting scholar with the Duke Global Health Institute and Duke’s Margolis Center for Health Policy, says that question comes down to three Cs: community, communication and competence.

“The research shows, and common sense would tell you, that trust really begins at home. It begins in local communities,” Leslie says in this Quick Take video. In this excerpt, he describes how health leaders can do better in two of those facets – community and communication – to restore public trust in their leadership.

Leslie, a veteran strategic communications executive and former chair of DGHI’s Board of Advisors, is leading an international effort to understand the crisis of distrust in public health. In November 2022, he helped convene a week-long meeting of global health leaders at the Rockefeller Foundation’s Bellagio Center to brainstorm strategies to reverse the trend.

One key recommendation from the group is to empower respected local figures, including doctors and faith leaders, to engage in direct conversations with people in their communities. But it’s equally important for those leaders to have a clear, coherent message, Leslie says.

While that didn’t always happen during the COVID-19 pandemic, Leslie cites Mandy Cohen, M.D., the former North Carolina secretary of health and human services who now leads the U.S. Centers for Disease Control and Prevention, as a leader who built trust through consistent, direct and empathetic communication.

“Coming out of the pandemic, I think there’s a real opportunity to learn lessons from what we went through with COVID and to do a much better job of building trust,” Leslie says, adding that how many people line up for COVID and flu shots this fall may be one of the first indications of whether that message is gaining traction.