Re-Building Trust: What Higher Education Can Do When Public Health Confidence Is Waning

A concerning trend has emerged over the past several years: the erosion of trust in our public health systems.¹ Magnified during COVID-19, this began with a profound anti-vaccination movement, now continuing into the dismantling of existing public health infrastructure.

This trend presents many challenges for higher education professionals supporting student health and well-being, as the field relies on strong public health partners, and student populations may reflect the same lack of trust in health leadership.

To address the decreasing faith in public health, it’s important to explore 1) why trust in public health is under pressure, 2) the implications for college health settings, and 3) what higher education institutions and health insurers can do to instill and sustain trust.

Why trust in public health is under pressure

There are several interlocking reasons that confidence in public health institutions is declining.

Declines in institutional trust

Trust in public health doesn’t exist in isolation — it mirrors broader trends in institutional trust. For example, historically, Americans have gradually lost faith in government and large institutions, including the health system sector.²

Pandemic-era disruptions and communications challenges

The COVID‑19 pandemic exposed many stress points: rapidly changing guidance, politicization of health messages, and an explosion of social media commentary and disinformation.

A recent analysis describes the “crisis of trust” in public health as rooted in “political, social, economic, and communications trends.”³ A poll from the Kaiser Family Foundation found that trust in the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and in state/local agencies has dipped considerably since June of 2023.⁴

Misinformation and transparency deficits

Mistrust is further fueled by perceptions that public health agencies may be influenced by politics, industry, or may not communicate clearly. Studies show misinformation via social media attacks public health agencies’ reputation and amplify skepticism.⁵

Equity, access, and past harms

Trust in public health can vary across communities. Lower trust is reported in certain demographic groups, such as lower income, rural residents, younger age groups, and those with less education.⁶ There is a legacy of past public health failures and systemic inequities that still shape how communities perceive current health guidance.²

Taken together, the weakening public trust in public health institutions is not surprising, nevertheless, has real and severe consequences.

Why this matters for college health

What does this mean in the context of higher education? As professionals in student health, we should pay attention to several implications.

Student willingness to engage

If students distrust public health guidance, whether from the institution, state, or national agencies, they may be less likely to follow vaccination, screening, engagement with mental health treatment, or preventive care recommendations. The erosion of trust thereby undermines our preventive and population health efforts.

Campus polarities and communication dynamics

College campuses reflect generational, cultural, and political diversity, all of which intersect with trust dynamics. Younger adults (Gen Z) report lower levels of institutional trust in some sectors, meaning our communications and programs must account for the fact that our audience may come in with skepticism or with prior negative perceptions of public health.⁶

Risk of health-equity gaps widening

If trust is lower in certain groups (e.g., students from marginalized backgrounds), then those students may engage less with health services, in turn exacerbating disparities. Promoting health and well-being on campus includes ensuring equitable access and built trust for all students.

How to instill and rebuild trust in higher education

Given this landscape, what actionable steps can campus health services take? Here are several strategies.

Prioritize transparency and communication

• Make sure that public health guidance shared with students is clearly explained: not only what the recommendation is, but why it matters, what evidence underlies it, and what uncertainties remain.
• Engage in two-way communication: provide forums, Q&A sessions, and town halls where students and staff can ask questions. This builds relationships with trust.
• Avoid overly paternalistic framing (“do this because we tell you”) — instead, emphasize partnership and empowerment.

Localize and personalize the public health message

• On a campus, students often know and trust their health center, student health providers, and peer health educators more than distant agencies. Leverage that trusted messenger rather than relying only on national institutions.
• Tailor messages for sub-populations — international students, commuter students, graduate students, first-gen students — acknowledging their specific needs and concerns.
• Use data on campus (claims data, student health utilization) to show how preventive efforts matter for this community — making the abstract concrete.

Build institutional trustworthiness and credibility

• Demonstrate fairness by ensuring that health services are accessible; that advice is equitable, and that no group is left out. As the AAMC trust-analysis found, institutions that are perceived to serve everyone fairly are more trusted.⁶
• Be consistent; a campus health program that shifts course too often without explanation can undermine trust. When guidance changes (and it will), explain why the change happened (new evidence, changed risk context) rather than simply issuing a new directive.
• Provide opportunities for students and staff to give input into health policy decisions. Shared governance builds buy-in and trust.

Leverage data wisely

• Use data to demonstrate the value of prevention and early intervention in terms that matter to students and campus leadership (e.g., fewer missed classes, lower stress, cost savings, healthier community).
• Report outcomes transparently, share how much preventive care uptake has increased, how students’ health metrics improved, and how campus outbreaks (if relevant) were mitigated to build credibility.
• Partner with campus health leadership and public health agencies to co-present findings and recommendations — showing alignment rather than siloed communication.

Address misinformation proactively

• Recognize that we operate in an environment of competing information (social media, peer networks). Provide regular “myth vs. fact” communication tailored to the student audience.
• Facilitate media literacy and health literacy efforts on campus, training peer health educators, hosting workshops, and collaborating with student activities.
• Highlight credible sources and contextualize them for the student audience: what the source means, how to evaluate it, how to apply it.

Takeaway

As for those of us working in higher education, we are in a privileged position to help rebuild and reinforce trust in public health at the micro level of our campuses. The erosion of trust in broader public health institutions presents real challenges, but also real opportunities to serve as the bridge between large public health systems and the lived experience of students and campus communities. By emphasizing transparency, localizing messages, leveraging data thoughtfully, and addressing misinformation head-on, we can help our institutions not only maintain student health but also become high-trust environments for health engagement.

I look forward to continuing this conversation and exploring how we might integrate some of these strategies into our upcoming webinar series on using claims data in population health for higher education.

References

1. Melchinger, H., Omer, S. B., Malik, A. A. (2025, June 26). Change in confidence in public health entities among US adults between 2020-2024, PLOS Global Public Health, 26;5(6):e0004747. doi: 10.1371/journal.pgph.0004747. Accessed on November 12, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12200701/
2. Blendon, R. J., Benson, J. M. (2022). Trust in Medicine, the Health System & Public Health, Daedalus. Accessed on November 12, 2025. https://www.amacad.org/publication/daedalus/trust-medicine-health-system-public-health
3. Leslie, J. (2023, February 14). The Crisis of Trust in Public Health, Think Global Health. Accessed on November 12, 2025. https://www.thinkglobalhealth.org/article/crisis-trust-public-health
4. Kearney, A., Sparks, G., et al. (2025, January 28). KFF Tracking Poll on Health Information and Trust: January 2025, KFF. Accessed on November 12, 2025. https://www.kff.org/health-information-trust/kff-tracking-poll-on-health-information-and-trust-january-2025/
5. Ahmed, N. (2025, June 27). Social media attacks on public health agencies are eroding trust, Science. Accessed on November 12, 2025. https://www.science.org/content/article/social-media-attacks-public-health-agencies-are-eroding-trust
6. Mendez, I., Alvardo, C. S., Alberti, P. M. (2025, February 18). Trust Trends: U.S. Adults’ Gradually Declining Trust in Institutions, 2021-2024, AAMC Center for Health Justice. Accessed on November 12, 2025. https://www.aamchealthjustice.org/news/polling/trust-trends

WFSTU-251099