Challenges facing local health authorities and declining public trust

Steve Hall called public health an “invisible profession.”

“Before, even though we were doing a good job, people didn't know about us,” said Hall, who was health officer for the Central Michigan District Health Department for 10 years.

Now, the COVID-19 pandemic has “really thrust the field into the spotlight,” Hall said, creating new challenges and some benefits for the network of local departments that promote health across the state. Ta.

Norm Hess, executive director of the Michigan Community Public Health Association, said political divisions over coronavirus policy often “divide” communities, with public health officials caught in the middle.

“Many communities were divided down the middle, and as health officials, we felt like we couldn't do anything right,” he said. “No matter what they did, it seemed like half the community hated them and half loved them.”

Hess said these divisions leave deep-rooted mistrust in public health officials.

“We have the challenge of rebuilding the image of public health and the respect that the field previously had,” he said.

Hall said his department has been able to maintain the trust of most community members by emphasizing that its staff are “a true part of the community.” Targeting counties are Arenac, Clare, Gladwin, Isabella, Osceola and Roscommon.

He said it may be more difficult for state and federal agencies to rebuild those relationships.

“The most important thing is that our employees are part of this community. They work here, live here, and send their children to school here,” Hall said. . “When you're around every day, people are more likely to trust what you say than when you're a federal employee in Washington and people don't know you.”

That message has been embraced across the state, with public health departments in the Upper Peninsula and northern Lower Peninsula funding television and social media advertising campaigns that portray staff as everyday members of their communities.

“We live here. We work here. We care about you, your family, and the communities we serve,” said the UP agency. The slogan of one advertisement created by the collective reads:

Linda Vail, the longtime public health director for Ingham and Kalamazoo counties, said community appeals alone won't repair the divide between certain people and public health officials. She resigned from her position in Ingham County in 2023.

“I wonder how many Qanon believers look at the current situation, including culture and politics, and think, 'Oh, this public health thing is great,'” Vail said. Qanon is a far-right conspiracy theory group.

She currently works for Health Management Associates, a national public health consulting firm.

While messages like the UP ad are a good start, real change will take time, especially as officials struggle with threats to funding and jobs from some elected officials. She said she was deaf.

Vail cited the ongoing battle in Ottawa County as an example of what health officials may face. There, the ultra-conservative county commission, shaken by emergency health orders during the pandemic, demoted the county's top public health official for allegedly violating state law.

In more mundane situations, public health officials working for conservative county commissions routinely struggle to get state and federal grants approved, Vail said.

Vail said conservative county leaders have become increasingly critical of public health agencies, making it difficult to get funding approved for sexual health services and programs for LGBTQ+ people and undocumented immigrants. He said there was.

“These things that are controversial now are things that public health agencies have been doing for years,” she says. “However, now there is stricter scrutiny and we have to overcome this difficulty.”

But Hall said the increased visibility has alleviated some of the funding problems, as officials with no political opposition to public health agencies are more likely to take notice of the profession. .

In the past, Hall said, it was difficult to get lawmakers to take public health causes into account when crafting new budgets.

But Hall said he feels that after the COVID-19 pandemic, there is “a newfound openness among decision makers to fund public health programs,” such as restaurant inspections and septic tank maintenance.

“When we were disappearing, it was more difficult to get interest in securing funding,” Hall said. “Now things are a little different and the door is opening to talk about increasing funding for public health projects.”