Why Do So Many Americans Distrust Science? (2024)

On December 27, 2022, Twitter CEO Elon Musk tweeted a message to his 134 million followers: “New Twitter policy is to follow the science, which necessarily includes reasoned questioning of that science.”

The reaction to Musk’s tweet ran the gamut from passionate support to enraged derision. NASA earth cartographer Joshua Stevens tweeted “This is fair and reasonable. If any scientist tells you otherwise, never let them wax poetic about curiosity and wonder again.”

But journalist Ashton Pittman pushed back on Musk’s tweet, writing “By ‘reasoned questioning,’ Elon Musk no doubt means clown car conspiracy drivel.”

Musk’s post appeared to be a not-so-veiled criticism of science related to the COVID-19 pandemic. There is little doubt that distrust of science has grown significantly since the onset of the pandemic. According to data from the Pew Research Center, fewer Americans trust medical science than before the coronavirus outbreak. The Pew study found that in April 2020, 11% of American adults said they had little to no confidence in medical science today, while 89% said they had a fair amount of trust and 43% said they had a great deal of trust. In December 2021 — in the midst of the pandemic — the percentage of people who said they have very little trust in medical science doubled to 22%, while 77% of people said they have a fair amount of trust and 29% said they have a great deal of trust.

“In reality, the majority of people haven’t really changed their views about science that much,” said Belinda Vail, M.D., chair of family medicine and community health at the University of Kansas School of Medicine. “They listen to their doctors; they trust their doctors and they have a good relationship with their doctors. But there is definitely a growing contingent that is very distrustful of science.”

THE HISTORY OF SCIENCE MISTRUST

Although suspicions about the efficacy of science seems to be a reaction to the COVID-19 pandemic, in fact, American skepticism about science has a long and shared history.

For example, when the germ theory was proposed in the 19th century by German physician Robert Koch, a significant number of people rejected the notion that disease could be spread through invisible microorganisms. Other scientific discoveries, such as the nature of the solar system and that the earth was round rather than flat, were also met with heavy opposition.

In the United States, the scientific validity of Charles Darwin’s theory of evolution was put on trial in Tennessee in 1925. In the Scopes trial, also known as the Scopes Monkey trial, science teacher John Scopes was prosecuted and convicted for teaching evolution in a public school, which the state had banned.

The rejection of evolution was spurred primarily by religious zealots in the 19^th century and is still not accepted by some factions of society. Organizations like the Discovery Institute, a conservative think tank based in Seattle, have funded efforts to put anti-evolution content in school curriculums, because they adhere to the belief that God created everything that exists on Earth ex nihilo (out of nothing), despite that evidence to the contrary is overwhelmingly accepted by the scientific community. The effort to undermine solid science has led to bills limiting the teaching of evolution in at least 10 states — including Missouri — although few have actually been signed into law.

More recent events like the Vioxx scandal in the early 2000s, when pharmaceutical company Merck skewed data to hide an increased risk of heart attack associated with the new painkiller, also contributed to the decline of public trust in medical data and research, according to Peter Smith, Ph.D., senior associate dean for research at the KU School of Medicine.

“Events like the Vioxx controversy can cause folks to begin losing trust in what they are being told,” Smith said. “And then we see intentional efforts to undermine science by entities like the tobacco industry, which misled the public for a number of years about the dangers of smoking and using tobacco.”

RACISM IN SCIENTIFIC RESEARCH

The historical mistreatment of people of color and people from marginalized communities, especially in clinical trials, began to erode trust in medicine for many populations long before the COVID pandemic.

The most notorious example is the Tuskegee study, conducted in Alabama between 1932 and 1972 by the United States Public Health Service and the Centers for Disease Control and Prevention. As part of the study, doctors intentionally infected roughly 400 Black men with syphilis, then withheld treatment from them because researchers wanted to understand the full progression of the disease. More than 100 men died as a result.

The history of medical and research abuse of people of color goes well beyond the Tuskegee syphilis study. James Marion Sims, often called the “father of modern gynecology,” developed pioneering tools and surgical techniques related to women’s reproductive health in the 1800s. But Sims’ research was conducted on enslaved Black women without anesthesia, because he falsely believed that Black people didn’t experience pain like white people did.

In another case, American researchers tested an early, high-dose version of birth control pills on poor Puerto Rican women in the 1950s. The women who participated were not told what the side effects might be because the effect of the drug was largely unknown at the time. At least three women died during the trial, but no autopsies were done to determine the cause.

