The Importance of Trust in Health Literacy
Trust is the foundation of health literacy. Without trust, even the most well-researched, evidence-based health information may be disregarded, misunderstood, or worse - used or shared in a way it wasn't intended.
Patients and the public are more likely to engage with health recommendations, seek medical care, and adhere to treatment plans when they trust the source of information.
Trust influences patient outcomes, policy adherence, and community engagement. When people believe in the reliability of health professionals and organisations, they are more likely to take preventive measures and engage in meaningful conversations about treatment choices. Conversely, a lack of trust can result in delayed care, increased health disparities, and resistance to public health initiatives.
Earning and Keeping Trust
Building and sustaining trust requires consistent effort. Here’s how health professionals and organisations can establish and maintain trust with their patients and communities:
1. Transparency – Clearly communicate the sources of information, potential risks, and the rationale behind medical decisions. Honesty, even when delivering difficult news, fosters credibility.
2. Empathy and Active Listening – Patients trust health professionals and organisations that listen to their concerns and acknowledge their experiences. Building rapport and showing genuine care enhances trust.
3. Cultural Competence – Respect diverse backgrounds and beliefs. Being inclusive and culturally aware improves relationships with patients from different communities.
4. Political Sensitivity – Health literacy should be safe to access for everyone, regardless of political beliefs. Being mindful of language and framing when discussing policies ensures that information remains inclusive and credible. Avoid partisan rhetoric. Instead, focus on the health outcomes for all communities to help maintain trust across diverse audiences.
5. Consistency – Trust is built through reliable, science-backed information that remains steady over time. However, consistency does not mean offering robotic, prefabricated or automated responses. It’s about delivering clear, thoughtful messaging while adapting to new evidence in a way that reassures rather than confuses. Sudden shifts without explanation can create uncertainty and compromise trust.
6. Community Engagement – Being involved in community initiatives and working alongside local leaders in a meaningful way helps reinforce a trustworthy presence.
7. Addressing Misinformation Respectfully – Instead of dismissing concerns, disrespecting or ridiculing, health professionals and organisations should engage in respectful discussions and provide evidence-based counterpoints.
How Trust Can Be Lost
Trust can be fragile and easily broken. When this happens it can impact your own, or organisational reputation and the public's trust in anything else you do. The following factors can contribute to losing public trust in health communication:
- Conflicting Information – Changing guidelines without clear explanations can make organisations appear unreliable and therefore untrustworthy.
- Lack of Accountability – Failing to admit mistakes and not updating outdated recommendations can damage credibility.
- Dismissive Attitudes – Ignoring or belittling patient or community concerns can alienate individuals seeking answers or reassurance.
- Political or Social Bias – Aligning too strongly with one ideology can make others feel excluded or disregarded. This in turn can lead to lack of trust in health professionals and organisations, and create barriers to accessing reliable health related information and services.
- Adopting a Lecturing or Dismissive Tone – When people feel they are being talked down to or criticised for their beliefs, it can create feelings of humiliation, fear, disrespect or rebellion. Even if you are not directly lecturing or dismissing them, if you do this publicly against someone who they respect, you can alienate individuals and reinforce resistance to the information being shared.
- Shutting Down Open Dialogue – Trust thrives in an environment where people feel heard. Dismissing respectful conversations—especially on complex or divisive topics—can make people feel excluded or silenced. When individuals believe their concerns are being ignored or disrespected, they may question the credibility of the information, or suspect that key details are being withheld.
- Avoiding Questions or Providing Unhelpful Answers – When people ask questions, they are often seeking clarity or reassurance. Deflecting, refusing to answer, or offering rehearsed, impersonal responses can make individuals feel unheard or increase their scepticism. A thoughtful, transparent response—even if the answer is uncertain—builds trust and credibility.
- Tokenistic Gestures - These often appear like insincere, tick box exercises that have no meaningful understanding or consideration to the people affected. These types of gestures can be perceived as undermining, insensitive and misinformed, eroding trust.
The Impact of Online Presence on Trust
The internet has revolutionised how health information is shared, but it has also created challenges in maintaining professional trust. Health professionals’ and organisational online presence—whether through social media, blogs, or public statements—can significantly influence how they are perceived.
Advocacy is essential, but it should be conducted in a way that does not alienate large segments of the population. For example, in the political landscape, many individuals passionately support or oppose policies being implemented by the Trump administration. These same policies were heavily featured in Trump's campaign promotions prior to the election. Many millions of people voted for him based on these policies, while millions also voted against him.
Health professionals and organisations who strongly criticise the Trump administration and their policies - implemented based on election promises, risk losing the trust of millions of people who voted for them. Similarly, those who offer support for these policies in a way that disregards different viewpoints, or without considering those who may be negatively affected by the policies, risk losing the trust of the millions who voted against them.
Should we stay quiet then?
No, not necessarily. But as a health professional or organisation in the public arena, aim to keep advocacy factual rather than emotional.
Instead of outright rejection or blinded support, frame advocacy efforts in a way that resonates with broader audiences. Demonstrate an understanding of how policies affect not only those you are advocating for, but those with a different viewpoint belief or need. Offer solutions, not only for those you are advocating for, but also those who may be harmed or distressed by your policy or viewpoint.
Rather than attacking a policy or leader, focus on the positive impact of alternative approaches. For instance, rather than criticising healthcare funding cuts - do your research, create a business case and advocate for sustainable funding models that avoid waste, promote efficiency and benefit everyone.
Advocating Without Alienating
To effectively advocate while maintaining trust across diverse communities:
- Stay Solution-Oriented – Instead of focusing on what is wrong, propose actionable solutions.
- Engage in Civil Discourse – Respectful conversations can enhance understanding, even in disagreement.
- Acknowledge Different Perspectives – Recognising valid concerns of various groups makes advocacy more inclusive.
- Use Neutral Language – Avoid polarising rhetoric to keep discussions open and constructive.
- Be humble - We are all human and can make mistakes or miss an important consideration. If someone raises a concern or point you hadn't considered or given attention to previously, be open to discussing further and finding mutually beneficial solutions. If someone else has missed a point, raise it with them in a respectful manner, and thank them for taking the time, and considered effort to address it.
Conclusion
Trust is the cornerstone of health literacy. By enhancing credibility through transparency, empathy, and inclusivity, health professionals and organisations can ensure their messages are heard and respected. Online presence and advocacy should be handled with care, as trust can be fragile, and loss of trust can have a ripple effect resulting in long-term avoidance of your information and services. By advocating respectfully and engaging all perspectives, we can support important health initiatives while maintaining trust across diverse communities.