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- [00:04]
A
This is in conversation from Apple News. I'm Shamita Vassu. Today, can MAHA and public health meet in the middle Americans faith in health institutions is eroding. Polling from earlier this year shows that trust in agencies like the fda, cdc, and even local health departments has dropped, a decline that began during the COVID 19 pandemic and has continued ever since.
- [00:38]
B
We can have the tools, we can have the expertise, but it doesn't matter if people don't trust it.
- [00:43]
A
That's Maggie Bartlett. She's a virologist and public health researcher at Johns Hopkins. Last year, she and Brenda Adhikari, a longtime journalist, along with two other hosts who launched a podcast called why Should I Trust yout? The show brings on guests who feel deeply disillusioned with the health establishment, members of the Make America Healthy Again, or maha movement alongside public health experts and officials. The idea is for them to talk about how trust can be rebuilt and what it'll take to strengthen America's healthcare system.
- [01:14]
C
Here's in order to leave one echo chamber or like kind of cross pollinate between echo chambers, you really have to talk to people from diverse perspectives. And not just talk, but like give them a seat at the table and make them feel absolutely heard.
- [01:34]
A
Since launching in January, the podcast has tackled everything from the measles outbreak to the pharmaceutical industry to nutrition, along with many of the sweeping changes to health policy under President Trump and Health Secretary Robert F. Kennedy Jr. But this isn't a debate show. They keep the temperature turned down by leaving a lot of space for everyone to share their perspective. In one recent episode, they convened a dozen doctors, scientists, parents and activists.
- [02:00]
D
I'm the dean of the Yale School of Public Health.
- [02:03]
E
I was working in New York City in March 2020 when Covid came in to our emergency rooms.
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D
I've been following RFK for a long time when I wasn't getting the answers.
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A
I was hoping for.
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C
I am not pro or anti vaccine. I think that the nomenclature that we.
- [02:18]
B
Have is evolving in the country. I study viruses and health impacts and why they happen. I'm not the biggest fan of the president's overall policies, but getting this issue to the forefront was important.
- [02:31]
A
I sat down with Brenda and Maggie to talk about what they're learning through these conversations, and Brenda started off by telling me about their goals. When creating the show.
- [02:42]
C
I would say my first goal would be, you know, even getting people to sit down at the table feels like a worthwhile endeavor and a goal. On one hand, it seems like, oh yeah, why wouldn't people just Sit down. But I will tell you, Shamita, it takes a long time to build these relationships, to invite people into an environment that could potentially be hostile to them, to come in and have a conversation. So a big part of what we've been doing months before the podcast even launched, was literally just building relationships with people and getting to know them and building trust with each other. You know, it was a two way, kind of like dance that we engaged in. So one step is just bringing people to the table. The next step is by humanizing both Maha Public health, maga, you know, all kinds of people with diverse perspectives that they're not just a function of what they post or a study that they write, or some really strong opinion that they have, but they're actually moms and dads and grandfathers and somebody whose husband may have had cancer and had a terrible experience at a hospital, or somebody whose child, you know, has an immunocompromised. Like, just making them a function of many other things aside from just an expertise or like a hot take felt really important. And then lastly, look, and I don't know that we've necessarily achieved this yet, but there are some instances where we are seeing some, some cross collaborations take place as a result of these conversations where people are realizing that they kind of can't do this alone. None of us can. Making America Healthy Again is a massive, massive priority and a goal and a vision. And to do that, you need so many more people than just people who are ideologically aligned with Maha or maga. But in order to do that, we have to build trust.
- [04:37]
A
Well, let's talk about the phrase make America healthy again because even some of the guests that you bring onto your shows, it seems, have some trouble with that as a label or kind of have resisted that as a label because it feels so politically charged. But help us understand, I mean, what is considered maha?
- [04:55]
C
Make America Healthy Again was a movement that really came to fruition because of Kennedy's alignment with Donald Trump after he dropped out of the presidential race. It's a movement that I think it's safe to say that Kennedy is sort of the head of. There are everything from MAHA Action to the Maja Institute, which is more of a think tank, to there's MAHA caucuses and state legislatures. But really the way that it presents itself is at a grassroots level with regular people without really any financial backing, that organized around things like corporate influence and government and in industry and in academia, nutrition, in schools, around their feelings for vaccines, about vaccines, around pesticides, around things like that. That they're just organ locally. And now there's a bit of a national structure to really see it and kind of give it voice.