“Unfortunately, there is a long history of physicians and researchers exploiting people of color in the name of science,” Vail said. “So, I can’t say it’s surprising that many people of color distrust science and the people behind it.”

ALTERNATIVES TO SCIENCE

As distrust in science grew, many people began searching for other ways to stay healthy. Alternative medicine — or complementary medicine, as it is also called —is a loosely defined and very diverse set of products, practices and theories that are perceived by its users to have the healing effects of medicine, but do not originate from evidence gathered using the scientific method. It often involves the use of herbs, homeopathic remedies, massage therapy, acupuncture and chiropractic care. These healing practices, which took off in the 1970s, are based in any number of beliefs, whether superstitious, cultural or religious. The common thread is that they are not tested by the traditional scientific process, and often have no concrete evidence to support their claims.

An offshoot of the explosion of alternative medicine was the growth of the anti-vaccine movement. Antivax sentiment has been around since the advent of vaccine development. For example, many people resisted getting the smallpox vaccine when it was first developed in 1796. Anti-vaccination groups in America and Great Britain claimed that the vaccine didn’t work and contained poisonous chemicals. They also claimed that mandatory vaccination laws were oppressive.

In 1998, a fraudulent British study falsely connected childhood vaccines — specifically the MMR vaccine — with the development of autism. The study was formally retracted in 2010, but many people still believe that vaccines can give children autism, despite no evidence to support that claim. But the fallout from the study, along with the fear of side effects and a belief that natural immunity is better than vaccine-induced immunity, has led to an increasing number of parents to postpone or totally abstain from getting the MMR (measles-mumps-rubella) vaccination for their child.

So, while COVID-19 may not be the origin of vaccine distrust, it did lead to more people becoming skeptical of other vaccines.

“The COVID vaccination really caused a pushback on many other vaccines,” Vail said. “We have just a plethora of data that vaccines work, and they are safe, but unfortunately, vaccine skepticism continues to grow.”

THE CAUSES OF SCIENCE DISTRUST

William Gabrielli, M.D., chair of the Department of Psychiatry at the KU School of Medicine, said that for some people, scientific distrust is rooted in a lack of understanding of how science works.

“Fortunately, this is among the easiest types of scientific mistrust to alleviate, because the solution is more and better education around how science works,” Gabrielli said.

It can be particularly challenging for the public to understand scientific research because science can change quickly, and people often only receive fractured bits of information.

“Science is constantly evolving, and people don’t always understand why,” Smith said. “It’s a difficult concept to explain how science is simply our state of knowledge at a particular point in time, and our best conclusion at that time is based on the information we currently have.”

Gabrielli said some people are naturally more skeptical than others, and they aren’t likely to be early adopters — whether it is buying a new smartphone or being the first in line for a new COVID-19 vaccine. This distrust can be eased over time as a new discovery becomes more widespread.

“Once a greater mass of the public is more comfortable with widely adopting a scientific discovery or invention, it becomes easier,” Gabrielli said. “There were people who were afraid to fly when the airplane was first invented, but now almost everyone is willing to jump on a plane.”

But when people already have deeply entrenched beliefs about something, it can become very difficult to change their minds, Gabrielli said. In psychology, this is called cognitive dissonance.

“Most of us like to stick to what is comfortable for us. If a new idea or concept comes along that is inconsistent with what we understand and believe, we will discount that information,” Gabrielli said. “That’s where education and experience and role modeling can play a role in changing behavior.”

Many times, distrust is rooted in personal experience instead of pure psychology, said Mario Castro, M.D., MPH, vice chair for clinical and translational research and a pulmonologist at the KU School of Medicine.

“If a patient or their loved one has been given incorrect information or been misdiagnosed by a health care provider in the past, it can be hard to regain their trust,” Castro said.

American culture plays a role, too, said Dorothy Hughes, Ph.D., associate professor of population health at the KU School of Medicine- Salina. Hughes, who previously worked as a government liaison for The University of Kansas Health System, said a white coat used to carry a tremendous amount of weight and prestige. Now, doctors are likely to face tougher criticism from lawmakers and the public — and they aren’t the only ones. Pew Research shows that trust in many other American institutions has eroded in recent years, including non-medical science, journalism, the government and law enforcement, among others.

“In the United States, at least, distrust of government is part of our history. As a nation, we are very individualist and hesitant to let the government get involved in our lives,” Hughes said. “We have seen a greater trend toward the employment of physicians by institutions, which means that, to the public, your doctor is no longer just the person you go to when you are sick, but they now may also be affiliated with a public or government institution.”

