Published: Sept. 15, 2020

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The Many Additional Battles Public Health Faces by Kainoa Cunningham

My experience with public health comes from working as a prevention department assistant at Boulder County AIDS Project* preceding the coronavirus pandemic. Through my nine months in the position, I became intimately aware of the socio-economic, structural, and resource challenges the U.S healthcare system faces daily.

Since the coronavirus began to be first widely discussed in January, 2020, naturally reporters, local health departments, and the public have relied on top health experts to provide clarity and guidance. With Dr. Anthony Fauci being among the top disease experts in the nation, many have looked to his leadership at The National Institutes of Health (NIH) to spearhead the broad war against the disease. Yet, it has become obvious that we face issues such as the spread of misinformation, health inequities, and political narratives- in conjunction with the virus. In order to truly tackle the devastating collective issue of COVID-19 we must also overcome these multifaceted barriers which glaringly accompany our healthcare system.

Fighting the Spread of Misinformation

The medical and scientific community are calling on others to look at another sort of pandemic of the modern world; the spread of misinformation. Misinformation has the ability to undermine almost every aspect of containment efforts, with convincing some to adamantly resist masks, disregard health rules and regulations, and even consume unusual and ​harmful substances​.

There have been growing cases of people utilizing fake face mask exemptions to avoid wearing a mask. As popularized on social media- some have begun to carry cards and fliers with statements claiming physical or mental conditions which exempt them from ​wearing masks in required places​. The narrative follows that anyone who resists such false exempts are violating the Americans with Disabilities Act (ADA). In reality, researchers and doctors have not identified a health condition that would justify remaining maskless. The Department of Justice has issued several statements that any such claims are “false and fraudulent,” and are subject to ​legal implications​.

No matter the politics, there is an undeniable fact that misinformation is widespread and the antithesis of efforts from the public health and scientific communities. Luckily, big tech companies aided by their vast power are on the side of science. Facebook, Google, and Twitter have worked to take down medical coronavirus misinformation such as ​false claims of cures​. Youtube, owned by Google, and twitter have created resources in “pop-ups with credible information.”

Our role as University students is to remain informed and focused on facts and scholarly research above all else. Through social media, our behaviours, and daily discourse with our own families- we live in an empowered position to make generative progress in the pandemic era.

Reckoning With Health Inequities

Another notable nuance to the conversation is that public health has now had to reckon with its long history of racial health disparities. Experts have begun pointing towards the evident-disproportionate COVID-19 death rates in poorer black communities. Jahmil Lacey, a researcher on health disparities, notes that ​black Americans often have a greater distrust​ in the “public health establishment,” and for good reason.

The Tuskegee experiment is a prime example of why such distrust exists among the black community. From 1932 to 1972, the United States Public Health Service ​withheld adequate treatment from poor black men​ with syphilis causing a large degree of unnecessary death and pain. With a long history of disinvestment in black health, Lacey and others point to the large

distrust in healthcare from black communities as one of the largest barriers to saving black lives now and in future health crises.

According to the ​June CDC reports​, “​adjusted hospitalization rates are highest among non-Hispanic American Indian or Alaska Native and non-Hispanic black persons.”​ This shows our medical system is failing minorities and bringing to larger light the health inequities which have plagued marginalized groups for many years.

Although there is grave evidence of the perpetuation of racial health inequities, the pandemic in context of a new wave of racial justice activism may serve to push the bounds of health equity. It begs the question- is this an opportunity to set in place the real proper investment into black health? I believe that it is if we determine it to be so. In taking the suggested defund and re-invest model from BLM movement and invest into social-health workers in underserved communities, we will be able to effectively combat the deep cyclical health disparities that continue to kill BIPOC groups throughout the country.

Politics and Contradicting Narratives

Forefront at the top of many health officials daily struggles are the contradictions thrown their way from President Donal Trump and some of the Republican Establishment, often from the same podium. Beginning back in February of this year, Trump blamed democrats stating coronavirus is “their new hoax,” ​at a rally​. As the 2020 Presidential race continues on, questions lume around what role the pandemic has had and will continue to play in the presidential race and vice versa. The President's blatant contradictions have certainly not gone unnoticed, even among the establishment.

Notably, in formally withdrawing the United States from the World Health Organization in July, 2020, the Trump administration has signaled an isolationist and distrusting narrative with the health establishment.

Trust in the medical establishment is a key factor in prevention and containment. Without trust and a concrete narrative from the medical establishment as well as the White House, efforts for prevention are undermined. A recent survey done by The New York Times and Siena College found that 51% of Republicans and 81% of ​Democrats trust Dr. Fauci​. However, this data does not suggest that Americans are following CDC guidelines in their daily behaviours- the most important tool for preventative efforts.

Through sticking to the well thought out guidelines provided by established health institutions such as the WHO and CDC, we can begin to have generative conversations on combating the

severity of the coronavirus in the United States. Without this the Politicizing of coronavirus will win and we will not be able to surmount the virus’s devastating effects.

* NOTE: the opinions and statements expressed in this article are my own and in no way reflect that of Boulder County AIDS Project.