- [05:50]
B
And I might just add to that. I think Maha focuses perhaps a little bit more on the individual, and public health has always been more focused on the collective, which makes sense. And there's this local versus national response that's also playing into this. And as somebody in public health, many of our colleagues, my colleagues felt like, well, we've been trying to make America healthy. We've been working on this for decades. And so there was some of that when this started to spin up. But I think what is drawing people to the messaging is a frustration about health and healthcare in America, and that's drawing them out to learn more things, to advocate for health. And that's what's so interesting. When we have these different conversations with people who are staunchly Maha and, you know, leaders of public health, they agree, they want to make things better. And so, like, that's a point we can take forward instead of arguing about, you know, this thing or that thing. And I think we're creating a place where those conversations happen. And then it becomes more than a podcast. Then people are going out and having events and tapping into their local public health, because we really didn't have that before. During the pandemic, no one knew who their local public health officials. And I think that that needs to change. Public health has to become local health. It needs to be more community driven, and it needs to be having these sort of listening, feedback conversations that we're modeling on the pod.
- [07:24]
A
I mean, even hearing Brenda describing sort of the issues that tend to draw people into these conversations, I mean, it's a big tent of issues that a lot of people can agree should be front and center for people today. At the same time, I think there is a widespread assumption that if people align with Maha, that they are probably anti vaccine, as we find so many times on your podcast. And from listening to a lot of the perspectives, that's not necessarily the case. And there's actually. It sounds like a lot of nuance along this topic. Maggie, can you speak to that a little bit too?
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D
Yeah.
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B
So I think that I would say it's not anti vaxx. There's vaccine hesitancy. And I think that when we binned people before on anti vax or supporters of vaccine, we did a disservice to those people who had understandable questions that we could have answered with better empathy and help them understand, because that's the key that comes out of so many of these polls is that, you know, up to 50% of people aren't sure if the COVID vaccine is safe.
- [08:30]
C
Yeah. And I just wanna underscore the point that most of Maha I think is quite reflective of broader trends that taking place around the country. There are very few people who are truly anti vaxx in this country, but there are many people who have questions about the vaccine schedule. When you break down actual vaccines, how they feel about the hep B birth dose, how they feel about the COVID shot, the flu shot. Just recently, Secretary Kennedy put out a seven minute video kind of questioning whether vaccines actually made the mortality rate for various diseases go down. And when you have things like that come out, it can certainly feel like there's an entire movement of people where this is the central thing that's driving them. I would say in our experience, and again, it's anecdotal, we've. These are relationships we're building. Vaccines is not the central conversation, like the central thing that comes up in the things we talk about.
- [09:31]
A
You know, we kind of ran past this at some point. But I don't want to miss an opportunity to ask what you both think about Robert F. Kennedy Jr. In his current role as health Secretary and as a communicator of a lot of the issues brought up by people who are now in this Maha sort of community. How do you see him as a communicator?
- [09:54]
B
I think he's a stellar communicator. I don't think what he's communicating is meeting the mark of what we expect for the lead of hhs. I think that there is rhetoric that has been very damag and there have been a lot of ideals that have been pushed out there that aren't based in gold standard science or really pushing these things that he says he holds so dearly forward. I do hear when people say that they trust Bobby, that they have belief in his intent, but I don't. I think I'm seeing that the things that he's saying are not moving us towards a healthier America, but taking us many steps backwards.
- [10:46]
C
I'll say, you know, from my perspective, what I hear from our listeners is more important to me than what I individually think about Kennedy or Trump or whoever. But I will say this, which is as broad of a coalition and as diverse in thought as a lot of our Maha listeners on are about different issues from vaccine to food safety to corporate capture and things like that. The one singular piece that brings everything together is a love of Robert F. Kennedy. Like A true respect, trust, and love for this man. I've never seen anything like it. I think the closest I can sort of see is maybe some MAGA supporters for Trump. But I would go so far as saying I think it's even more. They talk about him from years ago as being someone who went against the grain of his own party when he talked about the things he said about vaccines and he was ridiculed by Democrats. This is them recalling the story to me that he has held the hands of families who have kids with disabilities, you know, severe autism, other disabilities, and listened to them, you know, they all call him Bobby. And so I'm very aware of the impact he has on this community. And so I think it's really important to note that, like, if you think the way to change the situation right now is to, like, get MAHA supporters to think that Bobby Kennedy is, like, wrong or not, that's just like, not gonna work.
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A
Uphill battle. Yeah, a fight that won't be won.
