The George Washington University’s Milken Institute School of Public Health hosted a forum April 7 kicking off the 30th anniversary of National Public Health Week, an initiative of the American Public Health Association (APHA). The week is intended to highlight the impact of public health on our lives to date, and to identify some opportunities and challenges ahead.
Lynn Goldman, the Michael and Lori Milken Dean of the Milken Institute School of Public Health, delivered welcoming remarks, noting that the week celebrates both the power and the promise of public health.
“Over the past few years, the field of public health has been tested in ways few of us could have imagined,” Goldman said. “But we have also witnessed innovation, courage and community in action. Today is a reminder that public health is not just a discipline—it is a movement.” She urged listeners to renew their dedication “to the values that have always defined this work: prevention, protection and progress.”
Deanna Wathington, president of APHA, introduced the panels. The first, “Fact Versus Fiction,” addressed the growing problem of inaccurate information in the health messages we receive, particularly in the digital sphere. Panelists included TikTok medical mythbuster Joel Bervell; Georges Benjamin, executive director of APHA; and Julia Daisy Fraustino, founding director of the Public Interest Communication Research Lab and assistant professor of strategic communication at the WVU College of Creative Arts and Media.
Panelists decried the unprecedented situation facing public health professionals in the United States.
“We have people at the highest levels of government who are spreading fiction, when we know the facts,” Bervell said.
“We’re now in a different operating environment than we were when we planned this week,” Benjamin said, with people losing faith in genuine medical experts and giving credence to vaccine skeptics. That faith is difficult to restore, he said. “Trust is gained by drops and lost by gallons.”
Better storytelling on social media and elsewhere, Bervell said, can help to counter false information. Telling the stories of individuals can be effective against both misinformation and disinformation.
“Misinformation is information that's not evidence-based,” Bervell said, “that’s not agreed upon by the scientific community, that spreads online, and is incorrect.” Misinformation is not purposeful, he said, contrasting it with disinformation, which is deliberately misleading. Disinformation is “spread with the intention of misleading a population, an individual, a group, in order to make them believe something that is not true.”
“It’s all about intent,” Benjamin agreed, adding that sometimes people who intend to mislead speak only part of the truth, with a goal of driving people to a hidden agenda.
Noting that misinformation can be spread with good intentions, Fraustino said it’s important to “meet people where they are with the information they’re ready to hear.”
“Traditional public health institutions often struggle to compete with the speed and engagement of social media content,” Fraustino said. She asked what strategies public health professionals could adopt to ensure that accurate information reaches the public.
Bervell began with a nonmedical answer, noting that information is spread most effectively when people feel an individual voice is speaking to them. Business brands often speak with a recognizable voice, he noted, while public health institutions often do not. He pointed to an Instagram page maintained by Johns Hopkins University’s School of Public Health as a laudable exception.
Citing successful public health campaigns to educate people about the dangers of smoking or inform them about HIV, Bervell said that rooting remarks in everyday experience is the best way to combat misinformation.
Government is at a disadvantage in responding nimbly to misinformation, Benjamin said. There is always a concern that “somebody in government would say the wrong thing and offend somebody and undermine some political process.”
Restoring trust is a matter, first, of finding the right community partners, panelists said.
“The challenge in public health is that we’re the faceless bureaucrats that nobody knows,” Benjamin said.
Frank talk about the times when trust has been lost is also important, Brevell said, noting ongoing conversations within communities of color who remember betrayals such as the Tuskegee syphilis study.
Carefully chosen language, with attention paid to the connotations of words, also helps, Fraustino noted. People react more positively if professionals speak of “community vaccination clinics” instead of “mass vaccination sites.”
While it’s important to do more listening and less talking, Benjamin added, too few people know what, exactly, public health officials do. It’s valuable to tell them.
“We are the people that make sure the air is safe to breathe, the water is safe to drink, and the food is safe to eat,” Benjamin said.
From left, Veena Thamilselvan, Brian Castrucci and Sara Rosenbaum contrasted past public health successes with failures of the present and discussed hopes for the future. (Photo by Jamie Christiani)
Building on the lessons and successes of the past was the focus of the second panel, “Past Is Prologue,” featuring Sara Rosenbaum, Milken Institute SPH professor emerita of health law and policy, and Brian Castrucci, president and CEO of the DeBaumont Foundation. Veena Thamilselvan, a recent graduate of Johns Hopkins University, represented the next generation of public health leaders.
Thamilselvan asked panelists to name a public health win from the past 30 years that could help professionals navigate in the difficult present moment.
While the Affordable Care Act was not perfect, Rosenbaum said, it was one of the “greatest statements of social solidarity we have mustered in the past 30 years,” because its insurance reform meant that “we all agree to share the risks of illness with those with whom we share society.”
Castrucci said now is a depressing time to be talking about progress. “Steel may have built our skylines, but public health built our country,” he said, adding that public health “made the American dream happen.” He then drew a stark contrast with the present.
“We eradicated diseases,” he said, including smallpox. “We were on the path to being the healthiest nation, and now we’re not.”
“This is a very difficult Public Health Week,” Castrucci concluded. “We are down 20 points with a minute left on the clock. No matter what we do, we’re going to lose this game. The problem is if we let the loss dictate the rest of the season.”
His advice to professionals is to reengage and “get better at knowing what to say.”
Public health workers once normalized using condoms to combat the AIDS epidemic, Castrucci said. But if the same epidemic started today, he added, people would be talking about whether HIV causes AIDS, or whether condom companies started the plague to increase profits
“We’re experiencing the dark side of egalitarian media,” Castrucci said. “There’s always been snake oil salesmen—they just couldn’t reach a million people with the click of a mouse.”
Rosenbaum agreed that our society is in a sad state of atomization. This is a depressing time, she said, “just defending what we have, when everybody knows that what we have needs work.”
“Everyone wants to be healthy,” Castrucci said. “We agree on the goal—that’s a plus—but we disagree right now on the tactics.”
Both panels concluded with a short question-and-answer period. In closing remarks, Wathington compared Castrucci to a pastor whose remarks made her say, “Amen!” Her closing words, Wathington said, would reveal her as a Star Trek fan. “We are in unfamiliar territory. And so what we need to do is just ‘boldly go.’ We've got this. We need to get our messages together and step forward and keep fighting.”
A video recording of the forum may be viewed at this link.
