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

Dr. Georges Benjamin has seen many infectious disease outbreaks and bioterrorism threats in 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 on the field is different: “I think public health is under attack from our own federal government more than anything else,” he says.

The Trump administration is making significant cuts to staffing and funding of the existing health care system, while at the same time the Make America Healthy Again movement is on the rise. The movement, led by Secretary of Health Robert F. Kennedy Jr., seeks to dismantle the norms of a health care system that Kennedy calls “corrupt.”

MAHA's focus on combating chronic disease, with an emphasis on individual medical choices, is attracting headlines, Instagram-famous leaders, and a set of solutions not based on the best available evidence, public health leaders say. Traditional public health, in contrast, has focused on systemic solutions to prevent both infectious and chronic diseases.

More than 11,000 public health leaders and researchers gathered this week to navigate these changes and defend their vision for America's health. Held in Washington, D.C., for the first time in more than a decade, APHA's annual meeting takes a defiant stance.

The opening session, titled “Mission Possible,” focused on rebuilding the U.S. health care system.

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

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

Demolition of the system

The Trump administration's policies are “burning the health care system to the ground,” Benjamin said in his opening remarks at the conference.

In an interview, Benjamin elaborated. In addition to cutting staff and public health funding, “they are also cutting health care funding and health insurance.”

“They undermine the basic systems that allow people to receive quality, reliable health care in our country,” he adds. White House Policy are also disrupting the flow of doctors and nurses, and changing tariff policies are making it difficult to import drugs and new technologies, he says.

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

But MAHA, supported by new institutions such as MAHA InstituteThe think tank, founded earlier this year to influence federal policy, has its own vision for transforming public health.

According to MAHA Institute co-founder and co-president Mark Gorton, their goals include “eradicating corruption in the health care system and restoring the integrity of the public health and medical system.” “I'm not saying we should completely destroy public health, but we need to center it around truth,” he says.

Gorton is not a doctor. He founded the technology company LimeWire. He also founded the investment firm Tower Research Capital and has been a strong supporter of Secretary Kennedy—or Bobby, as he calls him—over the years.

But Gorton says people can take responsibility for their health.

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

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

Public health leaders say Gorton's assessment of public health measures is misinformed.

“The reason most of us live long enough to be able to complain about public health is because of public health,” says APHA's Benjamin.

He notes that public health has saved millions of people from early death by improving sanitation, vaccinations and discouraging unhealthy behaviors such as smoking.

Understanding MAHA

But public health leaders are listening to criticism of MAHA and trying to find common ground.

“MAHA doesn’t come out of nowhere,” says Dr. Carmen Nevares, a longtime public health leader and conference speaker. “It comes from people’s lived realities and circumstances where they felt something was handled incorrectly.”

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

“MAHA moms are great at making life easy—they are attractive and fit, and their homes are always clean,” says Storey. “And they are able to get their message across because they have understood something that is true and real: parents are afraid that large corporations will poison their children.”

This approach contrasts with traditional public health, which has been “paternalistic for generations,” Storey said. “We talked as if we were teaching people,” which turned many people off.

Public health's goals of achieving optimal health for all may seem to align with MAHA's, but there are key differences, says APHA's Benjamin: “Our approach is more evidence-based than theirs.” For example, Kennedy expressed concern about unverified link between Tylenol and autism, and he increased levels of 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: I’m sorry, you’re not only dangerous to yourself, you’re dangerous to others. And that’s why we are going to limit your freedom.”

When she worked as a public health officer in Berkeley, California, that job included measures such as requiring tuberculosis patients to be treated so they didn't infect others or closing a restaurant due to a rat infestation.

“If you live alone on an island, this is not your problem. If you live with neighbors and people in the city, that's your problem,” Nevarez says.

At this week's meeting, public health leaders are uniting behind their own vision of protecting the health of Americans.