A new national survey conducted by the Harvard T.H. Chan School of Public Health and the de Beaumont Foundation uncovers a deeper issue. With another transition in federal leadership, it’s no wonder that many Americans are concerned about the quality and trustworthiness of public health recommendations. The survey, titled “A View from 100 Days: Public Expectations about the Changing Public Health Landscape,” was carried out from March 10 to March 31, 2025, involving a representative sample of 3,343 U.S. adults aged 18 and older.
Overall, the results reveal a stark contrast in public trust towards health guidance issued by our nation’s federal health agencies. This is particularly the case for the Centers for Disease Control and Prevention (CDC). These insights could have far-reaching implications for public health policy and communication strategies as new leaders take charge of federal health organizations.
Survey Methodology
The survey used statistically sound measures to collect data. These involved measures like randomized geographic sampling, multi-wave contact efforts, repeated subsamples, and systematic selection of respondents with households. This sampling methodology helped to ensure that the final sample truly and accurately represents the increasingly complex and diverse demographic landscape of the United States.
The Harvard Opinion Research Program (HORP) project team includes Gillian SteelFisher, director of HORP and a principal research scientist at the Harvard Chan School. Mary Findling, managing director of HORP, is another key ingredient behind this highly energetic team. As SteelFisher pointed out, it’s important to know how the public thinks during these dramatic, leadership-shifting moments.
“New fault lines are emerging in trust for public health agencies.” – Gillian SteelFisher, director of the Harvard Opinion Research Program and principal research scientist at Harvard Chan School.
Public Trust in Health Recommendations
The survey found that 44% of respondents would have less faith in health recommendations. This distrust is a byproduct of the rapid turnover in leadership at our federal health agencies. Alarmingly, 30% of respondents reported they would have much less trust in these recommendations. 28% of respondents answered that leadership changes would improve their trust in recommendations. Yet just 10% said they’d trust them “a lot more.”
These statistics indicate a concerning trend for public health officials as they work to gain and maintain credibility with the American public. The survey highlighted the deep partisan divide. It’s huge, given that 76% of Democrats say they would lose trust in public health recommendations, and more than half of them—56%—say they’d lose “a lot” of trust. Fifty-seven percent of Republicans said they would lose at least a bit of trust. A mere 23% thought they would earn “a lot” more trust.
A whopping eighty-three percent of Democrats are scared that the CDC will go downhill under the incoming leadership. In comparison, just twenty percent of Republicans think it will do worse.
Trust Levels in CDC Recommendations
Despite an unknown future of leadership at the CDC, most U.S. adults still lean on the CDC’s general health recommendations. This trust is not uniform across the population. According to the survey, 77% said they trust CDC guidance. In particular, 38% said they trusted the CDC a great deal, and 39% said they trusted it some. These figures underscore a complex landscape where many Americans remain reliant on public health agencies even amidst concerns about leadership.
As leaders consider strategies for rebuilding trust in federal health recommendations, they may need to address these emerging divisions directly. As Gillian SteelFisher outlined at our summit, public health agencies have a difficult path ahead.
“More people are very concerned than very hopeful about what agencies will be able to do in the next few years and more anticipate losing a lot of trust rather than gaining it. This suggests that if leaders want to grow trust, the American people will need to see more effort to sustain public health capacity than what they’ve seen so far.” – Gillian SteelFisher, director of HORP and principal research scientist at Harvard Chan School.
Brian C. Castrucci, PhD, is president and CEO of the de Beaumont Foundation. He added depth to the debate about what public health priorities should be.
“Americans are more united than divided about the health issues they want the administration to prioritize.” – Brian C. Castrucci, president and CEO of the de Beaumont Foundation.
Implications for Future Public Health Leadership
It is essential that new leaders tackle ongoing public issues regarding trust and transparency. This is the only way to build public trust and confidence in health recommendations. Overall, the survey responses show extreme polarization. Leaders will need to adeptly maneuver this complex political terrain to bring together a diverse set of voices in support of timely public health priorities.
To restore public confidence, transparent communication and a clear commitment to bolstering our public health infrastructure will be essential. Building trust by actively involving communities in planning decisions and showing genuine intent to prioritize their priorities might ease fears about leadership changes.