20 Apr Trust in Healthcare Is Not a Given Anymore. It Has to Be Earned.
That is not a provocative take. It is what the data shows.
A recent survey from the Civic Health and Institutions Project, covered in Harvard Medicine magazine, found that confidence in doctors and hospitals dropped from about 70% in April 2020 to just over 40% by April 2025. Trust in scientists and researchers fell from 58% to around 36% over the same period.
Five years. A 30-point drop. Among the institutions that people rely on most when their health is at stake.
This Is Not Just a Pandemic Problem
It would be convenient to frame this as a COVID hangover, a temporary disruption that will stabilize as the memory fades. The researchers behind this project are not that optimistic, and neither is the data.
Roy Perlis, one of the principal investigators of the study and a professor of psychiatry at Harvard Medical School, points to something broader. The decline in trust in science and medicine is part of a wider erosion of trust in institutions generally. The pandemic accelerated it and made it visible, but the roots run deeper.
Misinformation played a significant role. So did shifting public health guidance that, even when scientifically appropriate, was experienced by many as inconsistency. And so did longer-standing grievances: the sense that healthcare is driven by financial incentives rather than patient outcomes, and experiences where something went wrong and the system did not respond in a way that felt honest or accountable.
As Perlis put it, a lot of people say they do not trust doctors in general, but they do trust their doctor. That distinction matters. Trust at the personal level can still hold even when institutional trust has collapsed.
What This Means for Care Delivery
Healthcare organizations cannot afford to treat declining trust as a perception problem to be managed through communications.
It is a structural problem that shows up in whether people engage with care at all. Whether they follow through on referrals. Whether they complete screenings. Whether they feel comfortable disclosing what is actually going on.
When trust is absent, engagement drops. And when engagement drops, outcomes follow.
The same CHIP50 research found that misinformation exposure and community context are among the strongest predictors of trust levels. These are not things that a better FAQ page or a rebrand can fix. They reflect real experiences people have had, and real gaps between what healthcare promises and what it delivers.
Building Trust Into the Model, Not Bolting It On
Across care navigation and engagement work, the difference between programs that build momentum and those that stall often comes down to trust that was or was not built early.
When the first touchpoint feels transactional, it is hard to recover. When outreach feels impersonal or disconnected from how someone actually experiences their health, people disengage. When navigation is built around institutional convenience rather than individual context, it loses the people it was designed to serve.
The shift that is needed is not just operational. It is philosophical. From building healthcare systems for communities to building them with communities. From assuming that making care available is enough, to recognizing that people will only engage with care they trust.
At Muse Health, this shapes how we think about care navigation. Relationships matter. Consistency matters. Meeting people where they are, not where the system expects them to show up, matters.
A Signal Worth Taking Seriously
The CHIP50 data offers a complicated picture, but not a hopeless one. Support for funding medical research remains high across political affiliations, demographics, and geographies. People want healthcare to work. They want to trust the systems and providers caring for them.
The drop in confidence is not a verdict on medicine. It is a signal about the gap between what people need from healthcare and what they have experienced.
That gap is closable. But it requires taking the signal seriously, and starting to build trust in, not after, the design of care.
Reference
- Harvard Medicine Magazine — “Is There a Crisis of Trust in Science and Medicine?” (Fall 2025): magazine.hms.harvard.edu