Trump’s victory underscores mistrust of public health agencies

In his victory speech Tuesday night, President-elect Donald Trump foreshadowed his health care agenda, crediting a key supporter who has proposed removing approved vaccines from the market, removing fluoride from the water supply and sweeping reform of federal health agencies.

“We might add a few names, like Robert F. Kennedy Jr.” Trump told his supporters. “And he’s going to help make America healthy again. He’s a great guy and it really means he wants to do something and we’ll let him do it.”

Kennedy, 70, a political independent who quit the presidential race in August to support Trump, applauded Trump’s victory in tweet Wednesday morning.

But Trump’s victory – and the newly forged alliance between the two men – has medical and public health experts expressing alarm. They are concerned that Kennedy’s proposals are not based on evidence and could harm Americans’ health.

Trump promised on election campaign give Kennedy free rein on the administration’s health care plans, including women’s health.

But it remains to be seen exactly how his plans will come to fruition.

Analysts and public health experts said Kennedy’s assessment of the U.S. health care network shows a growing trend of distrust in institutions that will be a top concern for the incoming Trump administration.

In March 2023 study About a quarter of Americans said they trust the Centers for Disease Control and Prevention’s health recommendations “somewhat” or “not at all,” according to cases published in the journal Health.

Ezekiel Emanuel, an oncologist and professor of medicine at the University of Pennsylvania, said in an interview that Kennedy’s mistrust of agencies reflects the rise of populism this election cycle.

“Every time populism rises, along with it comes suspicion and hostility towards experts, the idea that someone knows better,” he said.

Emanuel said there are many factors that play into this suspicion: “It has to do with the fact that many people feel like life is out of their control, like something is being done to them and not with their consent, which I think is quite legal, but I don’t think that’s what experts do by and large.”

Emanuel stressed there was truth to some of Kennedy’s comments, pointing to his concerns about conflicts of interest among agency officials. He also said Kennedy’s concerns about the country’s high rates of obesity and processed food are well founded.

Between 2021 and 2023, the prevalence of obesity among adults in the United States was 40 percent. according to the CDC. Obesity increases the risk of chronic diseases such as hypertension, type 2 diabetes and some types of cancer.

The ongoing mistrust stems from the federal government’s response to the COVID-19 pandemic, where Americans were skeptical of rapidly changing information coming from the government.

Emanuel said there were problems with how the government initially responded, including developing CDC guidelines regarding mask wearing and school closures. He said the public health community should be more “humble” about emergency response next time.

“We haven’t had a full period of real and important self-reflection on this,” he said.

“Learning on the job”

Another factor that has public health officials questioning Kennedy’s ability to become a health leader is his lack of experience in the field.

Kennedy is not a medical doctor and has never worked in health care, but Trump has hinted that he will play a key role in selecting administration positions such as surgeon general and secretary of Health and Human Services.

“The problem is that if you hire people who don’t have experience in this, there’s going to be a big learning curve, and people are going to get hurt along the way,” Georges Benjamin, executive director of the American Public Health Association, said in an interview.

Benjamin said that even in a consulting role, Kennedy could have enormous influence on the president’s health care agenda.

“We are open to working with anyone who wants to do what is scientifically sound and evidence-based and improves health,” he said. “We just think you should be led by people who don’t learn on the job.”

One way to increase public trust would be to rely on primary care providers, whom the public typically trusts more than federal agencies.

According to August poll According to a survey conducted by communications firm Edelman, 83 percent of respondents said they trust their primary care provider to tell the truth about public health issues.

“As Americans’ trust in public health in general and in the health care system as a whole has declined, their trust in individual clinicians, doctors, nurses, longtime primary care providers remains strong,” Sejal Khati, director of the University of Oregon. The Office of Public Health and a former senior White House policy adviser during the Biden administration said this in an interview.