479: Considering Rural Voices, Misinformation and Disinformation

ROBERT JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Thursday, August 10, 2023. I'm Robert Johnson. Now, celebrating two years of the newscast, here's today's news from the Association of State and Territorial Health Officials.

BETHANY ALCAUTER: 

We already weren't able to meet the needs of rural communities. And now those needs are even more complex.

JOHNSON: 

Bethany Boggess Alcauter is with the National Center for Farmworker Health. She says public health in rural communities is getting more complex.

ALCAUTER: 

We've always had this lack of infrastructure in rural communities, especially public health infrastructure. So, we already didn't have a strong system of surveillance or response or community support in these rural communities. And now that we have, you know, very large Spanish-speaking populations, populations that speak indigenous languages, refugees from Asia and Africa, and so this is becoming a really critical issue, I think.

JOHNSON: 

She adds the organization's approach is to consider and include all voices in the solution.

ALCAUTER: 

The core of NCFH is we really believe in engaging all the different stakeholders, including farmworkers themselves, in different programmatic efforts to improve vaccination rates. Overall, we've taken a national strategic planning approach that's really focused on local action. And that's because we have a pretty decentralized public health system in the US and rural communities are really different anywhere you go.

JOHNSON: 

Community-based organizations also play a vital role in helping to address rural health needs.

ALCAUTER: 

They are there day in and day out for their communities. They've built that trust, they've built the rapport, they know the needs of their communities and where they are and how they can access vaccines. So, leveraging that knowledge and empowering those organizations to be able to provide that service to their community is really just the most essential way to get vaccines out to rural farmworker communities.

JOHNSON: 

A new ASTHO blog article examines the importance of rural relationships in public health, you can visit the link in the show notes.

People everywhere are learning more about new vaccines to protect vulnerable populations against RSV. Yesterday, ASTHO members discussed the upcoming RSV season at an online briefing with reporters. We were there and we'll have more for you in the coming days.

The Morning Edition celebrates a birthday today. Our very first newscast aired Tuesday, August 10, 2021. Since then, we've done more than 1,500 interviews reported more than 2,000 stories, and in early September, we'll post our 500th episode. To mark the occasion, we thought we'd take you back to that very first newscast, kicking off with a conversation about misinformation and disinformation. Our guest was Dr. Nirav Shah, then-ASTHO president and director of the Maine Center for Disease Control and Prevention.

Why do you think vaccine confidence has eroded over the course of the pandemic?

NIRAV SHAH: 

I think that's a critical question. And certainly there will be those who come after us who study the pandemic that will do a deeper dive. There are a couple of hypotheses that I think are worth exploring. The first is that maybe vaccine competence hasn't really changed much at all. Maybe the opposition to any and all vaccines has at baseline been where we're seeing it right now. That's a possibility, but maybe a possibility where because of the stakes right now, that degree of of mistrust is just more magnified. Another possibility that might explain where we are, is the differences in the COVID vaccine from other vaccines may explain some of the concern and hesitancy we're seeing. For example, many recent polls suggest that one reason folks are hesitant or maybe even outright opposed to the vaccine is that they believe the vaccine was rushed. So, that's a possibility. The third, and perhaps concerning, is that there may be a group of folks out there who are organized to try to undermine the confidence in the vaccine. We perhaps all read about the 'Disinformation Dozen,' for example, understanding what those motivations may mean in terms of eroding confidence, that's going to be critical right now.

JOHNSON: 

From a messaging standpoint, what can public health leaders do about it? Is there anything they can do?

SHAH: 

I think the most effective thing that public health leaders can do is to answer difficult questions straight on. Now, I don't mean to suggest that every single question merits a full response, because there are so many, and many ebb and fall almost on a daily basis and disappear from focus, but there are from time to time certain questions that come into sharp focus. For example, concerns that have been expressed around fertility and the vaccine. Those, I think, deserve a full, robust, direct answer from public health authorities. We do that in different ways. We record short videos, which can be easily flipped around social media, as well as engaging with people one-on-one when they send us their questions. A lot of folks are sending questions not because they are aiming to cause waves, but rather because they in fact, have a sincerely held question. Answering those sincere questions can actually I think, bring people on board.

JOHNSON: 

Finally, do you think we can still beat the virus even if we don't win the info war?

SHAH: 

I think it will be a challenge. My concern out there is that we think about pandemic preparedness, sometimes, from a framework of, 'How many gloves, gowns, respirators, and masks do we have? And are vaccines ready to go?' But what about pandemic preparedness from the perspective of scientific literacy? What if, when the next pandemic comes, and we have a vaccine ready to go, the public is even more skeptical of that vaccine than they are for this one. That's every bit as part of a pandemic preparedness, as are the physical materials that we often think of. 'What should we start doing now, today to prepare the public from a scientific literacy standpoint, for the possibility for the next vaccine and the next set of treatment out there?' That is, I think, key and an instrumental part of, as you say, 'winning the info war' that we're in right now.

JOHNSON: 

As you may know, Dr. Shah is now the Principal Deputy Director of the CDC.

Also, we'd like to thank you for making us part of your morning routine the past two years. This is the only daily public health newscast in the country, and we're proud to bring it to you weekdays at 7 a.m. Eastern time.

That is exactly where we'll be tomorrow, right here, with more ASTHO news and information. I'm Robert Johnson. This is the award-winning Public Health Review Morning Edition. Thanks for listening, and have a great day.