How do public health institutions experiencing declining public trust go about becoming trustworthy again?

Erin O'Malley is the Executive Director and CEO of the Coalition for Trust in Health and Science, a coalition of more than 90 organizations working to enhance public trust in health and science. With nearly two decades of experience in health policy, advocacy, and cross-sectoral partnership, Erin leads an organization grappling daily with one of public health's most pressing and contemporary questions.

Erin joins Salma to discuss trends in trust in health and science in the United States—from the lasting impact of the Covid pandemic to the role of political polarization in eroding institutional trustworthiness—and what it actually takes to rebuild it. They discuss what the coalition has learned about the mechanics of trust-building across the health and science ecosystem, why community-level listening and interpersonal communication matter as much as institutional messaging, and how the language we use can impact public engagement and trustworthiness.

This episode will challenge how we talk about and classify information, explore the difference between being trusted and being trustworthy, and offer practical frameworks for how individuals, practitioners, and organizations can navigate an increasingly complex information landscape.

Useful resources:

1. Resources: Knowledge. Coalition for Trust in Health and Science. https://trustinhealthandscience.org/resources/category/knowledge/

Host: Dr. Salma Abdalla Editors: Catalina Melendez Contreras Marketing: Kinkini Bhaduri Music: Eden Avery / Melting Glass from Epidemic Sound https://www.epidemicsound.com/track/2fqOXWpHab/

The views and opinions expressed by the guest in this episode do not necessarily reflect those of their institution, the funders, or the podcast team.

By some estimates, hundreds of thousands of Americans die each year who would still be alive if the United States had the mortality rates of other wealthy countries. What makes this even more unsettling is that it wasn't always this way. In the mid-twentieth century, Americans actually lived longer than their counterparts in other rich nations. Something changed, and it's been getting worse for over four decades.

Dr. Andrew Stokes is an associate professor of global health at the Boston University School of Public Health. A demographer and sociologist by training, he founded the Uncounted Lab, a research initiative focused on mortality that official statistics miss, whether from pandemics, chronic diseases, or public health emergencies.

Dr. Stokes joins Salma to discuss what excess mortality reveals about who is dying in America and why. The conversation is anchored in the "Missing Americans" concept, which estimates how many US deaths each year would have been averted if the country simply matched the mortality rates of its peers. They trace why the US mortality disadvantage has grown steadily since the early 1980s, how the Covid-19 pandemic both exposed and deepened it, and why the burden has fallen disproportionately on Americans without a college degree, driven less by the "deaths of despair" narrative that dominates headlines and more by cardiovascular diseases. The conversation closes with GLP-1 drugs and the need to celebrate progress while still looking for structural interventions to prevent and mitigate the impact of obesity in the US.

This episode offers a new lens for analyzing preventable mortality in the United States and for thinking through what it can take to address it.

Useful resources:

• Bor J, Raquib RV, Wrigley-Field E, Woolhandler S, Himmelstein DU, Stokes AC. Excess US Deaths Before, During, and After the COVID-19 Pandemic. JAMA Health Forum. 2025;6(5):e251118. doi:10.1001/jamahealthforum.2025.1118
• Bor J, Stokes AC, Raifman J, et al. Missing Americans: Early death in the United States—1933–2021. Galea S, ed. PNAS Nexus. 2023;2(6):pgad173. doi:10.1093/pnasnexus/pgad173
• Paglino E, Wrigley-Field E, Stokes AC. Diverging Mortality Trends by Educational Attainment in the US. JAMA Health Forum. 2025;6(6):e251647. doi:10.1001/jamahealthforum.2025.1647
• Stokes AC. Public health should embrace GLP-1 drugs without abandoning obesity prevention. STAT. November 28, 2025. https://www.statnews.com/2025/11/28/weight-loss-drugs-obesity-prevention-importance/

Host: Dr. Salma Abdalla Editors: Catalina Melendez Contreras Marketing: Kinkini Bhaduri Music: Eden Avery / Melting Glass from Epidemic Sound https://www.epidemicsound.com/track/2fqOXWpHab/

The views and opinions expressed by the guest in this episode do not necessarily reflect those of their institution, the funders, or the podcast team.

This is a Purple Public Health Project episode.

Dr. Itai Bavli is a Research Associate and lecturer at the W. Maurice Young Centre for Applied Ethics at the University of British Columbia, as well as the author of the Substack When Public Health Goes Wrong. His research focuses on developing a framework for understanding public health decisions and actions that have gone wrong and caused harm, with particular attention to how these errors intersect with social inequalities, medical racism, and the ties between governments and the pharmaceutical industry.

In this Purple Public Health conversation, Dr. Bavli joins Salma to discuss public health errors, which are different from medical errors but can also result in harms to the population. By exploring a wide array of examples—including the approval of Oxycontin in the US and Canada—they discuss the difference between errors of commission and errors of omission and highlight the importance of having conversations about these errors within the field. They also discuss the importance of identifying the errors versus assigning blame, the role that polarization has played in prioritizing some errors over others, the key role that transparency about errors can have on trust, and explore when has enough time passed to determine if an error has been made.

This episode will invite you to think beyond ideological, partisan, and professional lines, to understand, identify, and confront public health errors to improve the health of all.

Useful resources:

• Bavli, Itai. When Public Health Goes Wrong. Substack, accessed March 19, 2026. https://itaibavli.substack.com/
• Bavli I. When Public Health Goes Wrong: Toward a New Concept of Public Health Error. J Law Med Ethics. 2023;51(2):385-402. doi:10.1017/jme.2023.67

Host: Dr. Salma Abdalla Editors: Catalina Melendez Contreras Marketing: Kinkini Bhaduri Music: Eden Avery / Melting Glass from Epidemic Sound https://www.epidemicsound.com/track/2fqOXWpHab/

The views and opinions expressed by the guest in this episode do not necessarily reflect those of their institution, the funders, or the podcast team.