Episode Transcript
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0:01
I'm Karen Anthony. I'm a health reporter. For
0:04
years I've been looking into the deaths of
0:06
two black men in Sykes in Missouri. They
0:08
were killed nearly 80 years apart by a public
0:10
health threat of their time. Cleo
0:13
Wright was lynched. They did
0:15
not want to talk about that except that's
0:17
a hush hush. Denzel Taylor was
0:19
killed by police. Go
0:21
Miss Monique! Through their
0:23
stories, we're exploring what it means to
0:25
live with racism and violence and the
0:27
toll it takes on our health. Heart
0:30
disease, cancer, all these
0:32
other ailments. Telling
0:35
these stories uncovered secrets in my
0:37
own family. I think
0:39
there's something in our DNA that
0:42
still makes us scared to talk about it.
0:45
From World Channel and KFF Health News,
0:47
this is Silence in Sykes Den, the
0:49
podcast about finding the words to say
0:51
the things that go unsaid. Listen
0:54
to all episodes now, wherever you
0:56
get your podcast. Things
1:24
might have changed by the time you hear this. So
1:26
here we go. Today
1:38
I am thrilled to be joined
1:40
here in our KFF studios by
1:42
some of the staff of KFF
1:44
Health News' newest project, HealthBeat, which
1:46
we've created with another non-profit, civic
1:48
news company to cover public health
1:50
in America. Here with us
1:52
today are HealthBeat editor-in-chief Charlene Pissenty.
1:55
Hello. Amy Maxbin, KFF Health
1:57
News Public Health correspondent and HealthBeats national
1:59
report. Hi. And
2:01
Eliza Fawcett, New York City reporter. Hi
2:03
there. Hello everyone and thank you so
2:05
much for being here. Charlene, I want
2:07
to start with you. What exactly is
2:09
HealthBeat and why do we need it?
2:12
Now more than ever, I would say, HealthBeat
2:15
was created in the wake of
2:17
COVID when it became very apparent
2:19
that people needed a deeper understanding of
2:21
what public health is. The kind of
2:23
invisible shield that keeps us all
2:25
safe. And we also needed
2:28
more news coverage that centers reliable, science-based
2:30
information so that people could make good
2:32
decisions about the health of their families
2:34
themselves and the people around them. So
2:36
we thought part of that coverage should be rooted
2:39
in communities. It's been shown
2:41
that no matter their politics or how they
2:43
feel about the federal government, people do trust
2:45
their local public health leaders. And we think
2:47
that by elevating those voices on timely issues,
2:49
we can start to win back people's trust,
2:52
not only in journalism, but in science. That
2:54
sounds like a very uphill battle. Yes,
2:56
as you mentioned. But we are part
2:58
of Civic News Company, which you mentioned,
3:00
whose model has been developed over the
3:02
past 10 years covering schools with ChalkBeat.
3:05
And so we're trying to leverage the
3:07
success they've had with a local plus
3:10
national reporting. So for HealthBeat, we're partnering
3:12
with KFF Health News, which has a
3:14
long tradition of excellent health reporting to
3:16
handle national coverage. And then we've opened
3:18
two local bureaus to start. We're in
3:20
New York and Atlanta with a third
3:22
location to come next year. Cool.
3:25
So, Amy, you're our public health expert at
3:27
the table. How is public health different from
3:29
what we think of as regular
3:32
health care or medical care in general? I'm
3:35
excited to answer that question because I'm really
3:37
into public health. So whereas
3:40
you think about health care as
3:42
what happens in a clinic, an
3:44
individual is sick, and they're treated
3:46
within a hospital system, public health
3:48
really focuses on preventing illness and
3:50
improving health at a population level
3:52
through population level interventions. So for
3:55
example, infectious disease outbreaks are often a big
3:57
component of public health, and that's because they
3:59
spread. in communities. So even though a person
4:01
is treated in a hospital, say
4:05
if you have a, somebody who has
4:07
measles, now the person's treated for measles in
4:09
a hospital, but public health officers actually go
4:11
into communities, they figure out how the virus
4:13
is spreading, they might go to schools or
4:15
to hospitals or to a shopping mall, wherever
4:17
that person was. Similarly, like
4:20
if a person is shot, they
4:22
go to an emergency room and they get healthcare
4:24
in that emergency department. But public health is going
4:26
to look at the surrounding issues. How
4:28
does gun violence affect the whole neighborhood? What does
4:30
it mean to grow up with stress? Does it
4:32
mean you can exercise as much if the neighborhood's
4:34
dangerous? So that's sort of why
4:37
also a big component of public health is about
4:39
collecting a lot of data and analyzing that data.
