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Health Influence Decentralized

The 2025 Edelman Trust Barometer Special Report: Trust and Health in South Africa coincides with the 5th anniversary of the COVID pandemic. We explore the question of influence – that is, whose voice makes it into our personal consideration set when making a health decision. The research shows that while influence was conventionally narrowly scoped, today it is quite broad, particularly among younger generations.

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SA’s Health Top 5

Institutions Fail Us on Health

Most South Africans feel that the most powerful entities in our societies do not support their health needs or concerns, or worse, may hurt their ability to get quality healthcare.

The percentage of global respondents who trust institutions to do what is right in addressing their health needs has declined across all categories year-over-year with NGOs seeing the sharpest drop.

However, in 2025, there has been marginal improvements in S. Africa, 56% trust business on health and trust in government, while low, improved by 8 points to 31%. Trust in NGOs dropped to 52%, while media, fell to 38%.
 

Decentralisation of Health Influence

Trust on health is being shaped on several fronts. Most trusted is my provider, then my friends and family – both of whom are local, nearby sources. Then as we radiate out from that inner orbit, trust lessens. The leaders of government and journalists are all distrusted.

Increasingly, South Africans are likely to have – at least in the past 12 months – disregarded their providers guidance in favor of what their peers or social media told them to do. That’s a double digit increase globally since last year and is even higher among young people.
 

The Youth Health Ecosystem Evolves

The South African youth health ecosystem is marked first by democratisation. Younger respondents among the ages of 18-34 were nearly two times more likely compared to those 55+ to believe they knew as much about health matters as doctors if they did their own research.

Young people are also increasingly engaged with health information. On a monthly or more basis, 2 in 3 globally are reading health media at its original source or sent over social media. And an increasing majority are also getting independent media created by podcasts and newsletters from outside of newsrooms.
 

Trust in Media to Report Health Information Collapses

Globally, trust in media to report health information has collapsed and failed to recover. Health journalism enjoyed relatively high trust in 2019, at 57 percent, but has since registered a drastic 13 point drop over a 5-year period to 44 percent this year. In SA, the figures have dropped to new lows at 36% – an 11-point decrease over the same period.
 

Communicate to Regain Health Influence

Providers and institutions can regain influence on consumers’ health decisions through effective communications. For South Africans, personal relevance is key. So is empathy and accessibility. We find that people who go to uncredentialed voices are doing so to find empathy and direct experience with their issues, which were the top two results, globally, across age, gender, and political affiliation groups. Conventional providers need to learn from this.
 

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