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C
But at the end of the day, there is a massive opportunity to align with this group because there are things we agree on. And I think that there's a lesson to be learned from that as people think about coalition building to make change.
- [12:44]
A
You can hear this coalition building happening in real time on the why Should I Trust you Podcast. In one episode, Dr. Megan Ranney, an ER physician and the dean of the Yale School of Public Health, posed a question to Elizabeth Frost, a MAHA organizer in Ohio.
- [12:59]
D
I think scientists try their best to be open minded. And the process of doing science, we like, push and test each other to make sure that we're getting as close to truth as we can.
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B
And just.
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D
Elizabeth, I'm curious what would help folks to feel like science was being done with and for them? Because to me, that's what most scientists are in this work for. And I also hear you saying it didn't land that way. There was a lot of outrage for having any questions, you know, about the way that the COVID pandemic was handled. People on the MAHA side of it felt that they weren't allowed to be a part of the conversation. And I think for people to have a better understanding of the reasons those decisions were being made would have gone a long way.
- [13:47]
A
Brenda says this type of exchange is exactly what the podcast is trying to foster.
- [13:53]
C
I do think what Covid ended up doing for many people was giving the impression of kind of these mad scientists in their white lab coats or these policymakers who were enforcing mandates, and it just, they became emblematic and proxy for an authoritarian way of forcing people to live their lives. I say that our show is an effort to kind of introduce America to itself. This is who we are. This is how we bring in information. These are our fears. These are our kind of wild ideas. These are our biases. We have to kind of live with it. We can't just tell people they're wrong for having that. That just doesn't work.
- [14:37]
A
The hosts are not afraid to get into the nuance of vaccine hesitancy, and they acknowledge that some decisions are shaped by emotion, even among scientists and other experts. Take Dr. Michael Mina, an immunologist who was on the show to talk about the hepatitis B vaccine. The shot that's recommended at birth.
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E
In the context of our family, the risk of getting hep B in those first two months of life are vanishingly low. And so we decided to put off getting a Hep B vaccine at birth and get one at two months.
- [15:07]
A
Dr. Minna explained he and his wife didn't like the idea of their child getting a shot right when they were born.
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E
Now, I'm privileged, if you will, to be able to make those assessments in a way that I can, like, weigh data. And so this was a risk that we felt we could absolutely tolerate. And the benefit was for us not having our big baby's first experience, you know, besides birth, you know, getting a vaccine. You know, I want to caveat that by saying there's no data to show that getting a vaccine at birth is a risky thing. It was much more emotional, like, period. We're emotional creatures as humans, and we make decisions based on that. And like that emotions have to play in, I think, to public health in a really serious way, in a way that, as infectious disease epidemiologists, we generally kind of avoid thinking about.
- [15:52]
A
By putting that vulnerability on the table, Minna revealed how even among scientists, the calculus isn't purely clinical.
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B
I would venture to say, you know, there's a lot of things going on in these rooms when we have these conversations. And the personal experience that brought people to either study public health or to align with Maja or any ideal system is so incredibly personal, and we kind of miss that from the public health perspective.
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A
Now, in some public health circles, even airing these kinds of doubts would be seen as harmful, a threat to vaccination campaigns. But Brenda sees it differently.
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C
If we are worried that having complex conversations about something are going to result in people not getting vaccinated, we're in real trouble. Those conversations are happening whether we want them to happen or not, because there's this thing called the Internet. Everything has to be viewed through the lens of the fact that people increasingly are trusting peer to peer and social media guidance as much, if not more than expert guidance. And so it is incumbent upon us to engage in these conversations and the complexities of them.
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A
Brenda says that these conversations are starting to lead to other collaborations.
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C
We weren't even really expecting this. These are just the feedback we've been getting that, you know Elizabeth Frost, who works at MAHA Ohio, she's been on our podcast several times. There's a couple of projects she's working on. So one with Caitlin Jettalina, who does your local epidemiologist.
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A
Right. That's the name of her substack. She's a public health expert.
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C
Right. They're doing some work, I know, in North Carolina and Ohio to work with their state legislatures on some nutrition legislation and as well as, you know, really underscoring the impacts of the cuts to Medicaid. And they're kind of trying to build some communication around that together. They've also done some work to write frequently asked questions on vaccines together, so that the MAHA questions are sort of really elevated and seen in that faq. Kevin hall, who's a nutritionist, is working with some of the MAHA people to look into SNAP for used in farmers markets or things like that. And, you know, we share each other's email addresses with each other, and I've heard that some of them will then email each other and then go off and have conversations. And there's something really just deeply moving about that. So it really makes me pretty happy to see that some of these pairings are happening.