4:41
I feel like people kind of misunderstand this
4:44
a lot. They think of public health, they
4:46
think of healthcare as something that's between a
4:48
health practitioner and you, the patient, whereas public
4:50
health is bigger than
4:52
that and you are not the focus
4:54
of public health, right? It's everybody
4:57
around you. Yep, that's the public
4:59
part. Yeah. And
5:02
it's fun because it's out there in the
5:04
world. But why do people, I feel like
5:06
people really misunderstand that and I feel like
5:08
that's the source of a lot of the
5:10
frustration that people get with public health. It's
5:12
like, well, that might not be good for
5:14
me. Yeah,
5:17
that's the tricky thing because I think that
5:19
is true. You have to believe in kind
5:21
of societal goods. You have to believe that
5:23
having a cleaner neighborhood is good for everyone
5:25
and not just because you have to take
5:27
out your trash or not. I don't know
5:29
if that's the best comparison. Eliza,
5:32
how did you get into public health? I
5:35
started as a reporter at the Hartford Courant
5:37
during the start of the COVID
5:39
pandemic. I became really interested in covering
5:41
health and also mental health during that
5:43
time. And I grew up
5:45
in New York and it's been really exciting to be the
5:48
first New York reporter for Health Beat, really
5:50
getting into community health issues
5:52
and understanding the sprawling
5:54
New York City Health Department, which is one
5:56
of the biggest in the country. And since
6:00
up in New York, it's been really exciting to
6:02
be doing this work. Certainly. What kinds of
6:04
stories is health beat pursuing? Well,
6:06
as you can imagine, public health is very
6:09
broad and we're just getting started. We just
6:11
officially launched August 30th. So we've just had
6:13
the last of our reporters come aboard for
6:15
right now. So we're trying to narrow it
6:17
down a little bit. And we're kind of
6:19
focusing on three key buckets for our coverage.
6:22
One is infectious diseases, which Amy's doing such
6:24
a great job on bird flu right now.
6:26
But also we're looking at that locally too.
6:28
What are the flu numbers right now? We're
6:30
going into flu season? What are the COVID
6:33
numbers? How's RSV ramping up and those sorts
6:35
of things? And the community's preparedness to deal
6:37
with outbreaks. Accountability is
6:39
another really big thing that we're focused on.
6:43
What many people may not realize is
6:45
that public health funding, even
6:47
at the local level, comes from Washington. It's
6:49
coming from CDC, it's coming from HHS. And
6:51
so we're looking at how those dollars flow
6:53
down to the local communities and how they
6:56
are spent. And also just, you
6:58
know, officials who are in charge of
7:00
public health policy. In Georgia already,
7:03
we've seen some pretty good impact in our
7:05
reporting, just by showing up, frankly. Our,
7:08
our first Atlanta reporter, Rebecca
7:10
Grapevine, she got on the job like the
7:12
first week and realized that the Board of
7:14
Public Health in Georgia had not held a
7:16
public meeting in like five months. So
7:19
we brought about that. And the story
7:21
got a lot of attention. And by
7:23
golly, in November, they had a meeting.
7:25
So that was really great. And then
7:27
the third thing is really community. We
7:29
really want to center our coverage on
7:31
the people on the ground who are
7:33
working on public health from many aspects.
7:35
It can be social workers. It can
7:37
be your local epidemiologist at the Health
7:39
Department. It can be volunteers at a
7:41
house of worship who has a ministry
7:43
trying to help with homelessness or maternal
7:46
mortality or any of those things. We're
7:48
really trying to be a platform and
7:50
a voice for those people. At
7:52
Civic News Company, we call people like that Civic Catalyst.
