Looking at the Next 4 Years & My Commitment to You

Three Things Thursday

Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week. This week has been all about the Presidential Election. And now that we know that Donald Trump will be in the White House for the next four years, I want to share a preview of what we know about his (proposed) health policies. Unlike Vice President Harris, who talked a lot about health and healthcare along the campaign trail, Trump did NOT talk much about health or healthcare.

Here are the top three things we know about Trump’s health policies moving forward:

1. RFK Jr will be on the health leadership team.
   On Tuesday evening, Trump said he would let RFK Jr “go wild” on health, medicine, and food policy. Trump continued, saying, “And he’s going to help make America healthy again… He’s a great guy and he really means that he wants to do some things, and we’re going to let him go to it.”
   
   RJK Jr and the leadership role he will likely play in the Trump Administration keeps me awake at night. NO JOKE. A recent article in Forbes summarizes why I am so concerned about RFK Jr becoming a federal health leader —
   
   “He has repeatedly made false claims that vaccines cause autism and chaired the Children's Health Defense, an organization that says it wants to end childhood health crises but is a source of vaccine misinformation. He compared vaccine mandates to the Holocaust in 2022, which he apologized for, and was previously banned by YouTube and Instagram for spreading misinformation about the COVID-19 vaccine.”
   

2. He has proposed federal policies that will restrict who can receive healthcare and expand the those who can deny it. Specifically, Trump has promised that he will block all federal funding for gender-affirming care and ban it entirely for minors. Additionally, Trump has promised to protect religious freedoms, which in his first term resulted in him allowing employers to deny birth control to employees based on their (the employer’s) religious beliefs.
   
   I want to be clear — denying healthcare to any group is unethical and a violation of human rights.
   
   In fact — the promises Trump made and his subsequent election have already resulted in an uptick in fears, concerns, and suicidal thoughts. Yesterday (seriously, from midnight through mid-day on Wednesday) the Trevor Project, an organization whose mission is to “end suicide among lesbian, gay, bisexual, transgender, queer & questioning young people,” reported to STATNews that they had seen a 125% increase in contact volume, with many callers citing the election results.
   

3. Along with RJK Jr and his gang of health experts, who want to Make America Healthy Again (MAHA), Trump wants to reduce the burden of chronic diseases in America.
   
   I agree with this goal 100%.
   
   The burden of preventable chronic diseases, such as Type II diabetes, heart disease, and lung cancer, is exceptionally high in the US. Where my thinking and that of Trump’s team diverge is what can be done to prevent these diseases.
   
   Years (actually decades) of research, show that the burden of chronic diseases could be reduced by helping individuals stop (or never start) smoking cigarettes/vaping, reducing the amount of alcohol consumed, improving individual diets, allowing individuals the time to (and providing an affordable form of) exercise, and addressing the mental health/loneliness epidemics in our country. We need to take on the tobacco industry/lobby; and Coca-Cola/Pepsi (getting soda out of schools needs to be a priority). We need to turn the Farm Bill on its head and remove subsidies for corn syrup.
   
   Trump’s team has not cited this research or discussed the solutions the public health community has been championing for years. Nor have they talked about providing healthcare for all, sick leave for all, affordable childcare for all, or an increased minimum wage. They have also failed to recognize that we have vaccines that prevent cancers of the cervix, mouth/throat, and liver, with a breast cancer vaccine on the horizon.

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That’s what we know right now. In the days, weeks, and months ahead, we will learn more. And I am committed to sharing all that I know here. And answering all of your questions.

I’m exhausted. Already. And there are four L-O-N-G years ahead of us.

Where do we go from here?

For me, I am going to double-down on my mission and will work hard and more collaboratively to CREATE HEALTHY COMMUNITIES FOR ALL.

In January 2020, I stepped out of my office and onto TV for the first time to share my knowledge of viruses, pandemics, and epidemiology with my community. That first interview turned into Ask the Expert panel discussions, my own TV spot Ask the Doctor, a weekly Facebook Live Q&A, and the title of Exclusive Medical Contributor. I began writing Epi(demiology) Matters in February 2021. And though I am still a professor and researcher, the course of my career has taken off in an unexpected and wonderful direction.

I will be here with you (at least) weekly throughout the next four years.

To create healthy communities for all, I am committing to —

1. Using data/science to create public health (aka preventative health) programs, policies, and interventions to save lives and decrease suffering.

