Trust in the United States has declined to its lowest level since the Edelman Trust Barometer has conducted its annual survey among U.S. adults. Welcome to America in Crisis, as Edelman brands Brand USA in 2018.

In the 2018 Edelman Trust Barometer, across the 28 nations polled, trust among the “informed public” in the U.S. “plunged,” as Edelman describes it, by 23 points to 45. The Trust Index in America is now #28 of 28 countries surveyed (that is, rock bottom), dropping below Russia and South Africa.

“The public’s confidence in the traditional structures of American leadership is now fully undermined and has been replaced with a strong sense of fear, uncertainty and disillusionment,” Edelman observes.

Government had the steepest decline (14 points) among the general population. Fewer than one in three believe that government officials are credible.

So who do we, the public, trust?

By industry sector, we trust technology, education, professional services, and transportation. We, the public, least-trust financial services, consumer packaged goods, and the automotive sector.

By country, the highest trust is for companies located in Canada (thank you, Prime Minister Trudeau), Switzerland, Sweden, and Australia. Least trusted nations for company HQs are Mexico, India, Brazil, and China. The U.S. is in the middle between most-and-least trusted, with 50% of the public trusting companies headquartered in America — a decline of 5 points since 2017, the largest fall of the countries surveyed.

By persona, who do we trust? Not our peers or people-like-us, as much as we used to. This year, we most trust technical and academic experts as the most credible spokespeople. “Credentialed sources are proving more important than ever,” Edelman found.

Health Populi’s Hot Points: In the U.S., “the biggest victim has been confidence in truth,” Edelman concludes. Richard Edelman, the company’s President and CEO, believes, “The root cause of this fall [in trust] is the lack of objective facts and rational discourse.”

Every year here on Health Populi, I assess the Edelman Trust Barometer’s health and health care implications. Back in 2012, the U.S. public trusted government much more, and social networks and people-like-me influenced our health and healthcare as a trusted source.

This chart on trust by industry sector illustrates that peoples’ trust in healthcare eroded by two percentage points over last year.

This year, health/care stakeholders have much to learn from the study. On the upside, it’s technical and academic experts who hold the most trust equity with consumers, even beyond peers (and collective social networks and platforms). Healthcare can leverage researchers (say, at pharma and life science companies), physicians and nurses (working in healthcare provider organizations), pharmacists (in retail pharmacies), and front-line nurse practitioners and clinical professionals in ambulatory care settings. At health plans, CEOs and leadership must bolster trust — and can — based on the Edelman Trust Barometer’s finding that 64% of the public believe CEOs should lead and not wait for government to mandate.

Technology is the most-trusted sector in 2018 — and healthcare has much to gain by modernizing the sector, going beyond the EHR implementations that have slowed down and physician productivity and burnt out their human capital and spirits based on the most recent Medscape physician survey.

Edelman has some recommendations for the biggest national “trust losers,” led by the United States, illustrated in the last chart. The five pillars are good advice for health/care:

  • To guard information quality (based on evidence-based medicine and sound clinical research);
  • To protect consumers (by reducing medical errors, harm, and healthcare disparities, right-sizing healthcare services, and shielding people from the financial toxicity of high healthcare costs);
  • To safeguard privacy, ensuring consumers’ HIPAA rights in the U.S. for privacy and security, guarding against cyber-attacks on personal health information, and demonstrating the highest level of data stewardship on behalf of health citizens;
  • To drive economic prosperity in communities, paying fair wages, supporting and respecting health care human capital; and,
  • To innovate.

All stakeholders, public and private sector, “will need to work together to find a new foothold with the public, one that is firmly grounded in a commitment to truth.” Edelman advises overall. Certainly, this advice is well-crafted for health/care in America.