- [18:31]
A
And as for all of this momentum that's being generated right now, more broadly, this, this interest in personal freedom, in health, where do you anticipate it leading us?
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B
You know, there are so many people who want to be able to live and work in this country in a way that allows them to have a life, but we don't have that framework in place. So to catalyze on the momentum, it's bringing people together to find out what do they actually want, what do people want versus what are the political talking points? Because those are just getting in the way of us being able to move things forward for real, tangible change. Nobody likes being sick. Nobody wants to get an acute viral infection and then have a chronic condition for the rest of their life. Could we be doing things that make it so they're less likely to get sick? Could we be doing things that make it so they're more. More likely to get better science can be leveraged way more than we are right now. And if people are saying that we want to have less vaccines given to our children in number, well, let's innovate. Let's make more combinations. If they're saying that we don't want to do shots, there's an option. We have transdermal patches. We could do oral vaccines. We could do these things.
- [19:57]
A
Yeah.
- [19:58]
C
Look, I think it's not lost on even many people in the MAHA movement that this incredible momentum is coming at a time of massive, just destruction of the scientific and medical infrastructure. I mean, we've seen the biggest funding loss for the science and medical infrastructure since World War II. When I imagine myself as being a public health researcher, somebody who's working at a health department whose funding has been lost, and literally they don't have the tools to provide resources, I feel for them. And I actually, there are a lot of MAHA folks who feel for them, too. A lot of them really weren't supportive of the cuts to Medicaid. So I think there needs to be, obviously, a period of rebuilding. But the one thing that I also think we have to kind of hold at the same time is that there's no going back. People want to be fighting for their children living with diabetes and chronic disease. They want to be fighting for getting toxins out of water. They want to be fighting for access to better food. But I do think widening the scope of what public health cares about publicly so that not everything is like all vaccines all the time, as being the only thing that sometimes it seems like they care about, can also communicate to the country that they do see you for the things that are really bothering you. And I don't know, I'm sort of this kind of eternal optimist who thinks that right now we've been given an opportunity to sort of rethink how we're going to do public health and health and media and communication, you know, can we put certain rhetorical weapons down and engage each other in the nuance and complexity that this country deserves in order to truly make America healthy again?
- [21:49]
A
One last thing I want to ask both of you is advice for people who are listening right now. I think, and you've said this repeatedly over the course of this conversation, I think what most people really want is information. They want agency. They want to be able to make choices on their own, but they want to be able to base that on something. And I think increasingly people are feeling like they just don't know where to go for good information. Or who to turn to. From all of these conversations you've been having with various people, what is your best advice for people who are just trying to navigate this and trying to understand things better on how to be an information seeker in this moment?
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C
I think what I'm learning increasingly through this process of having all these conversations is finding a doctor you trust is really important. And if you don't trust your doctor, make an effort to find someone that you do trust. You know, by and large, Americans still trust their personal physician as being the main purveyor of information. So I still hold that relationship as being an incredibly important one. You know, through all the different announcements that are being made about Tylenol or vaccines or even, you know, nutrition and things like that, your doctor is being the first line of like, hey, can you just help me understand this? I really recommend doing that. One thing I challenge myself to do a lot these days is like, not to sort of have the answer and then like, back in the facts to support that answer. It's to really go in with a sense of curiosity and personal fallibility and a sense that, like, well, am I open to what the answer might be, even if it may not be politically convenient or values convenient for me?
- [23:46]
B
Oh, man, I love that so much. I think that community has been lost in a lot of ways, and there are phenomenal science communicators. I could rattle off so many of them that I follow and that I trust. But would that break through to people who are looking for their own people to trust? I don't know. I think there are a tremendous number of influencers out there who are talking on these different things. But again, like the title of our podcast, why Should I Trust You? I think that should always go into your mind when you're evaluating if you trust what's coming in and find people that you can discuss it with. Because it's that conversation that I think is rebuilding community one at a time that I'm hopeful we can catalyze more in the future.
- [24:33]
A
Well, Maggie, Brenda, I think you're already doing really important work. Thanks so much for coming and talking to us about it.
- [24:39]
B
Thank you for having us.
- [24:40]
C
Thank you.
- [24:45]
A
You can listen to to why Should I Trust you? On Apple Podcasts. We'll link to it on our Show Notes page.