7:54
They're out there doing the work and we really want
7:56
to shine a light on them. So
7:58
Amy, what are the other Obviously, we're going to talk about
8:01
bird flu separately in a few
8:03
minutes. What are the other public health,
8:05
big national public health stories that you're
8:07
watching right now? I mean, I
8:09
think we'll keep an eye on vaccination
8:12
rates. You can expect those to unfortunately
8:14
drop and I'm not talking about just
8:16
the COVID vaccine, but childhood vaccination rates.
8:19
It's important to keep in mind the majority of adults,
8:21
around 70% still say that
8:23
childhood vaccines are really important. But
8:26
remember, going back to what's public health,
8:28
the power of vaccines is in kind
8:30
of herd immunity effect. So children
8:33
are being protected with say a measles
8:35
vaccine, but we want to have high
8:38
rates above 90% of vaccinations
8:40
so that teachers who are immunocompromised,
8:42
children who are immunocompromised, infants
8:45
too young to be vaccinated so that
8:47
they're all protected too. And
8:49
what we're going to see, if we see RFK Jr.
8:53
as the head of HHS,
8:56
there's some rumors
8:58
floating that Joseph Ladapo might
9:01
have a role in the administration as well. He's
9:04
the Florida Surgeon General who we've talked
9:06
about a lot on the podcast, who
9:08
himself is kind of vaccine agnostic. Yeah,
9:11
exactly. And so we're seeing a lot
9:13
of signs that we're going to hear
9:15
a lot of terms like choice and
9:17
consent when it comes to vaccines and
9:19
those sound like great words. But what
9:21
it ultimately means is that we'll
9:24
see a loosening of mandates around having
9:27
children be vaccinated before they go to public
9:29
school. And that combined with
9:31
misinformation, so we'll probably see lower vaccine
9:33
rates among children. So that's something to
9:36
watch because it means more outbreaks. Outbreaks
9:38
are costly to contain in money
9:41
and in life's last. So that's definitely
9:43
one story. There are certainly
9:46
others besides even the bird flu, which I'll
9:48
talk about. I write
9:50
a lot about occupational health. So there's lots
9:52
of health care workers who lost their lives
9:54
in COVID, but also have covered how
9:57
many are facing long COVID and PTSD because
9:59
they weren't. aren't very well protected when they
10:01
were at work during the
10:03
pandemic, during the peak of the pandemic. I've
10:06
written about how farm workers and
10:08
construction workers and landscapers have
10:10
had heat-related illness and injuries. There
10:13
was a law that the
10:16
Occupational Safety and Health Administration has
10:18
been working on, but it will
10:21
almost certainly stall under a Trump administration, so
10:23
we're not going to have national regulations on
10:25
heat. So those are some of the other
10:27
things I'll be thinking about. What
10:29
are the big stories in New York, Eliza? Well,
10:32
a lot of them are the same as what Amy
10:34
mentioned, and we're trying to
10:36
see how the big changes
10:38
coming down the pike with the second
10:40
Trump administration will impact us locally. Obviously,
10:44
that is in big part about
10:46
funding, and whether CDC funding stays
10:48
the same, is reduced,
10:50
et cetera. Same
10:52
for NIH and other federal agencies that deal
10:54
with health issues, the way
10:56
that local health departments
10:58
work, even really big ones like New York
11:01
City, is that they do get a lot
11:03
of money from the federal government, obviously, and
11:05
so any small changes could have a really
11:07
big impact on work on the ground, whether
11:09
that's making sure that kids can get vaccines.
11:12
The Vaccines for Children's Program
11:15
is responsible for making
11:17
sure that many, many, many children in the United States
11:19
get vaccinated. I'm of course so old
11:22
that I covered the Vaccines for Children program when it
11:24
began in the 1990s. But
11:27
yes, that is how most
11:29
kids get vaccinated now, is through the Federal
11:31
Government's Vaccines for Children program. One
11:34
thing that obviously we are looking towards
11:36
the possibility with Republicans backing control of
11:38
the Congress and the White House is
11:41
healthcare budget cuts. I mean, I assume
11:43
New York is assuming that there will
11:45
be less money in a Trump administration.
11:48
Yeah, I think it's a real concern for
11:50
public health leadership in the city, and it's
11:53
been interesting to see what the response has
11:55
been from city and state officials after the
11:58
election. They've kind of... made
12:00
this point of saying that New Yorkers
12:02
will be protected, whether that's reproductive
12:05
rights or vaccinations.
