This essay reviews more than forty years of public opinion polling to look at trust in medicine, the health system, and public health. We use polling data to explore the reasons for the decline and current level of public trust in leaders of medicine and public health, including underlying forces such as the decline in trust in other institutions. Except for the military, none of the efforts to improve public trust in various institutions have been very successful to date. Given the uncertainty about how to restore trust, this essay makes a number of recommendations that might improve public trust in medicine and public health in the future.