Rebuilding trust in public health: Authenticity matters
With information overload, short attention spans and growing division, Gillings faculty work to rebuild trust between public health and the people it serves.
Public health is everywhere, every day — yet Americans’ trust in it continues to wane. In a world where information overload, TikTok-length attention spans, and division and insularity collide, UNC Gillings School faculty hope to strengthen the bonds of trust between the field of public health and the residents it aims to serve.
“There’s a general increased distrust in institutions: People feel that they’re very separate from them, that they’re out of touch,” said Professor of Nutrition Lindsey Smith Taillie, PhD, one of several faculty members working on ways the Gillings School can improve trust. “We’ve moved too far apart — and that’s where misinformation can flow, because we’ve lost that connection.”
Technology, both as a source of information and a substitute for human connection, is a key factor. Even people who are not active technology users can be influenced by friends and family who are, said Alessandra Bazzano, PhD, MPH, chair of the Department of Maternal and Child Health.
We have to go beyond sharing health information and start telling stories, because stories are what social media is all about. We have to connect on values.
Bazzano created a course to examine how different technologies and platforms can shape the spread of information and misinformation, and the commercial or political motives behind certain posts or reels. The class explores how to leverage social media, AI and other tools not just to help sort out good information from bad but to better connect with others.
“Public health officials need to be more engaged online. That’s where everybody is increasingly going for their health information,” she said, but the conversation can’t just be about health. “We have to go beyond sharing health information and start telling stories, because stories are what social media is all about. We have to connect on values.”
Shared values and trusted relationships often lie within community groups and places of faith. A new course taught by Karl Johnson, PhD, assistant professor of public health leadership and practice, and Kim Ramsey-White, PhD, associate dean for well-being and associate professor of public health leadership and practice, aims to help students better understand the role faith communities play in public health.
When he’s not teaching, Johnson works with Granville County’s health department. One of his projects is Faith in Mental Health, a collaborative initiative that helps churches address community mental health needs and substance abuse issues. “We often depend on technical expertise to solve problems, but the evidence-based techniques we use in public health exist within a culture of nontechnical relationships: relationships of care, embodiment and presence, where you don’t just solve problems,” he said. “The crisis in trust is that we’ve overstepped in terms of how far our technical expertise can lead us. Interpersonal relationships and authentic trust-building require time and sacrifice. There’s no shortcut.”
Trust and technical expertise go hand in hand, especially when dealing with public health threats where unverified or changing information can put people at risk. John Wallace, PhD, MSPH, and John Wiesman, DrPH, MPH, co-directors of the Region 4 Center for Public Health Preparedness and Response, are supporting strategic planning to address rumors and misinformation as part of a Centers for Disease Control and Prevention-funded effort to strengthen public health preparedness and response across states in the southeastern U.S.
One of the most effective approaches, they found, is for agencies to build relationships with community organizations and local leaders who can help tackle rumors and make sure the right information reaches those who need it. “The community needs to trust the messenger, but the messenger also needs to trust the system they are advocating for,” said Wiesman, professor of the practice in health policy and management.
Their goal is for agencies to incorporate evidence-based protocols into their preparedness and response plans. “If you have a plan, you have these standardized processes and protocols built in,” said Wallace, senior data advisor for the N.C. Institute for Public Health. “When a public health threat occurs, you use those protocols and work through your trusted community contacts.”
While community and personal relationships are more common in practice, they’re essential in research, said Stephanie Wheeler, PhD, MPH, Michael S. O’Malley Distinguished Professor of health policy and management and associate director of the UNC Lineberger Comprehensive Cancer Center’s Office of Community Outreach and Engagement.
“You can’t do public health effectively if you’re not engaged in personal relationships to identify what the right research question should be, and to really listen and be responsive throughout the entire process,” Wheeler said. “And once we have results, they need to be returned to the community that is experiencing the problem. That is a really important element to the science.”
Schoolwide discussions about how the Gillings School can lead in trust-building are preliminary. But to break through the bots, algorithms, and social and cultural bubbles to truly connect with people, public health must change how it operates online and in real life.
“It’s not just teaching someone how to write a scientific manuscript anymore. It’s: How do you talk to communities in a meaningful way and understand the needs they have and do work that speaks to them?” Taillie said. “I have faith that if we can create shared spaces where we’re actually together, we can change things.”
