Four years after the COVID-19 pandemic propelled it to a global spotlight, public health is again a hot, political topic as president-elect Donald Trump prepares to make appointments to federal agencies.
Former presidential candidate Robert F. Kennedy Jr. has been floated as a key decision-maker for the Trump administration as it prepares appointments and policies for agencies that oversee American public health — the Centers for Disease Control and Prevention [CDC], Food and Drug Administration [FDA] and National Institute of Health [NIH] among them.
An environmental lawyer by practice, Kennedy has long been vocal on various health topics and his beliefs often diverge from common public health positions: He has been skeptical of vaccine safety and effectiveness, and has called for the removal of fluoride in public water sources.
And whether he is formally appointed to a position or not, the Trump administration's collaboration with Kennedy on these matters signals some measure of support for his positions, which could guide future public health policies.
Two Illinois State University faculty members who spoke on WGLT's Sound Ideas say that could pose potential challenges for those working in the public health sector.
"I would say that with the outcome of this current election — I'll speak more personally — it has seemed the most anti-public health, anti-science that we've seen in a long time," health sciences professor Jackie Lanier said. "Economic policy is public health policy. They're going to make decisions about how to fund the CDC, the FDA, the NIH — what research gets conducted."
Kennedy has never proposed an outright ban on vaccinations, but assistant health sciences professor Alicia Wodika said even positing that vaccines are unsafe or are ineffective counters decades' worth of scientific studies to the contrary and undermines public health messaging promoting inoculation.
"I think there's this idea of exactness, like, 'This vaccine is going to be 100% effective' or whatever it might be and then being upset or surprised if it isn't," Wodika said. "It goes back to really understanding the science and the motives behind what's going on in science and how we communicate that — but that goes back to trust in our communities and credibility with the individuals who are communicating the information."
Similarly, a proposal for a federal ban on fluoride stands in opposition to scientific studies that have shown the mineral's presence in water sources helps prevent an array of oral health issues; Wodika said the proposal reveals a misunderstanding between a potential health hazard and the probability of something actually happening.
"Really having an idea of what exactly is this health prevention method — whether that is fluoride or vaccines — and understanding hazard versus risk is something that's really important," she said. "That's something that I think we can do better, because we know how people get their information — whether we're talking about young people or older adults. We really just need to do a better job of filtering information so they're getting it accurately."
Potential shakeups to the public health policies or messaging coincide with an ongoing effort to rebuild public trust after the COVID-19 pandemic: In 2023, a study from Harvard University found than just over a third of Americans reported a high level of trust in the CDC — the rest reported some trust and a small percentage reported no trust at all in the country's largest public health organization.
"How do we communicate the science and evidence around what makes people healthy, communities healthy, and do it in a way that people understand but also, if people are fearful, be empathetic with that?" Lanier said. "We need... our trusted health agencies to be the go-to source for information, and I don't know that it always is. Building trust is communicating well about research and evidence and what works and being empathetic, understanding people's fears and not belittling them."
Some changes to public health, given the diminished trust in its intuitions, might not be unwelcome, she added.
"It depends on what those shakeups are, right? I think we want qualified, educated people who are knowledgeable about medicine and public health, with the experience and knowledge to run these agencies," she said.
Wodika added that the hope is that, if any major changes do come to public health, that they're done in a collaborative, cross-party manner.
"It's important to have a bipartisan response: Health is not just a Republican issue or Democratic issue or Green Party or whatever party you're looking at. I think it's really important, and helps to build trust, if it's not deemed as just a progressive or conservative thing," she said. "I think that it's really important, and our hope, is that these administrative changes would be something done together."
