The poll found that trust isn't just a problem for federal health agencies. State health departments have the trust of 41% of Americans, and local health departments only did slightly better at 44%. Trust in public health during a pandemic is incredibly high stakes. Public health measures — like mask wearing and business restrictions — can't work as intended to contain a pandemic if the community doesn't believe they're based on reliable information. If that trust is not there, people won't agree "to change their lives, take preventive [measures], take vaccines," Blendon says. The mistrust is not really surprising. There have been plenty of missteps throughout in the past year, due to everything from political interference, to incomplete information, to confusing messaging.