Who do you trust the most in America? Nurses, pharmacists, doctors, and police officers. Who’s least trusted? Elected officials in Congress, car salesmen, stockbrockers, and…HMO managers.

Gallup‘s annual Honesty and Ethics of Professions poll is out and finds that health providers and front-line health workers rank highest in the nation.

Nearly 9 in 10 Americans say nurses have the highest integrity, followed by 2 in 3 Americans ranking pharmacists and doctors as high or very high.

Integrity grades aren’t so high, though, for chiropractors and psychiatrists, ranked very high or high in ethics among 34% and 33% of Americans, respectively.

Negative perceptions have exacerbated among several professions in the past few years: the most dramatic declines have been in Congress and financial services.

The chart shows the high “low” and “very low” scores among the worst-regarded workers — note that HMO managers are ranked low by 43% of Americans, a similar low score with insurance salespeople. Only car salesmen, Congressfolk, and stockbrokers have higher percentages of low scores.

Gallup conducted the telephone survey with 1,017 adults 18 and older in November 2009.

Health Populi’s Hot Points: Health providers and front-line health workers enjoy high integrity marks among Americans. Congresspeople were major losers when it comes to honesty and ethics.

Integrity breeds trust. Americans en masse clearly trust the professionals who personally care for their health: the nurse in the doctor’s office, hospital or clinic; the pharmacist who dispenses their behind-the-counter prescription drugs; and, their personal physicians.

These are the highest-valued relationships in U.S. health care. Americans don’t tend to trust the executives who run health plans (“HMOs” as named in the Gallup survey).

When looking to motivate healthy behaviors and choices among Americans, public policy should at least do-no-harm. Policy should further bolster the relationships between the valued professions and health citizens through fair reimbursement, infrastructure investment (e.g., health IT and support for implementation), and other sound public policies that will help to ensure these positive relationships hold over time.

As for health plan execs and their relationships with American health consumers…they have their trust-work cut out for them.