Despite a wave of positive recognition at the start of the pandemic, public trust in hospitals and health systems has declined, according to Edelman’s annual Trust Barometer study. But the data also shows that the pharmaceutical industry continues to enjoy an uptick in positive public perception.

The venerable Edelman Trust Barometer, based on an online survey that spans 28 countries and some 33,000 respondents, examines trust and credibility in global institutions. Amid a climate of instability amplified by COVID-19, civil unrest over systemic racism and an economic crisis, this year’s study found that trust has decreased across all types of societal institutions – including business, government and media – and that misinformation has proliferated.

The results showed an unusual trajectory for trust in the health sector. It experienced a boost in May 2020, followed by a decline.

“Cumulatively, health was in this trusted place,” explained Courtney Gray Haupt, U.S. health sector lead at Edelman. “It rose by eight points in May, and we think that was spurred by the solutions the health sector was bringing.”

This included COVID-19 vaccines, she added. “When we looked at it again, in January, you saw this decline. The bubble burst, and we saw an 11-point decline globally. What that says to us is that people are losing their trust in all institutions.”

Among the health subsectors singled out in the report – pharma, biotech, hospitals and health systems, consumer health, and commercial insurance – hospitals and health systems seemingly bore the brunt of the backlash.

“Everyone really embraced the role that our frontline healthcare workers played,” Haupt said. “When we dug into the data and saw there was a decline in trust for the hospital and health system sector, it was only a few percentage points, but that’s really notable.”

It was largely driven by systemic disruption, with many patients unable or unwilling to venture into facilities for non-urgent surgeries or procedures. Emergency room footage provided viewers with a glimpse of the degree of strain on the system.

What the hospital sector should take away from the survey results, Haupt said, is that they need to think about improving their commitments to innovation and surrounding communities. It’s essential, she added, that hospitals place a greater emphasis on taking care of their employees.

“How are health systems showing up with how they’re acting, and with the stories they’re telling about the importance of their employee population? How are they really taking care of them and addressing the burnout we know nurses and physicians have? How are they valuing everybody, from the top of the organization to the bottom?”

The pandemic, meanwhile, provided the pharma industry with an unprecedented uptick in trust and reputation. Throughout 2020, as pharma companies scrambled to get vaccines developed and approved, the industry began to be perceived as a big part of the solution. Historically, “Big Pharma” was tagged with a rep of too willing to take advantage of patients through high drug prices.

“In the U.S., pharma had a nine-point increase in trust, which is considerable,” Haupt said. “People believe this sector is really driving the most critical solution for the global community right now.”

Despite those gains, however, pharma remains in what Haupt characterized as “distrusted territory.”

“They’ve had progress, but they haven’t risen up into trusted territory,” she said. “What that says to us is that there’s so much opportunity to take these trust gains and look at what they can do in the next 12 to 24 months, to think about the lessons they’ve learned during COVID.”

The study results also revealed a heightened expectation on business – including healthcare and pharma companies – to take the lead in addressing broad societal issues, like health inequities and needed improvements to the healthcare system. More than 60% of people in the U.S. said that the country would not be able to overcome its challenges without the business community stepping in.

“We now have this understanding that there’s an interconnectedness between the health of our communities and our people, and the health of our economy,” Haupt explained. “There has to be an appreciation going forward of how we address things to improve public health for all communities, with equity at the center.”

That means pharma and healthcare companies should prioritize employee well-being and allow CEOs to be heard early and often. Just as important is the need for these organizations to create and deliver trustworthy content.

Haupt advised companies to “think about an inside-out approach where you harness the positive pride that employees have, and help them to share stories externally… Give them opportunities to engage and take action, and then harness the pride they have in their companies playing a bigger role when it comes to societal issues and public health issues.”