Over the past few months, across the world, the importance of trust (both as regards trust in leadership and trusted information) has become clearer than ever before. In fact, trust as a whole has become a more valuable commodity as uncertainty and anxiety around COVID-19 and its impact has become more prevalent. Now in its 20th year, the Edelman Trust Barometer has recently published its health-sector specific data, this year augmented with findings from our Trust Barometer Spring Update: Trust and the COVID-19 Pandemic.
A familiar picture emerged in the January study
First, let’s take a look at the wider trust levels in healthcare from the January Trust Barometer. (This was an online survey in 28 markets with 34,000+ respondents in total, and all fieldwork was conducted between 19 October and 18 November 2019.) Remember, the survey was put into the field in late 2019, so well before the coronavirus overtook the world and looks at trust in these four institutions: government, business, media and NGOs.
Trust in the healthcare sector declined by one point and the sector remained firmly rooted in the middle of the pack, below technology, retail and education but above automotive, energy and financial services (which holds its position as the least trusted of all). However, all sectors of business lost trust (with technology and entertainment dropping most), so this appears to have been a general rather than health-specific event.
This loss of trust was also reflected across geographies. Of the 26 markets with trackable data, trust in healthcare fell in 13 markets. Some notable changes were in South Africa (where a seven-point fall could be related to continuing challenges in the public health system) and the US (whose five-point drop may be related to the acerbic debate around the cost of healthcare).
One of the more concerning changes from the January Trust Barometer is the decrease in trust in healthcare within our ‘informed public’ population. This, you may recall, is the group which makes up 17% of the total global population. The informed public is aged 25-64, college educated, in the top 25% of household income per age group in each market, and over-index on the consumption of public policy and business news. Historically, this group has remained a bastion of trust in healthcare, but this year we saw lower levels of trust in 16 markets with some massive reductions.
The largest drop among trust in healthcare within the informed public was a 19-point drop In France. Our team there hypothesised that this may be due to several highly publicised issues including Servier’s long-awaited trial over the safety of a weight loss drug, a large, monthslong hospital strike, increasing anti-vaccination sentiment and ongoing debate about drug pricing and the cost of health innovation. A 13-point fall in the UK could have been a reaction to the Brexit debate at the time the survey was fielded, with media focus on underfunding and potential staff shortages given immigration restrictions post-Brexit. There were also some high-profile reimbursement stand-offs between pharma and the NHS (eg, Vertex/Orkambi).
By May everything had changed
Now let’s take a look at how things have changed in the months since COVID-19 forced most of the world into lockdown. The Trust Barometer Spring Update, fielded in May 2020, showed a remarkable change. (This was an online survey in 11 markets with 13,200+ respondents in total, and all fieldwork was conducted between 15 April and 23 April 2020.) The average percentage trust across the four institutions studied has soared to an all-time high. Across the 11 markets included in the Spring Update, 61% of the general population trust all four institutions (government, business, media and NGOs).
Three countries (Canada, Germany and the UK) saw a double-digit increase and these feed into a record high of 61% as the overall average trust across all 11 markets. Another first is that government is now the most trusted institution globally; never before has it achieved this leading ranking. Of course, it remains to be seen if these gains can be maintained in the longer term.
It was a case of ‘all change’ in the health sector too. In a quite astonishing turnaround, the healthcare sector, along with food and beverage, occupies the top spot as the most trusted business sector, with 76%. Both of these industries have, of course, been front-and-centre during the pandemic. In the case of healthcare, this marks an increase in trust of eight points and is the largest increase we have ever seen in the sector since it has been included in the Trust Barometer.
There are notable increases in ten of the 11 markets included in the Trust Barometer Spring Update, with the largest gains in trust seen in Canada, Germany and the US. These are historically countries which have tended to demonstrate lower levels of trust in health in the past. In the case of the US, as noted above, trust in healthcare had dropped five points in the original study.
Pharma sector experiences record leap in trust
There is more good news for the healthcare sector when we look a little deeper into the healthcare sub-sectors we study. Perhaps the most eyecatching is to see the pharma sector leapfrog biotech and move into second place, behind hospitals. It is no surprise to see the hospital sector retain its place as the most trusted, particularly under current circumstances, when it has consistently held this position.
For the pharma industry though, this is a record-breaking result with a trust level of 73%. This sub-sector had the highest increase in trust globally and, mirroring the overall sector, had the biggest increases in Canada, Germany and the US. Historically, ‘big pharma’ has been seen somewhat suspiciously by the public but faced with an unprecedented global health threat, the population is looking to pharma for solutions in the form of treatments and vaccines.
Previous iterations of the Trust Barometer have seen the biotech sub-sector perform better than pharma, largely because people associate the industry with promising start-ups discovering new innovations (in contrast to the pharma industry, which is seen as being responsible for the high price of medicines). Currently, though, biotech is in the shadow of its larger, more global cousins, with trust at 72%.
As mentioned above, hospitals have consistently maintained the highest levels of trust across the healthcare sub-sectors (81% in this supplemental research) and is the only sub-sector trusted by all markets in the study. Of course, this subsector is the one that people associate with the individuals and organisations that actually deliver their healthcare. Around the world, healthcare professionals are rightly being recognised for risking their own lives to save others stricken by COVID-19 and this is reflected in our findings.
The last of the four sub-sectors we investigate is health insurance. Trust has increased in this industry too over the past few months (70% trust level), though not as dramatically as the others. We would imagine this is because insurers are not as prominent in the battle to overcome the pandemic as the other three sub-sectors.
Trust is hard won but easily lost
The healthcare sector is rather too busy at the moment to spend any time basking in its unprecedented levels of trust. But how might the sector maintain the huge gains in trust it is experiencing now? Throughout the history of the Trust Barometer, when we see double-digit gains in trust, they are often followed by losses. At the moment, the healthcare sector is carrying the hopes of the world in the fight against COVID-19. The sector will need to demonstrate that it is meeting those expectations and delivering value, in order to hold on to these higher-thanusual levels of trust.
For pharma, that means doing a better job of demonstrating its commitment to the health of the world than it has done previously, by showing that it can be relied on, not just in times of crisis, to put people before profits. For the biotech industry, that means reminding people of its ability to spark innovation and move quickly to follow promising lines of discovering. Hospitals remain the exemplar in terms of trust, and others would do well to consider how they might put a human face, or at least add a human touch, to the healthcare they deliver. Insurance companies may wish to focus on what they are doing to support not just their customers, but the wider community in these economically challenging times.
Much has been written about how the COVID-19 pandemic is a pivotal moment in the history of the world. For those within the healthcare sector who have been viewed with some level of suspicion and whose expressions of wanting to do good are treated with cynicism, this is a once-in-ageneration opportunity to change the narrative once and for all.