Distrust Isn’t a Feeling. It’s a Design Flaw.

What stood out to Limetree at IPHA’s 85th Annual Public Health Workforce Conference, September 2026.

The first week in September, Limetree attended the Illinois Public Health Association’s 85th Annual Public Health Workforce Conference in Springfield, right as IPHA turned 85. This year’s theme was Together We Thrive. Hale was there to present a session called “Designing for Action,” walking through a four-layer framework for using behavioral science to design prevention and patient communications that get people to act, instead of just informing them.

Get the full four-layer framework →

A fortuitous encounter with an IPHA representative at another conference got us excited to profess our passion for behavioral science to a new audience. It was our first time at a conference built specifically around public health, a facet of healthcare relatively new to Limetree. We came in with open minds to see healthcare through the eyes of a new group of practitioners and a sincere desire to contribute to the tough problems in the sector. What we found is that trust is a live issue there too, something that reaches well beyond public health.

Trust kept surfacing throughout the sessions. It wasn’t a track or an assigned theme, nor was it one of the categories organizers set out to address. It just kept showing up anyway. One session tackled AI-generated health misinformation. Another used community storytelling to address vaccine hesitancy. A third looked at how civic identity can bridge political divides in public health work. A poster from Meridian Health Plan asked point-blank why trust and friction matter so much in how people engage with healthcare at all. Different proposals, submitted independently, all circling some version of the same question. Why don’t people trust us, what are the consequences, and what do we do about it?

Hard questions. Trust in health institutions, across the board from government agencies and healthcare providers and payers alike, has genuinely dropped over the past several years, and that drop shows up consistently across age, income, and political lines. This isn’t a one-sided story. Here’s the encouraging part. Personal, local relationships have held up far better than the big, abstract kind. People still trust their own doctor more than they trust headlines.

At Limetree, we build communications that drive action, and trust runs under nearly every decision we make. Get it right, and people show up, follow through, ask questions. Get it wrong, and even the best-designed communication goes unread, or worse, unbelieved.

But trust isn’t a tactic you deploy on a single mailer or landing page. It’s built at the level of the organization, long before any individual message reaches a member, and it’s spent far faster than it’s earned. It only takes a confusing bill, a call that goes nowhere, or a benefit that doesn’t work the way it was described to chip away at an organization’s credibility, and no clever copy fixes that after the fact.

So what’s the job for behavioral scientists? Here’s where the behavioral science process shines. Define trust principles that hold across the entire member experience, and ensure each touchpoint aligns. Discover what worked and what didn’t. Analyze what experiences build trust, and what experiences erode it. Design systems that catch it when a member is struggling, and respond with care rather than a script. And above all, listen. Trust isn’t a feeling you can talk someone into.

Thank you to IPHA, and to Phil, for pointing us there. Happy 85th birthday, and here’s to thriving together for a lot more years after this one.