12:08
And there's this feeling of kind of pulling up the
12:10
drawbridge that New York has
12:12
a pretty robust public health infrastructure. And
12:14
so whatever happens on the federal level
12:16
will be okay. But obviously,
12:18
things are a lot more complicated and
12:20
intertwined than that. The city does get
12:22
a lot of its funding from... Or
12:25
the New York City Public Health Department does get a
12:27
lot of its funding from the city and from the
12:30
state, but also from the federal government. And
12:33
so if there are major changes
12:35
there, that could have a big impact
12:38
on the kinds of community-led programs that
12:40
do good public health work in the
12:42
city. And even
12:45
on vaccinations, that's an interesting question
12:47
too, because while
12:50
the CDC provides recommendations, they
12:52
don't actually provide mandates. That's
12:54
a state's issue. If the
12:56
CDC starts
13:00
changing its messaging around vaccinations, particularly if
13:02
RFK Junior is running HHS, which is
13:04
a big concern, that can still have
13:07
a trickle down impact on what
13:09
New Yorkers think about getting vaccinated in
13:11
general, which has already been a big
13:13
concern for folks. So I think it's
13:15
been interesting to see this dynamic
13:18
starting to play out in the city where
13:20
on the one hand, there's this strong progressive
13:22
leadership that is vowing to keep up the
13:24
good fight, but we'll see the extent to
13:27
which they can really protect themselves from any
13:29
large changes that are going to happen. Let's
13:31
talk about bird flu because it's sort of
13:34
the elephant or the dairy cow in the
13:36
room. We've been sort
13:38
of watching all year and I guess
13:40
health authorities have been watching with some
13:42
alarm as we're seeing bird
13:45
flu spreading in dairy cattle herds and
13:47
then occasionally to people, to dairy workers
13:49
and now to some people who are
13:52
apparently not dairy workers. What is your
13:55
feeling about where we are with bird flu
13:58
and what has the Biden administration done in
14:00
about it, and what do you anticipate that
14:02
the incoming Trump administration might do differently? Yeah,
14:05
so I think, you know, the past, looking
14:07
back on the past year with bird flu,
14:09
the huge disappointment appalling if you talk to
14:12
researchers, sort of frustrating if you talk to
14:14
public health officials, is we
14:17
failed to contain it when the bird flu
14:19
outbreak was confined to just a handful of
14:21
states. That would be when it was smaller,
14:23
it's like putting out a fire when it's
14:25
small versus, you know, once there's a huge
14:27
forest fire, it's harder to put out. So
14:31
now it's in at least 15 states,
14:33
and the number might be higher because a lot
14:35
of farms, maybe the majority of farms, haven't
14:38
tested at different periods
14:40
during the year. There's 52 cases
14:42
among people in the U.S., mainly
14:44
among farm workers. But yeah, as you
14:46
just mentioned from the case in California,
14:48
there's a few cases that have been
14:50
mysterious, people who have no contact, no
14:52
known contact with farm animals. These
14:55
unknowns are actually kind of what's a
14:57
staggering, is also the growth of the
14:59
epidemic. We're just, we've sort of
15:01
lost track of what's going on. So
15:04
what this means is, you know, I've talked to
15:06
so many experts at this point, and nobody
15:09
thinks we're going to eliminate this on dairy
15:11
farms. And to be clear, bird flu has
15:13
been around for 30 years, both the bird
15:15
flu and cattle spreading among mammals, that's new,
15:18
and that's in the U.S. So
15:20
what does this mean? This means, you
15:22
know, best case scenario, millions, not
15:24
billions of dollars in losses for the dairy and
15:26
poultry industry. It means farm
15:29
workers are going to continue to get the
15:31
bird flu, which is not comfortable. And
15:33
then it also means we just have this kind of
15:35
ominous, constant threat that maybe
15:38
the virus will evolve in a
15:40
way where it spreads between people
15:42
easily. And that's when you could
15:44
get a pandemic. That's
15:46
been the big fear about a pandemic. I
15:48
mean, but that was a fear even before
15:50
the COVID-19 pandemic, what everybody was afraid of
15:53
was a bird flu pandemic, was an avian
15:55
flu that mutated to pass from person to
15:57
person. Exactly. It's been on, you know, because
16:00
humans don't have a lot of experience with the
16:02
bird flu. It's novel, we may or may not
16:04
have some partial immunity to it. So it could
16:07
be very bad. So there's a chance
16:09
it will never mutate in a way that
16:12
has it spread easily between people. But
16:14
if it does, it could be horrible, like on
16:16
the scale of what we saw during COVID. And
16:19
so that's why everyone I talked to, I guess
16:21
the big question is, why are we taking a
16:24
gamble on this? But
16:26
that's what we've done this past year,
16:28
essentially, intentional, not intentional. I've
16:30
reported a lot on why this is, but
16:32
that's where we're at. I mean,
16:34
some of this I know comes back to
16:36
the whole trust issue, which is that the
16:38
CDC couldn't get on to some of the
16:40
dairy farms to test, because
16:43
the dairy farmers didn't trust the government.