Hughes added that if a person distrusts the government or what they consider to be elite institutions, they are more likely to link doctors and scientists to those institutions and stop trusting them.

SOCIAL MEDIA AND MISINFORMATION

Social media has emerged as a modern breeding ground for conspiracy theories and misinformation. When COVID-19 began, falsehoods about everything from masks to vaccines to alternative treatments were widely disseminated online, which created confusion and skepticism for many people.

“There is such an overwhelming availability of information on social media,” Gabrielli said. “But the downside is that social media propagates ideas and generates strong feelings, which can make the discussion about the issues more difficult and emotional, because people become more polarized.”

Scientists see social media as a double-edged sword. There is an unprecedented ability to share information that can help people — whether it’s a vital public health update about a virus, tips for managing a chronic illness or an exciting treatment discovery. But on platforms where anyone can say anything, a piece of accurate information can quickly become misinterpreted or even overshadowed by misinformation.

“Before, if you wanted to reach millions of people, you had to write a book or an article, editors would fact check it and other scientists would review it. You couldn’t just widely spread information,” Vail said. “Now with the internet and social media, you can put anything out there, whether it is true or not.”

Disinformation often starts small on social media, then spirals out of control as more and more people see and share inaccurate information. Smith said this happened during the pandemic with ivermectin, a drug that was tested and quickly debunked as a treatment for COVID-19. But the immediacy of social media didn’t mix well with the changing nature of science.

“Ivermectin does have some anti-inflammatory properties. But there was some pretty lousy science that was done, and people latched onto that and used it either to drive home a political point or sell snake oil remedies,” Smith said.

Smith said another problem with social media is that it can be difficult to discern when information is skewed to make a profit.

“There can often be an economic incentive to push the public away from the verified science and toward something that can make someone else some quick money,” Smith said.

Smith added that much of the nuance and detail that goes into scientific research is lost on social media, making it even more difficult for people to navigate a landscape of conflicting information.

“If you look at search engine results, they are all very reductionistic and oversimplified because it makes it easier for people to navigate,” Smith said. “But it doesn’t tell the whole story, and it is difficult to get people to explore beyond that.”

Jennifer Bacani McKenney, M.D., associate dean for rural education at the KU School of Medicine, said that when people with no medical background read complex research articles online, they might think they have the tools to understand it, but they often lack the context provided by a medical and research education.

“They don’t know what they don’t know,” Bacani McKenney said. “When they read papers full of huge words and detailed data and even a fancy title that kind of skews the information, they are going to grasp onto only the things they want to be true.”

“I think we have to meet people where they are,” she continued. “The medical world is generally more educated than the rest of the community they serve, and we need to be sure we’re not shaming people or making them feel bad for their beliefs and for the things that they don’t understand yet. That doesn’t get us anywhere.”

HOW SCIENTISTS ARE RESPONDING

For researchers, navigating misinformation means being more involved in communicating with the public about new research.

“I think the pandemic has taught us to be more open and more flexible in terms of communication early in the process to allow the public to understand that, as scientists, we are also learning as we go,” Castro said. “That is especially true when we are confronting a new challenge like COVID.”

During the peak of the pandemic, Castro participated in some of The University of Kansas Health System’s morning media updates, where he answered questions from reporters and from the public to try and address the rapidly changing news around COVID-19.

“Every day during the pandemic, we tried to educate the public and media and explain the impact of what we knew — and what we didn’t know,” Castro said.

He added that within the last few years, scientists have gotten savvier at using different means of communication to reach a wider audience.

“We can’t just do print media or only TV. Now, we’re looking at the best ways to communicate online and through other avenues,” Castro said. “But traditionally it hasn’t been part of our medical school curriculum. We often rely on other people like media and communications specialists to help us become more effective with the way we communicate.”

Sudip Parikh, Ph.D., CEO of the American Association for the Advancement of Science, told Pew Research Center in 2020 that building relationships and having an open dialogue with policy makers and journalists is key to building trust with communities. It is important to build trust with those people first because they are often the public’s first source of information.

Parikh also said it is important to build relationships outside of science, especially with the religious community. When there is disagreement, it is easier to navigate when there’s established trust.

“For instance, when discussing mask-wearing in churches, we have a starting place for dialogue rather than coming in as an outsider and saying, ‘I’m a scientist, and I'm here to help you,’” Parikh told Pew. “We should be having those conversations about the intersection of people’s belief systems and their feelings of faith with where science is headed in regard to some of the important questions in science.”

