Make America Healthy…Again?

Last week I had the honor of moderating an event called After the U.S. Election: What’s Next for Public Health? featuring a panel of BSPH professors (Joe Amon, PhD Shannon Frattaroli, PhD, MPH; Shelley Hearne, DrPH; and Don Warne, MD, MPH), who have decades of experience in health policy at the local, state, federal, tribal, and global settings.?

A group of us put this panel together because after the recent presidential election, students began reaching out asking questions about the future. The questions were not focused on specific policy proposals, but rather how the work of public health changes with a new presidential administration. We assembled this panel to begin a conversation; to make space for open dialogue and active listening, which are core tenets for engaging in public health.??

In setting the table for the conversation, I stated that the purpose was not about figuring out who voted for whom. Regardless of one’s political affiliation or voting record, it’s important to recognize that our mission in public health is to create a healthier world for all. As a health equity scholar, the commitment that I make to health justice and improvement of health does not depend on whether someone is a R, D, I, or non-affiliated. I also acknowledged that for many of us, working across the aisle when there seems to be a misalignment of core values is not easy. But as I learned early in my career, in policy there are no permanent enemies and dare I say, no permanent friends! Building bipartisan relationships is important because, as Dr. Warne said, “Both sides of the aisle are representing stakeholders and constituents who have health needs and who vote.” I personally have strategically worked with people who I didn’t think I could because it was critical to make progress towards my North Star—a healthier, more equitable world. I also have said “thank you for your time” and walked away when I knew that there was no chance, on that day, to find common ground.?

During the panel, a comment was made that some of the new administration’s nominees want to “Make America Healthy Again” (MAHA). This is a frame that we in public health might be able to get behind, but some of the proposals thus far are worrisome, running counter to evidence and best practices. Further, adding “again” at the end makes me wonder who is the reference group? Which subset of our population was healthy before and needs to be made so again? It is definitely not the communities that I come from or often work with, which have long been impacted by health inequities. When we talk about “Making America Healthy Again,” let us not forget the obvious – that many communities have been systematically disinvested in for decades and lack access to fresh food, affordable housing and other resources that foster health. We cannot allow the dominant narrative to be one that blames people for their poor health and tries to return this country to a time when inequities went unacknowledged and unaddressed.?

MAHA is the perfect example of something Dr. Frattaroli said on the panel: “With challenge comes opportunity.” It may require difficult conversations and the forging of unexpected alliances, but the public health community has the opportunity to own the narrative about health in America—advancing proven strategies that are backed by evidence, while contextualizing that troubling word “again.” Dr. Hearne captured the urgency of this moment when she said, “This is an incredible opportunity because people are actually paying attention.” I acknowledge the challenges that come with the opportunity that Dr. Hearne referred to, and the importance of proceeding with courage and tenacity.?

I believe if we seize this opportunity, we can Make America Healthy for all people who call this nation home, regardless of where they were born, the color of their skin, their gender, or their zip code. Everyone who cares about public health is needed to meet this moment and there are many different ways to make progress. As Dr. Amon said at the end of our event, “We need to be working in multiple levels and multiple spaces to advance health now. Don’t try to assess where you can have the most impact because we really don’t know where that will be. Just go where you enjoy. If you like being on Capitol Hill, go to Capitol Hill. If you like being in the streets, go to the streets. These are the times when we remember what we’re fighting for.”