16:45
I mean, what has the Biden administration
16:47
been able to accomplish in terms of
16:49
dealing with the bird flu? Well,
16:53
yeah, so on a
16:55
local level, this has really left to
16:57
local public health departments a lot
17:00
of the time. So that's really
17:02
who's doing the work here. Sometimes
17:04
it's state health departments. But on
17:06
the ground, we're talking about veterinarians,
17:08
farmers, and local health officials. And
17:11
I actually foyered a lot of health
17:13
departments and some agriculture departments to kind
17:15
of learn what's even happening. The system
17:18
of surveillance is a voluntary system. So
17:21
when there's mistrust, there are also just fears,
17:23
right? So farmers would be afraid of if
17:26
they say they have the bird flu of
17:28
losing their entire milk market, which is
17:30
a big one, cuz then they lose the whole farm. So
17:32
there's a lot of concerns sort of about
17:34
their own privacy. So basically,
17:36
a lot of the cooperation has kind of fallen
17:38
apart with that. What could the CDC do? I
17:41
think there's a lot of disappointment for the CDC and the
17:45
USDA from the experts that I speak
17:47
with. Because although, yes, they do, they
17:49
can't just storm onto farms. They
17:52
haven't actually been using sort
17:54
of the bully pulpit to say, this
17:57
is what's going wrong, we're really concerned, this is
17:59
how we can do it. do it better. This
18:01
is how we can get around some of these
18:03
problems like farmers being afraid of losing their milk
18:05
market or farm workers being afraid of losing their
18:07
job. They haven't really been very
18:10
open about the problems and
18:13
they also haven't acted with
18:15
urgency. So the
18:18
response on the high level has
18:20
seemed slow and uncoordinated. They'll announce
18:22
that they will be doing outreach
18:25
to farm workers, but then there
18:27
will be months past with
18:29
no outreach. They'll say that they're going
18:31
to be working on having other groups
18:33
be able to test for the bird
18:36
flu virus, but we still don't see any
18:38
group besides the CDC having that ability. So
18:43
there's a lot of
18:45
people who are aggravated
18:47
with the response under
18:49
the Biden administration. And
18:52
some of it's not just because of
18:54
leadership. There's kind of internal issues within
18:56
the U.S. We have a voluntary system
18:58
in a lot of ways. So for
19:02
better or worse, this might be the way
19:04
it is. And what would you expect from
19:06
an incoming Trump administration even? I mean, we
19:08
obviously don't know a lot about what to
19:11
expect from an incoming Trump administration, but based
19:13
on their handling of COVID, what would you
19:15
expect? Exactly. So based on their handling of
19:17
COVID, one is I
19:19
can say, you know, time-wise,
19:22
okay, so it's on our side. The plus
19:25
is as outbreaks continue, people
19:27
often get better at figuring out what to do.
19:29
So on the plus side, maybe
19:31
farmers will start to have a little bit more trust
19:34
that they're not going to have huge losses and that
19:36
therefore they'll be a little bit more open. Maybe vets
19:38
will get a better handle on how to control this.
