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NOW WHAT FOR PUBLIC HEALTH?  
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Katelyn Jetelina
November 8, 2024
Your Local Epdemiologist
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_ We need to be ready for a new world. RFK Jr. will have more
influence, with his cast of characters who have a history of opposing
evidence-based public health practice. _

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The U.S. election this week sent shock waves through the field of
public health—not just domestically, but internationally as well.

For many in public health, like me, the prospect of national
leadership by individuals with an established track record of ignoring
the evidence is deeply disconcerting. This has led to anxiety (and
even feelings of loss and sadness). So much is unknown about the
future of this field—from policies like routine vaccinations, to the
impact of falsehoods moving mainstream, to the resources available to
hold up an “invisible shield” for the public’s health.

What _is_ becoming increasingly clear is that we are entering a new
world. As we put one foot in front of another, we must remember
there’s a difference between what we can and can’t change, and
sometimes, there’s a difference between what is easy and what is
needed.

THIS WILL BE A DIFFERENT WORLD

While we in public health are all too familiar with the cycle of
panic and neglect
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this terrain is different. The leadership choices are categorically
unreliable for scientific narrative.

_RFK JR._ will have more influence with his cast of characters
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who have a history of opposing evidence-based public health practice.
For example, RFK Jr. founded Children’s Health Defense, a well-oiled
machine responsible for 1 in 4 low-credibility Tweets 
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pandemic, leading to a large profit
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His influence also led to a Samoa outbreak of measles
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caused more than 80 deaths, mostly among children.

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Tweets shared by users geolocated in the U.S. that link to a
low-credibility source. Source: Nature
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Similarly, the Washington Post reported
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Florida Surgeon General—is on the shortlist for the Secretary of
Health and Human Services. Although a doctor, he has a well-documented
history of falsehoods about Covid-19 vaccines and went against
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standard of practice guidelines for a measles outbreak at a Florida
school.

Leadership matters. Ineffective or dangerous health policy decisions
can be driven by mixing reasonable ideas with falsehoods and/or not
accurately identifying what is causing us to be unhealthy and
“fixing” that. For example, RFK Jr. said his first move would be
removing fluoride from water—this is not grounded in scientific
evidence, and reflects a fundamental misunderstanding between a hazard
(that something could potentially cause harm) and a risk (the
probability of something happening).

Importantly, all of this unfolds after 5 years of public health being
through the wringer. And, in an already shifting landscape: general
amnesia of vaccine-preventable diseases, loss of trust in
institutions, and a changing information landscape fueled by social
media. This has led to policies like the following:

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Last month, 6 counties in Idaho outright banned
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availability of Covid-19 vaccines.

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Texas doesn’t allow 
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health departments to educate about Covid-19 vaccines.

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Missouri has removed the ability for public health departments to
report data to WHO (and thus, CDC).

HOW WE NAVIGATE THIS NEW WORLD WILL MATTER

We will all overcome this together, and we will do so through
thoughtful and clear communication.

For individuals, this will mean consuming information with a healthy
skepticism. For trusted messengers, like physicians, faith-based
communities, and businesses, your jobs are more critical than ever.
For institutions, this means we need your courage to protect those who
are speaking truth. For public health leaders, it’s time to be
proactive.

How we navigate this changing landscape will matter if we want to
ensure that public health is still guided by values that are important
to _ALL OF US_. This does not mean surrendering our mission but
rather finding balance.

For public health (and all of us), this means: 

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_BUILDING BRIDGES_ instead of manning the barricades by finding
common ground, which requires active engagement and humility. (It
always helps me focus on one fact: No one wants to die. Then I move
from there.)

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_RECOGNIZING WHAT YOU SAY MATTERS._ That is, if you want people to
hear you. Through literally the words we use, the framing, and the
approach.

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_COMMUNICATE WITH EMPATHY,_ as anger and shame will only drive people
further away.

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_LISTENING (NOT SIMPLY HEARING)_ so we can respond better to the
needs on the ground. Americans need their questions answered, not to
be told what to believe.

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_MAKING STRATEGIC CHOICES_ about which battles to fight, at what
time, and at what level of government. Political capital is as scarce
as financial resources—and needs to be allocated carefully.

I think our _BIGGEST CHALLENGE WILL BE FIGHTING FOR THE TRUTH._

In this new world, there is a good chance that falsehoods and rumors
will be broadcast from the most powerful office in the nation. This
will drive even more confusion, anxiety, and questions that will have
a direct, negative impact on Americans who genuinely have questions
and are interested in making evidence-based health decisions. 

WE NEED TO ELEVATE RELIABLE NARRATORS TO PROVIDE A
COUNTERWEIGHT. Unfortunately, voices that provide unbiased,
evidence-based information are increasingly vulnerable, have limited
capacity, and are in a fragmented world. Some Good Samaritans are
holding up the front lines of science communication, but only with
band-aids, hope, and very limited funding (if at all).

BOTTOM LINE

We are entering an uncertain and unfamiliar public health world. We
must adapt effectively while keeping true to our mission—to protect
the public’s health—as our North Star.

One thing is for certain: The entire YLE team will keep showing up. We
will continue sharing accurate, honest, and reliable public health
information regardless of politics. And we will still be here to
empower you all to make evidence-based decisions to keep yourselves
and your loved ones healthy. That won’t change. 

Love, YLE

P.S. YLE efforts are 100% supported through your subscriptions
and donations
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consider an upgrade to keep this work fueled. We need all the support
we can get.

Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn
Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little
girls. The main goal of this newsletter is to “translate” the
ever-evolving public health science so that people will be
well-equipped to make evidence-based decisions. This newsletter is
free to everyone, thanks to the generous support of fellow YLE
community members. To support this effort, subscribe here
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* public health
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* vaccines
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* anti-vaxxers
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* RFK jr.
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* Donald Trump
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INTERPRET THE WORLD AND CHANGE IT

 

 

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