Beyond “Trust the Science”: How Public Health Must Relearn How to Engage Communities

Public health is facing a paradox.

On the one hand, never before has scientific evidence played such a visible role in public life. During COVID-19, epidemiological models shaped national policy. Scientists became household names. Research moved at historic speed.

On the other hand, trust fractured. Scientists were harassed. Communities disengaged. Evidence was reframed as ideology. “Trust the science” became a rallying cry—and, for many, a provocation.

The instinctive response has been to treat this as a communication failure: not enough clarity, not enough transparency, not enough media training. But a growing body of research suggests something more uncomfortable:

Public health’s engagement problem is structural, not stylistic.

Across four recent peer-reviewed studies, a consistent picture emerges. Public trust is not rebuilt by better messaging alone. Impact does not emerge from dissemination alone. And asking scientists to “engage more” without changing institutional conditions may actively backfire.

Together, these studies force a deeper question:

What would it actually mean for public health to engage communities as partners—not audiences—without burning out scientists, eroding legitimacy, or oversimplifying science itself?

1. Impact Is a Process, Not an Outcome—and Engagement Is Central

Public health has long talked about “impact beyond academia,” but often evaluates it backward—starting with outcomes and retrofitting narratives.

A large cross-disciplinary analysis of 200 Research Excellence Framework (REF) impact cases offers a different lens. Instead of focusing on final impacts, the researchers identify six stages through which research generates societal impact: problem identification, research conduct, output production, output utilization, impact formation, and multi-stakeholder interaction.

The critical insight for public health is this: Impact emerges through sustained interaction—not one-way translation.

Engagement is not a dissemination step at the end. It is present from the beginning—when problems are framed, when methods are chosen, and when findings are interpreted in context. For public health, this challenges a familiar pattern:

• Define problems internally
• Produce evidence
• “Push” findings outward
• Measure uptake

The REF analysis shows that meaningful impact is far more likely when non-academic actors shape the research trajectory itself. Communities are not passive recipients of evidence; they are co-producers of relevance.

This reframes engagement from “explaining science better” to sharing epistemic authority earlier and more honestly.

2. Scholar-Activism Reveals the Tension Public Health Refuses to Name

If engagement is essential for impact, why are institutions so uneasy about scientists being visible, vocal, or values-driven? A comprehensive review of 85 studies on scholar-activism helps explain why this tension persists.

Scholar-activism—researchers engaging in social or political change—is not new. But what is new is how contested it has become. The literature shows that scholar-activism is shaped by:

• Institutional incentives and career risk
• Norms about “objectivity” and neutrality
• Uneven protections for public engagement
• Fear of politicization and backlash

For public health, this is not an abstract debate. Public health exists precisely at the boundary of science and policy. Asking scientists to engage communities while insisting they remain “apolitical” creates a structural contradiction.

The review highlights a core problem: Institutions reward publication and grants—but externalize the risks of engagement onto individuals.

Public health often celebrates “engaged scholarship” rhetorically while offering little protection, training, or legitimacy when scholars step into contested public arenas.

This disconnect matters because communities can sense performative engagement. When scientists appear only during crises—or speak without acknowledging values, uncertainty, or lived experience—trust erodes.

3. The Pandemic Taught Scientists a Dangerous Lesson About Engagement

If public health wants more engagement, it must confront an uncomfortable reality: engagement has become risky. A survey of over 4,200 scientists in Germany examined how the COVID-19 pandemic affected willingness to engage with the public. The findings are sobering. Many scientists experienced:

• Harassment
• Threats
• Online abuse
• Personal safety concerns

The result? A divergence. Some scientists doubled down, feeling morally obligated to speak. Others withdrew—not just from controversial topics, but from public engagement entirely.

Crucially, this wasn’t driven by ignorance or apathy. It was driven by threat appraisal. When scientists perceive engagement as dangerous and unsupported, withdrawal becomes a rational response.

For public health, this creates a vicious cycle:

• Communities perceive silence or distance
• Trust declines
• Scientists face more hostility
• Engagement becomes even rarer

Telling scientists to “communicate better” without addressing safety, institutional backing, and emotional labor is not just ineffective—it is irresponsible.

4. The Trust Crisis Is a Legitimacy Crisis, Not a Knowledge Crisis

Perhaps the most challenging insight comes from a philosophical analysis of science’s legitimacy crisis. The declining trust in science is not primarily about misinformation or ignorance. It is about a mismatch between how science claims authority and how societies now understand knowledge, power, and participation.

For decades, science justified its authority through claims of neutrality, autonomy, and separation from culture. But in a pluralistic, networked world, those claims ring hollow—especially when scientific knowledge is visibly entangled with policy decisions that affect people’s lives.

The authors propose a radical but resonant idea:

Trust is not restored by defending autonomy—it is restored by democratizing knowledge production.

This does not mean abandoning rigor. It means acknowledging that:

• Problem framing is value-laden
• Evidence does not speak for itself
• Communities have epistemic knowledge
• Transparency includes uncertainty and disagreement

Public health, more than most fields, is already operating in this space—but often without naming it.

5. What This Means for Public Health Practice

Taken together, these studies point toward a clear conclusion: Public health must move from engagement as outreach to engagement as infrastructure. That shift has practical implications.

1. Engagement Must Start Upstream

Community engagement cannot be limited to dissemination or “buy-in.” Communities must shape:

• Research questions
• Definitions of impact
• Interpretations of evidence

This aligns impact generation with lived realities, not post-hoc justification.

2. Institutions Must Protect Engaged Scientists

If engagement is essential, then institutions must:

• Recognize engagement as core labor
• Provide safety protocols and legal backing
• Train scientists for dialogic—not adversarial—engagement
• Reward process, not just outcomes

Otherwise, engagement will remain uneven and inequitable.

3. Public Health Must Be Honest About Values

Public health already operates on normative commitments—equity, prevention, collective well-being. Pretending otherwise undermines credibility. Transparency about values builds trust more effectively than claims of pure neutrality.

4. Impact Metrics Must Change

Outcome-only evaluation distorts behavior. Process-oriented evaluation—tracking relationships, learning, and co-production—better reflects how impact actually happens.

5. Engagement Is Emotional Labor—and Must Be Resourced

Engagement involves fear, conflict, and vulnerability. Ignoring this reality fuels burnout and withdrawal.

Conclusion: From Broadcasting to Belonging

Public health does not need louder megaphones. It needs stronger relationships.

The evidence is clear: trust is not rebuilt through slogans, infographics, or media appearances alone. It is rebuilt when communities see themselves reflected in how problems are defined, how evidence is used, and how uncertainty is handled.

This is slower work. Messier work. Riskier work.

But it is also the only kind of engagement that produces lasting legitimacy—and real public health impact.

If public health is serious about serving communities, it must stop treating engagement as an accessory and start treating it as the work itself.