2. Fighting misinformation.

3. Inspiring others to understand the science to make healthy decisions and create healthy communities.

I am also brainstorming new projects and research; imagining ways to bring us together (IRL or virtually); and dreaming of grassroots public health work that can be done in the face of decreased budgets, canceled federal programs, and a lack of leadership and expertise in key public health roles.

If you have ideas, thoughts, or suggestions — please share them with me.

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I will wrap up with two nuggets of personal information…

First, last semester I worked with an amazing group of undergraduate researchers, and we completed a huge project looking at the community health benefits of having a local health department. That research should be published soon. I CANNOT wait to share it with you all — and yes, you will be the first to read it and hear all about it. Right here. Be sure you are subscribed so you don’t miss a single post —

Second, in October of 2021, I wrote a post titled, What I Wish I Had Known Before COVID, where I listed seven lessons I learned through the COVID pandemic (and the first Trump Presidency). At this moment (as we face four more years of a Trump Presidency and serious threats to our public health system), I need to remind myself of those lessons and carry them with me, especially during the hard/dark days that lie ahead. Here’s what I wrote —

If I could go back and talk to my pre-pandemic self with what I have learned over the past 18 months, I would tell her -

You are needed.
Your public health mind, your knowledge of diseases, and your understanding of science and statistics are valued. The labels of nerd, geek, and bookworm are to be treasured. You will be needed by your community. Keep pursuing excellence and never stop learning and being passionate.

Be yourself. Accept yourself. Value yourself. You will be needed in ways you cannot imagine.

Epidemiology is narrative.
You heard an English professor make this claim at a conference many years ago. Remember this! Communicating epidemiology and helping communities implement public health programs, policies, and interventions is your superpower. Translating complicated epidemiologic concepts will be another superpower. Remember what Dr. Bill Foege (former Director of CDC) said —

“The power of science is in the application. It has to be applied to be powerful.”

You will be responsible for applying the science to improve community health. Be courageous and communicate epidemiology with clarity.

Science keeps changing.
Your job is to remind people of the scientific process and how it is applied in epidemiologic studies. You will need to say “we do not know at this point in time” repeatedly. You will need to speculate about what will happen next and how epidemiology will be used to answer key questions.

A health threat anywhere is a health threat everywhere.
In a world where individualized medicine and personal wellness are prioritized, speak up for community health. Never forget your calling to “CREATE HEALTHY COMMUNITIES!”

Local health is global & global health is local.

Though the risk factors and diseases will continue to change and challenge our understanding of public health, the science of epidemiology remains the primary tool used to understand the determinants and distributions of disease.

Develop a thick skin.
Fatigue, fear, and politics are going to cause confusion, rage, and a surge of misinformation. You will be dismissed and alienated as a human being because you are an epidemiologist. Your expertise will be taken for granted by some and dismissed by others. There will be days when you ask yourself “why should I stay in the field? why continue to be an epidemiologist working in the midst of a pandemic?” When those days come (and they will, more than once) — remember that you are an expert.

Your voice is needed.

Your ability to see the big picture and to navigate a way out of the pandemic is needed. Stay true to your mission to CREATE HEALTHY COMMUNITIES. And never fail to —

Act justly.
Love mercy.
And walk humbly.

Prioritize your physical, emotional, mental, and relational health
To be all that you are about to be asked to be — you have no idea how much your understanding of epidemiology and ability to communicate it will be needed — you must take care of yourself.

The safety lecture on airplanes - where they tell you to put your oxygen mask on first before helping others - needs to be your North Star. Take care of yourself first so that you have the strength to give to others, work overtime, overcome criticism, and see the joy in your life (both personally and professionally).

As an epidemiologist, you have been called to create healthy communities and to train the next generation. Your classroom will expand to include your whole community, your audience will grow, your ability to communicate will be needed, and your expertise will be needed.

Shine bright.

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Friends, may we all find the strength to shine bright. Together, we will work to create healthy communities for all.

Love,
Your Epidemiologist, Becky

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Epi(demiology) Matters is written by Dr. Becky Dawson, PhD MPH — an epidemiologist, teacher, mom, wife, and dedicated yogi. She is a tenured professor at Allegheny College, Research Director at a community hospital, and an exclusive contributor (all things health & medicine) at Erie News Now (NBC/CBS). Her goal is to create healthy communities for all. She writes Epi Matters — first & foremost because epidemiology does matter (to all of us) and she hopes that each post will help to educate and empower readers to be healthy and create healthy communities.

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Epi(demiology) Matters is free — because science, reports, news, updates, and alerts about health should NOT be behind a paywall. EVER. Everyone needs access to up-to-date health information in order to be healthy and create healthy communities for all.