Public educational sessions about clinical trials are another way Castro tries to educate the public about what medical research is and how it works. During these sessions, he answers questions about everything from control groups and placebos to the differences between trial phases.

“We haven’t traditionally talked that way to the public, but it is very important for us to do so,” Castro said.

In his own research and his work as co-principal investigator for Frontiers Clinical and Translational Science Institute at KU Medical Center, Castro works to educate and enroll patients from diverse backgrounds in clinical trials, not just because it improves the quality of the science, but because it gives patients more information about their disease and helps patients understand how research works.

“We might not always know the answer right now, but I always try to tell people that you can help contribute to the science as a participant,” Castro said.

Smith said while better communication plays a major role is combatting science misinformation, it won’t solve everything.

“The problem doesn’t end simply with scientists being better communicators or having more valid science,” Smith said. “For the past few years, we’ve largely lived in a fact-free world, and until facts become really accepted and embraced again, this is going to be continue to be an issue.”

Smith added that it is unfortunate that there are some rare instances where researchers can be the sources of false science. As the field of medical research becomes more competitive, it can lead to a greater number of instances of exaggeration and falsification and a further erosion of trust.

“There is a lot of pressure on researchers and pharmaceutical companies to come up with that really big find and put it out there,” Smith said. “And while the vast majority of scientists and big pharma companies play by the rules, some take liberties and get into falsification.”

That is why it is essential for researchers to build trust with the public by making sure their experiments are well run, with enough subjects, appropriate statistics and repeatability, Smith said.

“We really try to make sure there aren’t any problems with the research, so we aren’t contributing to misinformation,” Smith said.

WHAT DOCTORS CAN DO

Family doctors and primary care providers are often the first line of defense against medical and science misinformation, because they are typically a patient’s main point of contact with the medical industry. Primary care providers like Vail said it is critical to build strong relationships with patients in order to build trust.

“The best doctor-patient relationship is when there is a true partnership, and you see me as someone who can help you stay healthy,” Vail said. “I am not the end all authority — I don’t know everything. But when you see a doctor at urgent care once and never again, we miss so many learning opportunities. I can’t learn from my patient, and they can’t learn from me if I only see them once.”

Listening and taking a patient’s concerns seriously is one of the most simple and effective ways to build trust.

“Listening to the patient and giving them some credit for their inquiry is really important,” Vail said. “You can’t just roll your eyes and tell them what they believe is false — that just shuts down the conversation.”

Vail said she uses modern tools like the chat function on patient portals to help connect people with the information they need to make decisions.

“If my patient is wondering if they should be worried about something, I’m happy to have them send me a message so I can help answer their questions,” Vail said. “Being able to have that two-way conversation and feeling like your doctor is a trusted place that you can get information is imperative.”

Erin Corriveau, M.D., associate professor of family medicine and community health at the KU School of Medicine, said it is also important for clinicians to connect with people outside of their office to build trust.

“It is imperative for doctors to become more involved in their communities and remain involved.,” she said.

For Corriveau, being active in her community means taking on a role as deputy county health officer for Wyandotte County, Kansas. When people come into her office with concerns about the COVID-19 vaccine or any other skepticism, Corriveau said the best way to navigate the conversation is to try and get to the root of what they are concerned about.

“I realized during the pandemic that I needed to listen to people to understand what they were truly worried about,” Corriveau said. “I would sit there with them and look through the information with them because, even for us, the amount of information can be overwhelming at times.”

Vail, Bacani McKenney and Corriveau are now teaching students at KU Medical Center how to navigate difficult conversations with patients who might be skeptical or scared or new treatments and vaccines.

“Rural areas of Kansas are known to have lower vaccination rates, in large part because studies show that people in rural areas are more susceptible to believing in misinformation. Our future doctors and nurses need to develop the skills to deal with that,” Bacani McKenney said. “We all wish misinformation and mistrust in medicine would just end, but it’s going to be around for a while, and it needs to be part of their education now. They need to observe how their physician mentors interact with patients and then continue to refine how they communicate with patients themselves.”

Despite uncertainty and rising distrust from the public, scientists and doctors remain committed to caring for the public and moving medicine and science forward.

“The pandemic happened, and it changed a lot,” Corriveau said. “But in the end, we’re still here and we still care. We might take two steps back sometimes, but we’ll keep marching forward.”