Tuesday, February 1, 2022

Can Media Training Save Public Health?

I’ll confess there are days when I wish media training for CDC Director Dr. Rochelle Walensky (among many other public health experts) would turn the tide, get us out of this pandemic mess. When I wish that simple honesty would win the day. But, because I’m a sociolinguist who has studied and taught public understanding of health and science for four decades and spent untold light years tweaking public health messages, I’m not inclined to magical thinking.  

I default to a far more fundamental and addressable problem.  The fact that health experts know and trust “the science” (even when the path is pothole filled), while the public understands far less science and is hardly ever in the room where it happens.  This chasm has enormous consequences for personal and community health, policy, politics economics and civil society.

Frustration would be a mild way of characterizing the whiplash inducing changing public health guidance the CDC has made recently related to OMICRON -  quarantining, rapid antigen tests (home tests) and PCR tests, attending school... 

I certainly embrace the criticisms made by the always insightful social scientists (NYT Sunday 1/9/22) Zeynep  Tufekci makes: 1) Why is Dr.Walensky contradicting her research conclusions of 2020?; What’s behind the guidance? 2) Is it unreasonable for us to conclude that officials are discouraging rapid tests for the same reason Dr. Anthony Fauci originally told us we didn’t need face masks back in February 2020—that we simply don’t have enough? 3) Many Covid public health guidelines are faintly disguised paternalism – the masses are far too likely to have a false sense of security.  If their rapid test is negative, then all hell will break loose.  Tufekci concludes her essay with a clear call to action.  “The government can help us pull out of this fog, but it should always be based on being honest with the public. We aren’t expecting officials to have crystal balls about everything, but we want them to empower and inform us while preparing for eventualities — good or bad.

Media training?  
Not so much.

But how?  Where to start? 
So, for what it’s worth - Thanks to NSF study (and more recently PEW surveys) of public understanding and engagement with science information we have over 30 years of survey evidence showing that science, while interesting to most adults in the US remains poorly understood at many fundamental levels.  Take for instance that only about half of adults know that antibiotics kill bacteria, and don’t kill viruses, or that only about half of us understand how a drug is tested. Not surprisingly those with the lowest education levels understand science less. 

On the hopeful side, currently most (74%) believe in the benefits of science, and we seem to be moving in the right direction regarding astrology which less people now say is a “science.” Advancing the public’s health and science literacy is fundamental.  

No less important to achieving greater public health and wellness for all is that  public health experts need to re-interrogate their mission and the trajectory.  Writer Ed Yong has written astutely about this. Yong reminds us that back then public health professionals fully understood that you had to address social issues – housing, poverty education- if you were going to achieve universal better health. (see Ed Yong’s piece on how the fields of medicine and public health compete with themselves

Covid has made it embarrassingly clear how surprised by social inequity many contemporary public health experts have been.  There’s been a strange schizophrenia in how public health has comported itself during this pandemic. Some willingly acknowledge and judge the corrosive political atmosphere during the first 18 months of the pandemic but then vehemently sidestep the daily political and societal problems that prolong it.  For some it’s simply been a vexing puzzle, for others a call to action.

What could “empowering and informing” the public look like?  
One critical part would be to advance the public’s understanding and engagement with all aspects of health by not exclusively privileging “scientific evidence” because so many millions don’t fully understand that science.  We must recast the pandemic (because that’s what’s on the table right now) in terms of contextualized science - science in the context of people’s lives and realities. 
Frame public health guidance by simultaneously talking about the “science” and the social science.  If we know that masks would cut down on transmission--say that--while also explaining the shortage and proposing acceptable alternatives.  What is the government going to do about the problem? 
Discuss the mission of public health – the difference between focusing on “flattening the curve” vs. teaching people how to protect themselves.  
Acknowledge without judgment that the science and health literacy of the public needs improving and commit to teaching not just “disseminating” health information through policy and endless, changing guidance. 
Introduce the public to basic public health and science concepts. Develop ways to build a knowledge base and shared vocabulary to get from viruses and spike proteins, to social spread and the greater good. 
So, for me, the central problem is not that scientists and public health experts need media training to better anticipate questions, avoid common traps and focus on delivering clear, confident messages.  To achieve a healthier people and planet we need to recalibrate the critical relationships between medical science,  the field of public health and the public living the very lives we aspire to improve. 

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