Trust in healthcare systems is declining: what role do marketers play?

Healthcare has a trust problem, and the data is hard to ignore. According to the 2025 Edelman Trust Barometer Special Report: Trust and Health, no institution studied (business, government, media, or NGOs) is trusted to address people’s health needs and concerns. Alarmingly, a majority of people believe these entities actively mislead on health matters, and trust in business and NGOs has seen significant declines since 2023.

For healthcare marketers, this distrustful environment diminishes the impact of every campaign, message, and channel. What role has marketing and communications has played in the erosion of trust in healthcare, and more importantly, what role can we play in reversing it?

What role have marketing and communications professionals played in the erosion of trust in healthcare?

Marketers and communications pros didn’t create this crisis on our own, but we certainly contributed to it both directly and indirectly. We must take stock of these contributions, so we can stop the bleeding and refocus our attention to the tactics that rebuild trust.

Direct-to-consumer pharmaceutical advertising

The United States is one of only two countries in the world that permits direct-to-consumer pharmaceutical advertising (DTCA), and the volume and influence of that advertising has grown dramatically since FDA guidance loosened in 1997. The consequences for trust are well-documented.

A 2024 scoping review by HHS of DTC video ads judged 62% as poor in scientific quality, with only 32% considered useful. Nearly half were classified as misleading, and 34% as potentially harmful.

Research suggests drug ads can diminish a patient’s trust in their healthcare provider’s clinical decisions, and clinicians report increased frustration when patients question their judgment based on information obtained from an advertisement. In one physician survey, one-third of respondents said DTCA made patients less confident in their clinical judgment.

Indirectly funding the misinformation ecosystem

Health organizations and government agencies, including the CDC, the American Heart Association, and the Alzheimer’s Association, spent nearly $37 million over four years advertising on news websites flagged for promoting health misinformation, including false claims about COVID-19 vaccines. Although most of those placements were not intentional, those ads help fund and legitimize the misinformation shared by those sources.

Corporate messaging that prioritizes brand over transparency and authenticity

Our role in diminished trust isn’t limited to paid advertising. The very way we communicate as brands has also harmed our credibility. Consumers have become wary of the overly-sanitized corporate tone most healthcare organizations continue to lean on.

FleishmanHillard has tracked this dynamic since 2012 through their Authenticity Gap research, which measures the gap between what consumers expect from companies and what they actually experience. The message is clear: consumers value authenticity and behaviors that back up aspirational messaging.

Failing to adapt to the new health information ecosystem

Social media promised healthcare marketers an opportunity to meet patients where they are, tell more human stories, and cut through the sterile voice of institutional communication; however, faced with privacy concerns and bandwidth limitations, healthcare institutions have largely failed to adapt to short-form video content. These spaces have been dominated by individual content creators who are incentivized to scare and confuse users.

Many health and wellness influencers and brands use social media to spread misinformation for economic benefit, and research has shown that wellness marketing content on social media often contains misinformation. The largely unregulated social media environment means that influencers and brands can continue to monetize their content while breaching platform community guidelines.

How can healthcare marketing and communications teams rebuild trust among consumers?

Now that we understand our role in this crisis, it’s our responsibility to take ownership to rebuild trust among healthcare consumers.

Enforce tighter controls on the quality of programmatic ad placements

The fix requires tighter allowlists and blocklists, regular auditing of where programmatic buys actually land, and a deliberate shift toward curated direct buys in environments that reflect the standards your organization claims to uphold.

Advertisers may be able to leverage intelligent, AI-driven tools to identify risks at scale; however, a human analyst may be required to find trickier websites.

Align brand promises with the authentic experience

Before a campaign launches, someone needs to ask whether the organization can actually deliver what it’s about to promise. That requires marketing to be in the room with operations and experience leaders to serve as an organizational conscience.

Marketers should also make use of patient feedback data to shape messaging, so that the stories being told externally are grounded in what patients are actually living, not in out-of-reach brand aspirations.

Double down on transparency in high-stakes communication moments

When the stakes are high and trust is a stake, communications leadership must advocate to move away from highly-sanitized holding statements as the default response to difficult moments. A trustworthy approach acknowledges uncertainty, commits to timely updates, and treat patients as people who deserve a straight answer.

Leverage providers to scale short-form, social-first video content

Healthcare organizations can capitalize on the creator personality trend by leveraging their providers to create short-form, social-first video content:

• A physician explaining a common misconception about a condition they treat
• A nurse practitioner walking through what to expect from a trending procedure
• A pharmacist answering the question patients are embarrassed to ask at the counter

Marketing’s job in this model is to identify, equip, and amplify those voices and optimize their content as the social media ecosystem continues to evolve.

Go further by closing the equity gap

NRC Health data shows that Spanish-speaking patients rated provider listening 16.9% lower and trust in provider 17.5% lower than English-speaking patients. This gap has measurable consequences in outcomes, disengagement, and readmissions, and trust scores followed similar patterns across racial and ethnic groups.

Closing the equity gap in healthcare communications means treating accessibility, cultural relevance, and language equity as baseline requirements rather than optional enhancements. Marketing and communications professionals can invest in community partnerships that give trusted local voices a platform. Finally, we must measure whether communications are actually reaching and resonating with the communities an organization serves and adapt accordingly.