19:40
So that's the plus side. The
19:42
downside is also pretty huge. So
19:45
during COVID, the
19:47
CDC basically stopped holding press briefings. So
19:49
right now, at least there are press
19:51
briefings. The hero is critical of the
19:53
CDC, but I might completely
19:56
lose all contact with them under
19:58
a Trump administration. has
24:00
been, I think, of everything, of all
24:02
of the sort of parts of American
24:04
society where the public has lost
24:06
trust, public health is way up towards the top,
24:08
and also it's way up towards the top in
24:11
terms of the misinformation that's been spread. So how
24:13
do you combat those two things? It's something that
24:16
we talk about all the time on the podcast,
24:18
and I don't know how to fix it. It's
24:21
really tough. I think that one
24:23
way that we really look at it is elevating
24:25
local voices. To your
24:27
point about immigrants and immigration status
24:29
as a social determinant of health,
24:32
we had a report just yesterday that came
24:34
out in Georgia that laid out all the
24:36
things that Amy and Eliza were just talking
24:38
about in Georgia as well, the stigma, the
24:40
not asking for help because
24:44
you fear about getting involved with
24:46
the authorities in some negative way.
24:48
But there are a lot
24:50
of community organizations that are a safe
24:52
space that do work to
24:54
provide culturally sensitive
24:56
care and speak the language and
25:00
offer the help to people so that they're not
25:02
threatened. So I think by highlighting those resources, that's
25:04
one thing that we can do. And
25:06
another one is just highlighting people who
25:08
know what they're talking about, scientific experts
25:11
in the community, particularly local ones.
25:14
One really exciting thing that we're doing
25:17
in New York is we're kind of
25:19
combining two of those concepts through a
25:21
partnership with your local epidemiologist. This
25:24
is a newsletter that is run by Caitlin
25:26
Jettalina who back in 2020
25:28
started an email. She was teaching at
25:30
the University of Texas. She's an epidemiologist
25:32
and she was just writing an email
25:35
to her students and her family and
25:37
friends to explain the science behind what
25:39
was going on with COVID. And
25:41
it has snowballed and four years later,
25:43
it's really huge. So we have partnered
25:45
with her to bring that
25:48
concept to health beat readers in New York.
25:50
So every week we have our own epidemiologist.
25:52
Her name is Marissa Donnelly and
25:54
she does an email newsletter every week that
25:56
kind of breaks down what we call the
25:58
community health forecast. And
26:01
it's all kinds of really great science-driven
26:04
information with nice little charts that
26:06
just lays it all out for
26:08
you. It's like the weather forecast,
26:10
but for health. Exactly. So
26:12
I think that's one way. Just lay it out
26:14
for people, give them the rationale behind it, the
26:17
science behind it. And I think
26:19
that work like that over time hopefully will
26:21
help regain some trust. Well, I
26:23
want to thank the panel. This has been
26:25
really inspiring. I'm
26:28
hoping that we can come back to you periodically
26:31
to see how public health in general and
26:33
health beat in specific are doing. So thanks
26:35
for joining us. Okay, that is
26:37
this week's show. As always, if you enjoy the
26:39
podcast, you can subscribe wherever you get your podcasts.
26:41
We'd appreciate it if you left us a review.
26:44
That helps other people find us too. Special
26:46
thanks this week to our producer, Taylor
26:48
Cook, our editor, Emory Hutterman, and KFF
26:51
Health News Enterprise editor, Kelly Johnson. As
26:53
always, you can email us your
26:56
comments or questions. Remember what the
26:58
health, all one word at kff.org,
27:00
or you can still find me
27:02
at X at J. Robner and
27:04
increasingly at BlueSky at JulieRobner.BlueSky.social. Do
27:07
you hang around on social media any place,
27:09
Amy? You know, I've just started,
27:12
I've joined the BlueSky trend. I just
27:14
sort of came over there. There's a
27:16
lot of, there's kind of one
27:18
of those moments where there's a lot
27:20
of journalists and health people and researchers.
27:22
So it's, yeah, I've... Do
27:25
you have a handle? My
27:27
handle is AmyMaxman.BlueSky.social. Excellent.
27:30
Charlene. I'm most active on
27:32
LinkedIn where all the health people are. There
27:34
you go. Eliza. I'm
27:36
also on BlueSky newly under my name,
27:38
Eliza Fawcett, and still kind of lurking
27:41
on Twitter. There you go. We'll
27:43
be back in your feed next week. Until then,
27:45
have a very happy holiday weekend and be healthy.
28:00
you
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