Challenging Public Health: a Q&A with Rebecca Traister.

As we slowly emerge from the depths of the COVID-19 pandemic, the School of Public Health is launching Challenging Public Health, a new series of Public Health Conversations that feature voices from outside of public health reflecting on the public health response to the pandemic.

 Rebecca Traister, a journalist and author with incisive takes on the intersections of policy, health, and feminism, will be the first guest tasked with helping bring an informed and occasionally iconoclastic perspective to those working within the field.

In a wide-ranging conversation ahead of her virtual appearance on Feb 1, Traister explored how the past two years laid bare the missed opportunities of the past two decades in healthcare access, reproductive rights, and systemic political reform.

She watched, as we all did, a nation that stumbled blindly during the first year of its response to COVID-19, then appeared to regain its footing with the rollout of vaccines and the continuation of policies such as extended unemployment, rent relief, and student debt deferment.

“We saw the impact of that on keeping our economy alive and keeping people healthier and enabling them to make the best choices for themselves and their families to stay healthy and safe and not suffer economically. It was on view right in front of us,” Traister lamented.

“And yet we could not come out of this with the policies in place to make those shifts permanent in a way that would better strengthen us going forward and as a result, we actually lost so many of these fights.”

Like many observers within the field of public health, Traister said she believed that the pandemic would finally shine a light on the inadequacies of the interconnected structures of healthcare and economic policy, and why they desperately need repair.

 “And instead, in many ways, we’re coming out of the pandemic with the system in worse shape than when we went in.”

In the early days of the pandemic, March 2020, you published a Q&A in The Cut on How Far-Right Media is Weaponizing Coronavirus. I was stunned by how prescient it was and how much the last two years have followed the playbook of attacking prominent women and their ideas.

So much of what we’re coded to understand as reliable, trustworthy, solid is designed around a white patriarchal model of authority. That’s how our government is structured, our courts structured, it’s how society is structured. And it’s not to say that this is an uncomplicated white patriarchy. There have been huge changes made to that.

But you still have these models that are fed to us in ways that are often imperceptible, that leave those on the fringes of that power structure very vulnerable to assertions that they are somehow untrustworthy, or that they’re crazy when it comes to some of the gender assumptions that are very easily made about people. And of course, this is further determined by race but women can very easily be painted visually, as well as verbally, as hysterical. And hysteria itself is an inherently female concept, right?

Hysterical, infantile, crazy, dangerous, again, all of this is informed by the race of whichever women you’re talking about, these particular characterizations emerging because anything outside the realms of whiteness is also very easily painted as suspect.

I think this is where it comes forward in a partisan way, with the Democratic Party since the middle of the 20th century and the success of a lot of social and political movements for greater gender, racial, and sexual equality. The Democratic Party has owned all of those successes — whether or not they’ve actually done a good job of fighting on behalf of those people is another question.

How do those characterizations play into the effectiveness—or lack of effectiveness—of disseminating information about public health?

We’ve seen that play out over these past two years. I mean, look at your Facebook feed or think about the conversations you might have had with an in-law or a friend from high school. One of the things I’m currently obsessed with is how this period has really thrown into stark relief how closely a sense of certainty is actually aligned with a sense of power. It’s just something I’ve been thinking about nonstop over the past couple years in both electoral terms and when it comes to COVID, and what we’ve seen happen around public health. That there are periods when those who have had a comfortable degree of power—and I’m talking about those on the right and the left.

Over periods of decades, say since the middle of the 20th century, many have felt a certain kind of certainty, and these past years have really shaken that sense of certainty for a lot of people. For every political persuasion, and I would argue every class—and especially those who are used to being at the top—that uncertainty feels very uncomfortable. People in vulnerable communities and populations are much more used to feeling economic uncertainty, uncertainty about access to healthcare, to safe schools, all that stuff.

That is a very unusual experience for those who are used to having degrees of power and therefore degrees of certainty about the world. And I think that it has happened coterminously with the rise of a disinformation marketplace. Fox News is the central and biggest and most mainstream but as Jiore Craig was pointing out to me in that Q&A a couple years ago, this is happening on all kinds of other levels that aren’t just a major television network or its newspaper entities, it’s via the internet, via deep fake stuff, all kinds of ways in which the media and social media permit information to be manipulated in ways that weren’t as easy just a few years ago.

