CIDRAP-COMMENTARY: To regain trust in public health, untangle it from politics

[Lance]

COMMENTARY: To regain trust in public health, untangle it from politics

www.cidrap.umn.edu

COMMENTARY: To regain trust in public health, untangle it from politics​

Kevin Griffis

Today at 8:34 a.m.
Public Health

Anti-science


US Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. took office pledging to restore trust in the CDC and public health.

National Institutes of Health (NIH) Director Jay Bhattacharya, MD, PhD—one of his lieutenants—took it a step further. In the New York Times, Bhattacharya, who until recently also led the CDC (Centers for Disease Control and Prevention), said of his goal in strengthening trust in federal scientists: “It needs to be 100 percent. It’s not politics, where if I get 50 plus one, I’ve succeeded. If only 75 percent of the public thinks that the work that the N.I.H. does benefits them, it’s an utter failure.”

The latest data indicate that Kennedy and Bhattacharya have indeed failed—utterly.

The hole their successors will have to climb out of is deep.

Trust in the CDC, FDA is nosediving​

According to new Gallup survey data, the percentage of Americans who believe the CDC is doing a good or excellent job—a pretty clear indication of trust—has fallen to an all-time low: 26%, down an additional 5 percentage points from last year. The CDC and Food and Drug Administration (FDA) scored lowest among 12 federal agencies tested by Gallup. Their scores were lower even than survey results taken in 2021, at the height of Americans’ pandemic frustrations (40%).

Meanwhile, a spring Harvard Chan School of Public Health survey indicated that only 50% of US adults say they trust health recommendations from the CDC. That number was 77% in March 2025. The decline in both surveys reflects huge decreases among Democrats and Independents. For example, according to the Harvard survey, “trust in CDC health recommendations has fallen from 92% to 34% among Democrats and from 77% to 47% among Independents.”

Those numbers matter profoundly in public health. During an outbreak, the CDC can't physically compel someone to isolate, vaccinate, test, or avoid contaminated food. Public cooperation is part of the intervention. To make informed decisions about their health, it is vital that Americans trust what public health agencies say, especially in the event of a public health emergency.

A radical shift in HHS communications​

Many of the reasons for the decline are self-evident. Kennedy has supported policies that are unsupported by evidence, undermined vaccine confidence, fired all members of the CDC’s Advisory Committee on Immunization Practices without legitimate justification, and unilaterally issued new childhood immunization recommendations with little explanation.

There’s nothing to suggest that Kennedy will change tack to improve trust. So the challenge to restore confidence in federal health agencies will fall to his successor.

The hope is that if health authorities in a future administration execute their duties with quiet competence—helping to stop disease outbreaks with urgent action and proven strategies, collecting and disseminating timely data and information and making evidence-based immunization recommendations—it will begin to rebuild bipartisan trust and arrest the party-line survey volatility that is a real and present danger to Americans’ health.

But that’s not the only change that needs to happen.

The public voice of the agencies communicating Kennedy’s policies became politicized in unprecedented ways, especially on X (formerly Twitter). In a highly polarized political environment, that feeds partisan distrust and can help explain the further erosion of faith in the CDC and FDA.

There’s nothing to suggest that Kennedy will change tack to improve trust.

Prior to Kennedy’s arrival and across administrations, federal health agencies worked to maintain an independent voice and avoid statements and posts that might be considered overtly political. Admittedly, it’s a strange setup—one that doesn’t exist in the corporate environment. Imagine a company subsidiary—say, Instagram—refusing to post a message the corporate parent, Meta, wanted to see. But that’s exactly what happened in federal health agencies.

To be sure, there has always been a messaging push and a pull between career staff at agencies and political appointees, reflecting their different points of view and imperatives. The willingness and ability of political appointees to influence what the agencies say waxes and wanes.

I served at HHS as an appointee and at the CDC as a career official. I saw the firewall from both sides: sometimes getting brushed back by agency communicators when I was at HHS. At the CDC I had to do the brushing back when appointed leadership wanted to say something that might compromise the appearance of the agency’s scientific independence.

Under Kennedy, communications across HHS have become more centralized. The CDC’s social media team was dismissed, and the agency’s voice changed dramatically with their departure. Meanwhile, its leaders and spokespeople are harder than ever to find quoted in news stories.

The CDC's account on X.
To illustrate the point about the independence of its voice, look through CDCgov’s X posts in 2024, prior to the start of the current administration. You won’t find any amplifying the HHS secretary’s political messaging or engaging in overtly political topics, like support of the president’s State of the Union speech. This had been the norm—no matter who was in the White House. The CDC’s main handle—written and managed by career staff—confined itself to public health topics, and the main voices it amplified were of its centers and programs: the National Center for Health Statistics, Smoking, Birth Defects, etc.

If you had to criticize social media in previous administrations, you could say it was often dry and perhaps too diffuse, focusing on too many topics.

CDC now communicates much less from its X handle. It sometimes spotlights Kennedy, including a bare-chested AI-generated secretary in a mixed martial arts octagon, punching a cartoon Red Dye 40 in the face. But mostly it posts banal content. In the middle of a huge outbreak in Pennsylvania, for example, the agency has not used one of its 15 posts so far this month to talk about measles. And despite an early influenza uptick, there’s not a peep about flu or getting vaccinated.

Future leaders must right the ship​

The question for future federal health agency leaders is whether they’ll have the will to put this particular toothpaste back in the tube and whether it will stay there. They will surely face pressure to use their communications channels to achieve political communications goals. Now that the previous norm has been flouted, it will be easier to do so.

The next HHS secretary should resist that urge. Health agencies that communicate with an overtly political voice feed a future in which an individual’s trust in federal public health recommendations will depend on which party occupies the White House.

Health agencies that communicate with an overtly political voice feed a future in which an individual’s trust in federal public health recommendations will depend on which party occupies the White House.

For the sake of the nation’s health, we have to try to restore the CDC’s independent voice and the voices of the FDA and NIH. It’s vital that when authorities urge people to take action to protect their health—getting vaccinated or avoiding tainted food, for example—they have confidence that science and data are the only things driving the recommendations.

The alternative isn’t merely bad poll numbers. It’s less trust in data, information, and recommendations that can save lives.

Kevin Griffis is director of media relations and public affairs with the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota.