Alliance Discussion with Dr. Céline Gounder: Meeting the Moment – Fostering Medical Progress and Tackling Large-Scale Health Threats
Dr. Céline Gounder, Senior Fellow and Editor-at-Large for Public Health, KFF Health News, and recipient of Research!America’s 2024 Meeting the Moment for Public Health Award joined us recently for an alliance discussion. She shared insights from her career in epidemiology and health news reporting on how we meet the moment when tackling large-scale health threats, from smallpox to COVID-19, and speed the pace of medical progress. Here are some of her thoughts on:
Engaging global and local communities in medical and public health:
“I think where I really learned about [community engagement] was in the earlier part of my career working in global health in Southern Africa. I found myself getting pulled in to help with a lot of community activities, whether it be a town hall or working with local journalists or patient organizations. This was also a time when there was an understanding that if you’re going to be doing research of any kind in communities, that you really need to have their involvement and they need to be empowered to engage and weigh in.”
“I decided I was going to focus in on some of the areas that had the worst health outcomes in the U.S. Around the same time, Chris Murray at the Institute for Health Metrics and Evaluation, that group started to release these papers in JAMA and elsewhere, with these maps of burden of disease. What I took away from that was really a story. Every map has a story of disease in this country. And as I drilled down further and further, I picked out a few places I wanted to work. I went first to West Virginia, to Kanawha County, which, at the time, had the highest rate of opioid overdose in the country. Then I decided to go to Indian reservations, and in terms of engaging with communities, tribal communities, just one example of a story is around uranium mining, which continues to impact the health of Navajo and other indigenous groups in the Southwest. I spent some time with the folks on Red Water Pond Road, that community, which has been very active in advocating. They have a yearly commemoration, and I just spent the day with the folks from the community. They do a march around the area, where they showed us where the uranium mining had occurred, and how it had damaged the environment. I just spent time listening. I think that’s perhaps some of the most important work that needs to be done.”
How can public health practitioners better engage with communities:
“I think first, listening, and secondly, show that you care. I think those are probably the two most important things. So, that might mean having more town halls, more engagement. One of the things I also learned working in Southern Africa is the importance of if you’re going to have a town hall meeting or something like that, you need to provide food, you need to provide transportation so that it’s easy for people to engage, attend, and take part. So those would be some of the simple things. I think part of what’s really challenging in storytelling is that people want to hear stories, usually of individuals, individuals who are facing a challenge and how they are overcoming that challenge. And public health is a story of communities, not individuals. So, it can be challenging right? To tell that story in a way that will resonate with another individual. How can we make the stories of public health as personal as possible, and that means sometimes use a public health worker may need to be part of the story.”
Expanding our knowledge of how to take on public health challenges:
“[…] This notion of moral imagination, which is how do you judge the morality or ethics of different policies that you might implement? Should we be measuring that against what’s obvious? Or should we be measuring that against what’s possible if we dare to imagine bigger? And I would argue that we should really push ourselves to imagine bigger and not just look at what are the options in front of our noses. You know, we’ve been very focused on these specific tools for controlling COVID – vaccinations, masking, testing, treatment. The discussion doesn’t really go further than that and there are so many other tools that we could be employing here. Whether it’s improving indoor air ventilation, which would build public health resilience for many of the other threats we have coming, whether that’s wildfire-related smoke, or the next pandemic. That’s just one example. Are we talking about paid sick and family medical leave? To make it possible for people to stay home when they’re sick or their child is sick. You know, when you’re asking people to do these pro-public health things and it’s going to cost them a day’s wages, extra childcare, or whatever is it, it’s really a very big ask. So, I would say, having the imagination to dream bigger.”
Being a successful advocate for public health:
“I think that starts with us thinking bigger, right? You know, what are you advocating for? Are you advocating for the obvious things? Or are you advocating for something bigger? One of the things Dr. Bill Foege told is that people require evidence of sustainability before they’ll fund something, but you don’t know what’s sustainable, until you try and do it. I think that’s so important to remember is to try and do some of these things and experiment, even if it’s at a smaller community level, but to demonstrate what works and then to try to use that as leverage to push for expansion of what works.”
Public health issues to consider for the future:
“I think the intersection of climate change and public health is going to be really important in the years ahead. Whether that’s in terms of air quality, water quality, emerging infectious diseases – we are going to see the expansion of tick habitats, mosquito habitats; are we going to be prepared for that? And that’s partly a question of surveillance; it’s partly a question of our healthcare system, which unfortunately, is coming out of the COVID pandemic pretty battered; it’s a question of being able to communicate with the public. I think related to that is also this parallel disinformation epidemic, which I think is really fueling many of the challenges we’re seeing in public health.”
Combating disinformation utilizing effective science communication:
“A lot of the work I did during the pandemic was with local community groups. Sometimes it’s just listening, letting people vent, and showing that you care enough to spend the time because that’s what convinces people. You don’t have to spend a lot of time providing facts, it’s showing that you care and that you can be trusted and, honestly, your message that you’re delivering can be short and to the point. Then make your yourself available for questions about that.”
Watch the full discussion here.
Dr. Gounder is the 2024 Advocacy Award Recipient for the Meeting the Moment for Public Health Award, an award recognizing an individual that has been a “clear voice,” playing a key role in communicating important public health information to the public and rising to the challenge of the day. Register for this year’s Advocacy Awards and learn more about the 2024 honorees.