A trust deficit is undermining public health across Europe

Map of Europe on globe

A new World Health Organisation (WHO) report written by a University of Liverpool Professor reveals that since the COVID-19 pandemic, the number of people out of work, in Europe who trust their governments has fallen by an additional 40%.

The report, written by Professor Benjamin Barr, Professor in Applied Public Health Research, University investigators, partners from Leeds Beckett University and the WHO have set out alarming data showing a trust deficit is undermining public health across the WHO European Region, highlighting that urgent solutions are needed.

Transforming the health and social equity landscape: promoting socially just and inclusive growth to improve resilience illustrates that Europe is in the midst of a serious trust deficit following the COVID-19 pandemic. The report explains people from the lowest income groups show lower levels of trust in others and their governments when compared to people from wealthier groups, and those out of work are experiencing a 40% decline in trust in their governments.

New WHO data shows that when people don’t feel the benefit of government policies — including on health issues — yet see others benefitting, they turn away from government and other public entities and institutions. The pandemic has highlighted the often-fatal consequences of these inequities, with 600,000 excess deaths in the European Region attributable to low human development and poor investments in health systems.

The report’s key findings show widening health inequalities are leaving behind marginalized groups—particularly young people.

Christine Brown, Head, WHO European Office for Investment for Health and Development, which coordinated the review said: “We stand at a critical turning point. Our new analysis further confirms “profit-only” economic policies do not work, reinforcing the importance of health as a beneficiary and a driver of well-being economies. This report shows that health, the economy and the social fabric of our daily lives are interwoven. We see that when the benefits of government policies fail to create better lives and opportunity for all in society, solidarity and trust are compromised, leading to a breakdown in the dynamics of relationships between people, governments and institutions, all of which is at the heart of social stability and the well-being of our Region.”

Significantly, the new report calls for high-quality, accountable and transparent public policies and services—such as ensuring that social support targets those who need it the most—as a way forward to build and strengthen social cohesion, resilience and trust, and reduce the widening health gap.

At the same time, the research finds that countries’ recovery and resilience plans do have the potential to turn the tide, with smart investments in green and digital economies—but only when designing these policies based on the principles of equity and solidarity.

The report sets out concrete actions that governments and policymakers should take to turn this into reality, including:

  • Investing in young people
  • Developing responsive and integrated social and health protection systems
  • Ensuring community voices, particularly young people, are heard
  • Promoting well-being through equitable digital and green economic recovery
  • Ensuring mechanisms for equitably distributing health and care resources to enable people to thrive
  • Access should be universal and proportionate to need across the socioeconomic gradient.

Professor Ben Barr from the WHO Collaborating Centre for Policy Research on Determinants of Health Equity, and one of the lead authors of the report said: “These policy solutions show how public investment can and must reduce the health and social equity divide and prevent the rising crisis of mental health and social exclusion of our populations, including young people, and particularly those falling behind.

“They show how digital and green transitions can promote health and well-being. And they highlight the importance of listening to and working with diverse groups impacted by the widening social and economic insecurities to build trust, resilience, and social cohesion.”