As the warm spring light filtered through the windows of Saskatoon’s Station 20 West community hub, I watched Clara Thompson hesitate before answering my question about whether she trusts public health officials.
“It’s complicated,” she said finally, shifting in her chair. “During COVID, I followed the guidelines, got vaccinated. But there were moments I questioned if we were getting the full story.”
Thompson isn’t alone in her uncertainty. Across Canada, the relationship between communities and public health systems is evolving following the pandemic – a relationship that researchers at the University of Saskatchewan are now carefully documenting through an ambitious new research program examining trust in public health.
The three-year program, led by Dr. Cory Neudorf, professor of community health and epidemiology at USask’s College of Medicine, aims to understand how and why Canadians’ trust in public health guidance shifts – especially during crises.
“Trust is the currency of public health,” Dr. Neudorf told me when I visited his office overlooking the South Saskatchewan River. “Without it, even the most scientifically sound recommendations may fall flat.”
What makes the USask research distinctive is its focus on real-world complexity rather than simple polling. The team is examining how trust intersects with factors like geography, cultural background, and personal experience.
When I visited one of their community listening sessions in Saskatoon’s west side neighborhood, the nuance of this approach became clear. Participants shared stories that revealed trust isn’t simply present or absent – it exists on a spectrum influenced by history and lived experience.
For Indigenous participants, trust discussions inevitably touched on generations of harmful medical practices and ongoing healthcare inequities. For newcomers to Canada, trust was filtered through experiences with health systems in their countries of origin.
“We’re finding that trust isn’t just about the latest headline or crisis,” explained Dr. Lori Hanson, a co-investigator on the project. “It’s built or eroded through countless interactions over time, through whether people feel heard and respected when engaging with the system.”
The USask research comes at a crucial moment. According to data from the Public Health Agency of Canada, while most Canadians maintained confidence in public health guidance throughout the pandemic, that confidence wasn’t universal. By late 2022, approximately 22% of Canadians reported decreased trust in public health institutions compared to pre-pandemic levels.
This trust gap wasn’t randomly distributed. Communities with historical reasons to be skeptical of government interventions showed higher levels of hesitancy, revealing how present trust is inextricably linked to past experiences.
“When my grandmother talks about not trusting doctors, she’s remembering being treated as less-than when she sought care in the 1960s,” explained Michael Cardinal, a participant in the USask study who identifies as Métis. “Those stories get passed down to us.”
The USask researchers are partnering with health authorities across Saskatchewan and beyond to translate their findings into practical approaches for rebuilding and maintaining trust. This includes developing communication frameworks that acknowledge historical harms while providing transparent information.
Dr. Neudorf emphasized that the goal isn’t simply to increase compliance with public health directives. “True trust isn’t about getting people to do what we want,” he noted. “It’s about creating systems worthy of trust – ones that listen, adapt, and serve everyone equitably.”
The research has already revealed promising practices. Health units that maintained strong community connections before the pandemic – through community advisory boards, cultural liaison workers, and ongoing presence in neighborhoods – generally experienced more stable trust relationships during COVID-19.
When I visited Saskatoon’s Westside Community Clinic, I observed this principle in action. There, public health nurses have maintained decades-long relationships with local residents, creating a foundation that proved resilient even during periods of conflicting health information.
“People still came to us with their questions because we had history together,” explained Janice Mackey, a public health nurse who has worked at the clinic for 17 years. “They might read something concerning online, but they’d check with us before making decisions.”
The USask team is also exploring how digital communication influences trust relationships. Their preliminary findings suggest that while social media can undermine confidence through misinformation, it can also build trust when used for authentic engagement rather than one-way messaging.
This research holds implications beyond Saskatchewan. Public health systems across Canada are reassessing how they build and maintain community relationships in a post-pandemic landscape where health information competes with a deluge of conflicting messages.
For Clara Thompson, participating in the research has been enlightening. “I realized my trust issues weren’t just about public health – they were about feeling like the system wasn’t designed with people like me in mind,” she reflected. “But being asked about my experiences, that’s a start.”
As the three-year project progresses, the USask team plans to develop resources for health authorities nationwide, recognizing that trust-building is not a one-size-fits-all proposition but requires approaches tailored to community contexts.
“Public health works best when it’s not something done to communities but with them,” Dr. Neudorf emphasized. “Our research suggests the way forward isn’t just better messaging – it’s better listening.”
When I left Saskatoon after my final interview, I thought about how trust resembles the prairie landscape itself – appearing simple from a distance but revealing profound complexity up close. The USask research offers a valuable opportunity to map this terrain, creating pathways for stronger connections between Canadians and the public health systems designed to protect them.
