The paradox of trust in health care in the age of social media.

Abstract

Health systems worldwide face two fundamental and connected challenges: pervasive misinformation and disinformation and eroding public trust. This erosion reveals a paradox at the heart of contemporary science-society relations: the more science succeeds in solving complex problems through rigour and institutional coordination, the more it alienates a public that values immediacy, authenticity, emotional resonance, and personal connection. Consequently, those most committed to scientific rigour-scientists, health-care institutions, professional societies, and public health agencies-are increasingly distrusted, whereas those least accountable-untrained influencers, unqualified individuals with financial motives or political agendas, and artificial intelligence bots-are deemed credible. This so-called trust paradox is amplified by engagement-driven social media environments that reward disinformation, immediacy, group identity, and authenticity over factual truth. The consequences are harmful health outcomes and misguided policy decisions. Addressing this paradox requires not only technical accuracy but also co-production from the outset, overarching horizontal communication, infrastructures for transparency and emotional resonance, and regulatory reforms for algorithms and digital environments.