With MAHA on the rise, traditional public health regroups : Shots

Dr. Georges Benjamin speaks at American Public Health Association meetings in Washington, DC

EZ/APHA Event Photography

hide caption

toggle caption

EZ/APHA Event Photography

Dr. Georges Benjamin has witnessed numerous infectious disease outbreaks and bioterrorism threats during the nearly 25 years he has led the American Public Health Association, or APHA, a professional group representing thousands of public health workers and researchers across the country.

But the current crisis hitting the ground is different: “I think public health more than anything else is under attack from our own federal government,” he says.

The Trump administration is slashing staffing and funding for the existing health care system, and at the same time, the Make America Healthy Again movement is booming. Led by Health Secretary Robert F. Kennedy Jr., the movement aims to upend long-standing norms in the health care system, which Kennedy calls “corrupt.”

MAHA’s focus on fighting chronic disease with an emphasis on individual medical choices comes with headline-grabbing headlines, Instagram-famous executives — and a set of solutions not based on the best available evidence, public health officials say. In contrast, traditional public health has focused on systemic solutions to prevent infectious and chronic diseases.

More than 11,000 public health leaders and researchers are coming together this week to fight these changes and defend their vision for American health. APHA’s annual meeting, held in Washington, D.C. for the first time in more than a decade, takes a defiant stance.

In an opening session titled “Mission Possible,” the focus was on rebuilding the U.S. health care system.

“This year’s mission is clear,” the announcer said in a trailer-style video introducing the event: “Defend the integrity of public health. Protect vaccinations and immunization systems. Denounce and resist political interference. And above all, never let fear win.”

Participants gathered between call-to-action sessions such as “Defending Science as a Higher National Value: A National Imperative” and “Attacks on Science and Public Health: How We Fight Back,” and others on more typical public health topics such as epidemiology, climate change and modernizing data collection. The meeting is expected to conclude Wednesday with a “Rally for the Health of the Nation” on the National Mall.

Tear down the system

The Trump administration’s policies are “burning the health care system to ashes,” Benjamin said in his conference opening speech.

In an interview, Benjamin explained. In addition to cutting staffing and funding for public health, “they are also destroying funding for health care and health insurance.”

“They are undermining the basic systems that we have to enable people to receive quality, robust medical care in our country,” he adds. White House policies also interrupt the supply of doctors and nurses, and changes in tariff policies make it harder to import drugs and new technologies, he says.

“The question is, three and a half years from now, when the next administration comes in, how are we going to fix it?” So the good news is that this leaves a relatively blank slate on which to build a better health system, Benjamin says.

But MAHA, supported by new institutions like the MAHA Institute, a think tank founded earlier this year to influence federal policies, has its own vision for transforming public health.

Their goals include “eliminating corruption in the health care system and restoring integrity to the public health and medical systems,” according to MAHA Institute co-founder and co-president Mark Gorton. “I’m not saying we should completely destroy public health, but we need to refocus it around the truth,” he says.

Gorton is not a doctor. He founded the technology company LimeWire. He also started Tower Research Capital, an investment company, and he’s been a big supporter of Secretary Kennedy — or Bobby, as he calls him — for years.

But Gorton says individuals can take responsibility for their own health.

“The fact that you have a government that thinks it knows better than people themselves how to take care of themselves and that government bureaucrats are able to tell people what to do about their health is just, I think, perverse,” he says.

According to Gorton, the US health care system is “a fear machine for marketing pharmaceuticals,” the public health system “has a long history of exaggerating fake pandemics” and Americans would be healthier if they stopped drinking fluoridated water and got vaccinated.

Public health officials say Gorton’s assessment of public health measures is ill-informed.

“The reason most of us are alive long enough to be able to complain about public health is public health,” says APHA’s Benjamin.

He notes that public health has saved millions of people from premature death through improved sanitation, vaccination and the discouragement of unhealthy behaviors like smoking.

Understanding MAHA

But public health officials are listening to MAHA’s criticism and trying to find possible common ground.

“MAHA didn’t come out of nowhere,” says Dr. Carmen Nevarez, a longtime public health leader and speaker. “It comes from the realities people experienced and the circumstances in which they felt something hadn’t been addressed properly.”

Health care costs are undeniably high in this country. The years of the COVID pandemic have been difficult and isolating for many people. And MAHA influencers are more interesting and fun to watch than traditional public health messages, says Sarah Story, executive director of the Jefferson County, Colorado, health department, who spoke on a panel titled “Breaking the Mold: Bold Leaders Shaping the Future of Public Health” at the conference.

“MAHA moms are good at making life easy: they’re attractive and fit and their house is always clean,” says Story. “And they’re getting their message across because they’ve tapped into something true and valid, which is that parents are afraid that big corporations are poisoning their children.”

This approach contrasts with traditional public health, which has been “paternalistic for a few generations,” Story says. “We talked like we were teaching people,” which put off a lot of people.

The public health goals of achieving optimal health for all may seem to overlap those of MAHA, but there are key differences, says APHA’s Benjamin: “Our approach is more evidence-based than theirs. » For example, Kennedy raised the alarm over an unproven link between Tylenol and autism and promoted vitamin A as a widespread treatment for measles.

And while MAHA focuses on individual freedom, public health sometimes limits it, Nevarez says. “There are times when you have to say: sorry, you’re not only a danger to yourself, you’re a danger to others. And that’s why we’re going to limit your freedom.”

When she was responsible for health for the city of Berkeley, California, this work included measures such as requiring a person with tuberculosis to seek treatment so as not to infect others, or closing a restaurant infested with rats.

“If you live alone on an island, it’s not your problem. If you live with neighbors and people in town with you, it’s your problem,” Nevarez says.

At this week’s meeting, public health leaders are mobilizing to defend their own vision for protecting the health of Americans.