As you referenced, there are so many more ways that people are getting information now, that just means that there are so many more ways of serving up disinformation. And it’s a particular problem that we’re encountering about public health itself.

So many of the scientists that I am watching are so much more comfortable with saying, `I don’t know the answer,’ than the people who are their interlocutors—whether that means literal spokespeople or journalists. And I wonder if, going back to the craving for certainty that perhaps has to do with a desire of those with a lot of power to feel even more power over scary things around them, to get to certainty when there really isn’t certainty on a lot of ways. That we made false promises that we would have control over things that we don’t actually have control of—and that makes it seem like suddenly, we can’t trust things.

 In fact, when I’m talking to a doctor, I am 100% more likely to trust the doctor who tells me that they don’t know, or that they’re not sure. But it’s like that became a sign of weakness somewhere along the way, and as soon as we got to the point where we had to have certainty in order to trust public health then you have people trading in certainty and then when that certainty turns out to be wrong, then, “Well, we can’t trust you anymore.”

Messaging has to convey certainty in order for people to feel safe—but it’s true with the vaccines too. We had people out there from the government saying, “You’ll be fine now that you’re vaccinated,” and then somebody gets sick when they’re vaccinated and they’re, “Well, now I can’t trust you at all because you told me it was going to be fine.”

What if people said, “Look, we have a great degree of faith that this is going to radically improve outcomes for lots of people and there may still be breakthrough infection,” or had there been a more nuanced, “We have a lot of data that suggests that this is going to be good.” But people had to communicate in soundbites, which have to be shaped around authoritative certainty, but authoritative certainty is bullshit, nobody knows.

It’s okay. We live in the world, we’re human beings. It’s okay that we don’t know everything. It’s actually better if we acknowledge that.

Many of the spokespeople during the pandemic, and in public health in general, are women and the vilification of these trusted sources seemed to be incredibly counterproductive from both a societal and a public health standpoint.

Some of the ways in which I’ve seen this particularly gendered stuff during the pandemic are certainly tied to public health but may not officially fall within the domain of public health — as with teacher’s unions. Again, its teachers who are mostly understood to be female and of course, in many cases are women of color. The notion of these teachers as somehow lazy, not wanting to go to work, babies who are scared of going back into classrooms and need to be coddled. All that stuff is classically, gendered and in many cases racialized.

I would say the same thing is true of some of the other side, which is the parents demanding to have their kids go back to school. They’re often characterized as the moms and sometimes cast as, “Oh, they just want somebody to take care of their kids.” They’re somehow bad moms because they want their kids back in school. This is an issue where I know everybody’s extremely upset. But how is it that everyone here is a villain and they’re all the women? I think that’s an area where I see a lot of gendered aspersions of stupidity, laziness, cowardice, all kinds of things, sometimes they contradict each other. That, again, stems from the base fact, which is nobody is sure what the right thing to do is. There may not be one right thing to do but everyone’s convinced that the person who wants the thing that’s different from what they want is a malevolent actor and not just also confused about what it is that we’re supposed to be doing.

 I’m very aware of the fact that I’m not a public health expert and that sometimes I wind up covering issues directly tied to public health, often about reproductive healthcare. But what I do cover is politics and social movements, the push for more equitable systems whether that means the courts in terms of democracy and institutions, or within the workplace. And so much of what I have covered over the past few years is so intimately tied to public health even if it doesn’t officially fall under the rubric of public health.

One of the things that I have seen on my beat, which I think is interconnected in 15 different ways to public health, is this explosive set of opportunities in this period of horror and confusion. There were so many opportunities to change, to make better policy and also to make clear how these policies are interconnected.

And that was true when it came to making clear, for example, the need for better funded schools, the need that we have for paid leave, for child tax credits, for the support that families need, for better wages for caregivers, for subsidized 0-5 education. Better unemployment benefits, more better access for people in rural areas to good medical care, all of those things, it was this moment where the pandemic laid bare all of this and then we had an election that produced promises of possibility.

And at the moment they’re all squandered.

Hear more from Rebecca Traister during SPH’s Challenging Public Health event on Tuesday, February 1 from 1-2 pm. The event will be held on Zoom. To register, click here.