How did public health became a four-letter word, and what to do about it?
America’s public health leaders gathered in Minneapolis this week to grapple with the frustrating reality that too many people stopped listening to them during the COVID-19 pandemic, and still aren’t heeding their advice today.
The question looming over the conference of the American Public Health Association: how to win trust back, especially when views on public health are rooted in cultural or political beliefs.
Public health has traditionally involved one-way communication and scientists telling communities how to protect themselves from chronic diseases such as obesity, infections such as influenza, and environmental threats such as lead in old paint. That approach isn’t working, said Dr. Simbo Ige, commissioner of the Chicago Department of Public Health. Public health workers must listen, she said, even to people guided by misinformation.
“If you don’t understand how people arrive at some of these ideas, it is very hard to correct,” she said. “Our first instinct is [to say], ‘No, you are wrong.’ You cannot motivate people with shame and guilt. You have to try and spend some time to understand where [they] are coming from.”
Trust has fractured somewhat along political lines, as Republicans were more likely during the pandemic to oppose government mask-wearing requirements and vaccine mandates that were put in place in an attempt to slow the spread of COVID-19. A study last fall showed lingering resentment over the pandemic response made Republicans even less trusting of cancer-prevention messages.
Mistrust extends beyond politics, though. Minnesota once had one of the nation’s highest rates of children vaccinated for measles by the time they entered kindergarten, at 94%. That rate dropped to 87% at the start of the 2022-2023 school year, sixth-worst among states.
Minnesota consequently has reported 60 measles cases this year, the second-most among states. The outbreak is largely among unvaccinated Somali children whose parents have harbored fears, contradicted by research, that the vaccine can lead to autism.
