To make progress, focus on building trust

As our nation continues to reel from the impact of the dual crises of the COVID-19 pandemic and racial strife, we increasingly understand that trust in each other and our institutions will be essential for progress. However, data from the last several decades show a progressive erosion of trust. Absent a foundation of trust, we have watched pseudo-science and conspiracy theories gain traction on social media and other domains with real-world consequences. As AcademyHealth pointed out in a denouncement of the assault on the U.S. Capitol, “the growing fragmentation of our public discourse and the embrace of opinion as fact has evolved from disturbing trend to direct threat to our country and people.” As we look forward to a virtual gathering next week focused on health data and policy innovation, at least three dimensions of trust are essential to addressing the health and health care challenges ahead: trust within historically disenfranchised communities to achieve equity; trust in science and scientific innovation; and trust in health care itself. All three are needed if we are to achieve better health and health care for all. (author abstract)