Conflicting health advice from authorities causes confusion, research shows, but doctors remain the most trusted

Distrust of health experts and gullibility in the face of misinformation can be deadly. For example, during the COVID-19 crisis, high-profile health experts received death threats, while misinformation went viral on social media. And long before the pandemic, easily preventable but potentially serious diseases were making a comeback around the world due to vaccine hesitancy – often driven by conspiracy theories.

But what fuels this lack of trust in reliable sources of health information? Can it perhaps be mitigated? Those are the topics of a new study in Frontiers in medicine by researchers from the US.

“Here we show that individuals who experience conflict between experts over health recommendations, and who perceive that recommendations are constantly changing, have significantly less trust in health information provided by government health agencies,” says Dr. Arch Mainous, professor at New York University. Florida in Gainesville, and senior author of the article.

Nationally representative sample

Mainous and colleagues analyzed responses from 5,842 women and men over the age of 18 to the Health Information National Trends Survey, which collects information on how the American public uses various communication channels to obtain cancer-related health information. Due to stratification, clustering, and weighting of subgroups within the broader population, this sample is believed to represent approximately 242 million people, or 93% of the U.S. adult population.

The survey assessed trust in different types of medical experts by asking, “To what extent would you trust information about cancer from a doctor, government health organization or scientist?” The answers to this and follow-up questions were on a four-point Likert scale.

It measured perceived uncertainty with two questions: “How often do expert health recommendations appear to change over time?” and “How often do expert health recommendations seem to conflict or contradict each other?”

One final question: “How much of the health information you see on social media do you think is false or misleading?” focused on respondents’ trust in social media as a source.

A lot of trust in doctors

The results showed that doctors were the most trusted source of information, with 95% of respondents reporting high levels of trust in them. High levels of trust were less likely to be felt towards scientists (84%) and government health agencies (70%), and least towards social media (18%).

The minority who found social media trustworthy seemed a somewhat special group: for example, they had slightly but significantly less trust in doctors (92%) than their peers in terms of age, gender, race, total annual income and education.

Importantly, people who noticed that recommendations often changed or were contradictory reported significantly less trust in scientists and health authorities compared to their peers. In contrast, their trust in doctors was not affected by their perception of uncertainty. These results imply that the process of scientific discovery, with its inevitable disagreements and changes in expert consensus, appears to be confusing to the general public.

“As our scientific and medical knowledge is constantly changing, this leads the public to question the expertise of government health agencies and brings to the fore perceptions of political considerations in drafting the recommendations,” Mainous concluded.

Restoring trust

Fortunately, given that physicians are still highly trusted, the results immediately suggested a path forward: harnessing the power and trust inherent in the patient-physician relationship, ensuring better health and rebuilding trust in public health authorities.

“Government agencies must continue to provide patient education, which is an integral part of public health. However, they should focus more on ensuring that individual physicians, rather than, say, the agency’s director, are the ones to disseminate the agency’s recommendations to patients. ”, advised Mainous.