1162: Rebuilding Public Trust Through Storytelling

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Thursday, July 9, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials.

 

Today, what happens when a public health agency decides to step out from behind the scenes and tell its own story? Dr. Jerome Larkin, ASTHO member and director of the Rhode Island Department of Health, tells us about the department's "Better State of Healthy" campaign, an effort to help residents better understand the role public health plays in their everyday lives. Launched during National Public Health Week, the campaign highlights the people behind public health and the services that support Rhode Islanders every day.

 

JEROME LARKIN: 

Through the campaign, Rhode Islanders have been seeing stories from public health professionals about the breadth of the department's work, as well as the role it plays in their daily lives, and the ways to access the department's resources and services, and this includes things like vaccination programs, resources to help quit smoking, cancer screening, testing, and prevention of sexually transmitted infections, our women, infants, children services, and much, much more. And our vision was to inform people about all that we can do, but also to humanize public health and help people see and connect with the public health professionals in their communities. It's all about telling your story. It's about telling the story of the professionals that are working there, that are part of their families, their neighbors, their community, who are there to serve them and to help them.

 

SHEEHAN: 

And so, when you were formulating the campaign, what were the gaps you were seeing in either public awareness or public trust?

 

LARKIN: 

So, we did an extensive audience research across the state and in multiple different languages, because we have a very diverse state, and we learned that beyond COVID, people were really unsure about what the agency does or how it can help them, and we realized we needed to build an understanding of the many things that public health does every day to protect people and communities. You know, there's an adage that public health is invisible, or it's working when you can't see it, but we realized that we needed to come out of that invisibility, or kind of cast off the invisibility cloak, if you will, and let people understand all of the things that we are doing, not just as prevention, but as actually promotion of their overall well-being, and we also learned that there's a lot of distrust of things that people don't know about, and in particular when it comes to government agencies, if they don't really understand what the agency is doing or how it helps them, there tends to be some mistrust. Public health agencies, people tend to be a little bit more neutral about, and or perceive as more trustworthy than some other government agencies, but there was still this lack of understanding, and therefore a lack of sureness, really more than trust, actually about the Department of Health.

 

SHEEHAN: 

And so, speaking of the diversity of cultures that you have in Rhode Island, what have you determined to be, like, the more effective ways to reach people and communicate those stories and communicate that trustworthiness across communities?

 

LARKIN: 

So, I think again it really comes to making people understand that the people of the Department of Health are from their community and that actually the staff of the Department of Health is as diverse as all of Rhode Island, and so focusing on again that story of the person who grew up in Rhode Island, went to school here, maybe from an immigrant community, and they're there now to really help raise up their community. Oftentimes our staff speaks many different languages, Portuguese, Spanish, languages from elsewhere in the world, we have a large Liberian diaspora. The official language in Liberia is English, but there's 17 to 20 different other languages that are spoken, and most people speak a different language than English. So, letting people know that it's the same language that you hear at home that can actually be spoken at the Department of Health.

 

SHEEHAN: 

Yeah, and so that the campaign has made use of that and has really highlighted the diversity of your staff and telling these sort of first-person stories.

 

LARKIN: 

Correct. And part of it also is, again, they're not just staff in the Department of Health, they are your friends and neighbors. Another thing that people talk about is five degrees of separation, right? In Rhode Island, it's more like two degrees of separation. If you don't know how you're related to somebody, it's just because you haven't figured it out yet. And that was an experience for me after practicing here for 20 years, even though I am not a quote "native Rhode Islander". I was really surprised at how often I would go to different events, particularly in my first six months, and I would be bumping into people I knew already, because Rhode Island is that interwoven. Our population is a million, so it's not like it's a tiny place in terms of population, but it is a tiny place, and in the sense of the relatedness of people, some people call it, “the biggest small town in the world.”

 

SHEEHAN: 

Yeah, I think that resonates for a lot of East Coast communities. When you have a place where a lot of people have grown up and lived for a long time, even if you're not necessarily born there, you can become part of that community pretty quickly.

 

LARKIN: 

Absolutely, and my wife is a native Rhode Islander, and her larger family is here, so I kind of bumped into relatives that she didn't even know she had on some regular basis.

 

SHEEHAN: 

Another aim or another goal of the campaign is to connect residents to services that, again, maybe they weren't aware were public health services. How did you decide what services to sort of promote within the campaign?

 

LARKIN: 

It was based on the research that we had done, as well as the sense from the staff itself, because again, the staff itself is of Rhode Island, and you know, I think the things that resonate most with people are the things that they can see in their daily lives, such as the Women, Infants, and Children Nutrition Program, lead screening, healthy homes in general, safe food and water, and a big part of what we do is food inspections and licensing of food trucks, which Rhode Island is quite famous for. So, it's those types of stories that I think really resonate with people, and that was informed by both the research as well as the staff themselves.

 

SHEEHAN: 

When you're talking about sort of tracking effectiveness of the campaign, what are your metrics like for targeting impact, particularly when, like, the focus of it is on interpersonal connection?

 

LARKIN: 

So, one thing we will be looking at is the engagement with our social media platforms, as well as our website, and then interactions at community events, and then calls to our health information line, which is sort of the single phone number that people can call, and then they get routed to the appropriate center or part of the agency that's going to help them, and ultimately the utilization of our services. So, how many times are people asking for their, for our help with things like lead screening, or water safety, or food safety vaccination programs, nutritional programs, other chronic disease management programs like smoking cessation and cancer screenings? Ultimately, we'd like to repeat some of the research to sort of see what has changed in terms of the overall perceptions that we got from our first survey, which was about 1,400 Rhode Islanders. The reassuring thing was that most people did trust the Department of Health, even though there was a degree of unsureness sometimes about exactly what we did.

 

SHEEHAN: 

Dr. Jerome Larkin is director of the Rhode Island Department of Health.

 

The leading causes of death in the United States are attributed to chronic diseases, such as cancer, stroke, and diabetes. ASTHO works with state and territorial health officials to provide the tools necessary to address the burden of chronic diseases, such as heart disease, dementia, and obesity. Our work centers on supporting members and their agency staff to improve public health systems and infrastructure to advance health equity in chronic disease prevention and health improvement. Find resources at the link in the show notes.

 

Join ASTHO on July 13 for the final Lunch and Learn series webinar focused on preserving institutional knowledge during workforce transitions in public health agencies and the implications for STI and infectious disease programs. As part of ASTHO's Policy Institute, this session will examine the challenges health departments face when staff retire, change roles, or leave organizations, and how these transitions can affect program effectiveness and continuity. Learn more at the link in the show notes.

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.