---
title: "Ratios of Trust: the Rise and Fall of the WHO’s Popular Legitimacy"
description: Christiane Melchior discusses her team's research on the World Health Organization
image: https://blog.jmir.org/hubfs/StoryTap%20Videos/Christiane%20Melchior%20blog.png
---

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# Ratios of Trust: the Rise and Fall of the WHO’s Popular Legitimacy

![Reviewed by Kayleigh-Ann Clegg, PhD](https://blog.jmir.org/hs-fs/hubfs/Headshot.jpg?width=45&name=Headshot.jpg) 

[Reviewed by Kayleigh-Ann Clegg, PhD](https://blog.jmir.org/author/reviewed-by-kayleigh-ann-clegg-phd)

Published Date: 13 March 2026 4:55 p.m.

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![Photo of Christiane Melchior, a postdoctoral researcher at Lappeenranta-Lahti University and her colleagues from the Université de Montréal](https://blog.jmir.org/hubfs/StoryTap%20Videos/Christiane%20Melchior%20blog.png)

In the digital age, a ratio on social media is more than just a fleeting moment of internet drama, it can be a measurable signal of institutional trust. As global health crises like COVID-19 unfold, the battle for public confidence moves from official press releases to the real-time arena of social platforms. But can we scientifically measure something as complex as popular legitimacy simply by looking at how the world interacts with an organization on X?

| --- **Key Takeaways** |
| --- |
| **The Retweet-to-Reply Barometer**: Researchers introduced the retweet-to-reply ratio as a framework to scientifically measure the World Health Organization’s (WHO) popular legitimacy on social media. |
| **COVID-19 Caused a Plunge in Trust**: The onset of the COVID-19 pandemic triggered a significant and sustained decline in public confidence, as the ratio of retweets (endorsement) to replies (dissent/scrutiny) plummeted through 2021. |
| **Real-Time Early Warning System**: This ratiometric framework offers global health leaders a practical tool to move beyond anecdotal evidence, monitor institutional reputation in real-time, and dynamically adapt communication strategies to combat misinformation. --- |

Listen to this blog post

3:26

**Christiane Melchior**, a postdoctoral researcher at [Lappeenranta-Lahti University](https://www.lut.fi/en) and her colleagues from the [Université de Montréal](https://www.umontreal.ca/), has pioneered a way to do exactly that. In their recent study, "[Social Media Metrics and Popular Legitimacy: Content Analysis of Pre- and Post-COVID-19 Public Engagement With the World Health Organization on X](https://www.jmir.org/2025/1/e69959/)," published in the [*Journal of Medical Internet Research*](https://www.jmir.org/), they introduced a framework that turns digital engagement into a barometer for global health governance.

### Moving Beyond Likes and Shares

While many social media strategies focus on raw reach, Melchior’s research looks at the quality of the interaction. By analyzing 46,667 tweets from the World Health Organization (WHO) spanning a 13-year period (2008–2021), the team identified a critical indicator: the **retweet-to-reply ratio**.

The logic is simple but powerful:

- **Retweets** generally signal endorsement and a willingness to spread a message.
- **Replies** on institutional accounts often signal dissent, scrutiny, or controversy.
- **A higher** **retweet-to-reply ratio** can be interpreted as more supportive engagement, and a lower ratio as more public skepticism.

The research found that the WHO’s popular legitimacy remained remarkably stable for over a decade. However, the onset of the COVID-19 pandemic triggered a game-changing shift. As tweet frequency surged, the ratio of retweets to replies plummeted, signaling a sustained decline in public confidence that lasted through 2021.

|   | In this video, Cristiane Melchior examines a decade-long longitudinal study analyzing the World Health Organization’s popular legitimacy through the lens of social media metrics on X. |   |
| --- | --- | --- |

### The Infodemiology Frontier

This study sits at the cutting edge of **infodemiology**, which is the science of how health information spreads, what influences it, and its impact on public health. Melchior notes that global crises fundamentally shift how the public views international institutions. By tracking these digital signals, leaders can move beyond anecdotal evidence to monitor their reputation in real-time.

The practical implications are clear: global health leaders can use this ratiometric framework to adapt communication strategies dynamically. If engagement acceleration slows or replies begin to dominate the narrative, it serves as an early warning system to fight misinformation and rebuild trust before the damage to institutional authority becomes permanent.

### Why JMIR?

Melchior and her colleagues chose to publish in the *Journal of Medical Internet Research* because of its status as the gold standard for research at the intersection of social media and public health. As a pioneer in open access, JMIR ensures that these findings reach the policymakers and practitioners who need them most to navigate future global health revolutions.

Curious to see how social media metrics can predict the rise and fall of institutional trust? [Watch the video](https://www.youtube.com/watch?v=VKwGPZhMeF8) featuring Christiane Melchior and read the [full research article](https://www.jmir.org/2025/1/e69959/) to explore the ratiometric framework used to analyze the WHO’s digital legitimacy.

---

Please cite as:  
Warin T, Melchior C, de Marcellis-Warin N. Social Media Metrics and Popular Legitimacy: Content Analysis of Pre– and Post–COVID-19 Public Engagement With the World Health Organization on X. J Med Internet Res 2025;27:e69959  
URL: [https://www.jmir.org/2025/1/e69959](https://www.jmir.org/2025/1/e69959)  
DOI: [10.2196/69959](https://www.jmir.org/2025/1/e69959)

![Reviewed by Kayleigh-Ann Clegg, PhD](https://blog.jmir.org/hs-fs/hubfs/Headshot.jpg?width=150&name=Headshot.jpg)

#### Reviewed by Kayleigh-Ann Clegg, PhD

[Follow me on my website](https://www.researchgate.net/profile/Kayleigh-Ann-Clegg) [Follow me on LinkedIn](https://www.linkedin.com/in/kayleighclegg/)

Scientific News Editor @ JMIR Publications with a diverse background in clinical psychology, academic research, and digital health program development. I'm passionate about knowledge translation and accessibility, as well as data- and values-driven innovation. My goal is to make vital scientific knowledge clear and accessible to everyone so that we can better our lives and the world around us.

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