Declining confidence in major institutions is driving more people to trust their own ability to assess health information or turn to friends for guidance, indicates a new global Edelman Trust Barometer survey provided exclusively to Axios.

Why it matters: Lack of trust in public health agencies, nonprofits and the media is emerging as an enduring legacy of the COVID-19 pandemic, and it has huge implications for how we respond to the next big disease threat or even manage our day-to-day health.

• The growing rise of "health empowerment" is a double-edged sword — it can make people more engaged stewards of their own care, but it can also leave them vulnerable to rising health misinformation that's become a major threat.
• "The rise of empowerment is potentially something great," said Richard Edelman, CEO of the global communications firm. "But without it being balanced with some form of trust in institutions, trust in expertise — if it's all self-reliance, it's like giving a kid the keys to a car and saying, 'Go drive!'"

The big picture: The U.S. is far from alone in the political fracturing and rising skepticism that characterized our own COVID-19 response, suggest the Edelman survey of 15,000 people across the U.S. and 15 countries.

• Fears about the politicization of medical science have shot up, rising 13 percentage points in the past year to 64%. That puts it on par with concerns about health care affordability and the possibility of another pandemic.
• 4 in 10 said they have regretted a health decision they made based on misinformation at least once, with higher rates among younger populations.
• They said the top source of misinformation was a product advertisement, followed by friends and family, and then user-generated content.

Still, people continue to have enormous trust in their doctors' advice, though a sizable portion are concerned whether their doctors share their values.

• 41% of adults ages 18-34 say they wouldn't trust their doctor or would drop them if they don't have the same political or social views.
• It was 35% for people 35-54 and 18% for 55-plus.

Zoom in: Overall, 2 in 3 say they feel confident making decisions about their health, sorting out bad health info from good, and raising concerns with their doctors.

• But only 37% said they feel empowered and trust the health care system. That sense of empowerment could ultimately end up being a good thing if trust in institutions could be restored, Edelman said.
• "Just in general, this empowerment thing is across income groups, education levels, age groups," he said. "So that shows me that there's a solid foundation, and if we can get the politics out of this, we're going to be in a good place."