In Spring 2023, the ‘Edelman Trust Barometer Special Report: Trust and Health’ revealed that the health landscape across 13 countries, including the USA, UK, South Africa, Germany, India, China and Brazil, is shifting.

  • Societal factors are negatively impacting people’s overall health with inflation being the top issue.
  • How we define health and who we think is responsible for keeping us healthy is broad.
  • Who we trust to give us the truth about health issues is no longer just the domain of experts.

Why it matters

The pandemic brought health to the top of the agenda for everyone, where previously it had mostly been a topic confined to those operating within healthcare systems. However, despite the deluge of information on health and the expansion of products and services within the health and wellness market, our global data shows people’s own evaluation of how well they’re taking care of their health vs. how well they should be is getting worse. At the same time, their expectations are high on what they believe institutions, including businesses, are responsible for when it comes to keeping them healthy. Based on the data, business and other major institutions beyond healthcare systems have a key role to play in helping everyone to live healthier lives.


  • People’s evaluation of the quality of their own health is poorer as socio-economic levels decrease, with cost and information being key barriers to improving health. Understanding these barriers gives businesses, governments and healthcare systems opportunities to rectify these inequalities.
  • How we define health is no longer confined just to our physical health, and we believe that businesses from all sectors should be playing a role in keeping us healthy.
  • Who we trust to tell us the truth about health issues is no longer confined to medical experts such as doctors, with our friends and family seen as just as important. Business needs to ensure it is working with all these audiences if it wants to remain credible with consumers.
  • Overall, the health landscape has shifted significantly, but with those changes comes new opportunities for business and other institutions to find different ways to ensure consumers are able to be as healthy as they want to be.

Low income equals poor health – is that anything new?

Perhaps not, and the research from our report certainly shows that those on low incomes are 20 points less likely to report very good, excellent or perfect health than those with a high income. However, having a good income alone doesn’t provide complete protection against poor health, with 15% of those with a high income reporting fair or poorer health. And regardless of income levels, the number of people who believe there is a moderate to extremely large gap between how well they are taking care of their health, versus how well they feel they should be, has increased by 14 points in the last year. For people who report a gap, the biggest barriers to improving their health are cost and information.

And whilst decades of scientific research on the factors which contribute to poor health in people on low incomes have shown they are multiple and diverse, the Edelman report this year showed that for those respondents on low income, inflation was the issue most reported to be negatively impacting health.

It’s clear from our research that despite, or maybe because of the pandemic, people’s view of their own health is poor and getting worse. However, knowing what the barriers are to improving health gives businesses, governments, healthcare systems and each of us as individuals, opportunities to halt the declines the survey revealed. 

Health is all about the physical – isn’t it?

Not any longer; our survey found that only 1% of respondents globally said being healthy is just about physical health, with 66% saying mental health, physical health, social health and community liveability are all dimensions of what makes up their health.

And alongside the broadness of our definition of what being healthy means, comes a wide expectation of who should play a meaningful role in making sure we are as healthy as possible. Employers come second (79% among those people surveyed who were employed) to healthcare systems (87%) and business comes fourth (70%). And with respect to business, respondents had the same expectations of most sectors, not just those businesses considered to be ‘in healthcare’.

Sadly, what we also found was that the institutions we expect to keep us healthy don’t appear to be living up to expectations. Only 55% of people surveyed say employers are doing well at keeping us healthy, and less than 50% of people say this for healthcare systems, NGOs, business, and government. This gap between our expectations and what we actually experience from our institutions provides a great opportunity for employers and business to find ways to help both employees and customers to be as healthy as they possibly can be.

Doctors know best – don’t they?

As the health landscape changes so does who we trust to give us information on health issues, and whilst ‘my doctor’ still tops the list globally, followed by nurses, trust in our friends and family has risen 11 points in the last year to take third place, tied with pharmacists. The role of friends and family as trusted sources of health information also rises to the top among people who have lower trust in the health ecosystem compared with those with higher trust.

So, the people we trust to deliver our health information has changed and so too has the amount of research we do ourselves. Forty-one percent of respondents globally reported educating themselves about their health more than before the beginning of the pandemic. And whilst education is generally viewed as a positive, a worrying 44% of respondents aged 18 to 34 years feel that the average person who has done their own research is just as knowledgeable on most health matters as a doctor.

And as we think about how these factors play out in terms of behaviour and actions that people take, our data show that what we do with our doctor’s advice is impacted by whether we believe our healthcare system is failing or working. Among those who believe the average person can be as knowledgeable as doctors after doing their own research, those who believe the system is failing are twice as likely to have followed advice found on social media advice that contradicts that of their doctor, compared to those who believe the system is working.

As communicators looking to provide evidence-based information on health issues that people will trust, we need to remember to think beyond the traditional experts and bear in mind the views of our audiences when it comes to the success or failure of their own healthcare system.

In the face of all this change what should brands do?

The good news from our data is that it is clear there are things brands can be doing to address the societal factors affecting our health.

  • Firstly, provide trustworthy health information, remembering how trusted friends and family are, especially for those people with lower trust in the healthcare ecosystem.
  • Address health issues such as climate or inequality, remembering that 79% of people felt community liveability is part of the definition of ‘being healthy’.
  • Improve the health of your local communities; 73% of people say businesses are obligated to improve the health of the communities in which they are headquartered.
  • Convene stakeholders to improve healthcare. Improving healthcare is a role that people expect all major institutions to play, not just the healthcare system.
  • Optimise your product and operations for health; 64% of respondents consider the impact the brand, its products and its business practices have on people’s health when deciding which brand to buy.

The pandemic no doubt changed the health landscape for everyone, whether you caught COVID-19 or not. But how people think about what health means to them now offers opportunities and highlights increased responsibilities for businesses and other major institutions, beyond the healthcare sector, to improve not only the collective health of the world but also to improve their own bottom lines.

A version of this article was originally published by WARC Exclusive, June 2023.