Weakening Public Health Authority
It is a sad state of affairs when those charged with protecting the public are instead disparaged by it. But as sad, unwarranted, and uncivil as the harassment of health officers has been, far more disastrous is the resultant long-term damage to public health authority that has followed. Public discontent with mask mandates and school and business closures catalyzed policymaker backlash against public health authority. By November 2021, almost every state legislature has seen the introduction of a bill to weaken or remove the emergency powers of governors and/or local or state health officials.[11] Successful efforts to reduce the power of public health authorities are a Pyrrhic victory: knee-jerk reactions that incite one's political base but with potentially deadly consequences for all of us when health officials' hands are tied in new outbreaks. These legislative attempts to purportedly check unbalanced executive powers are misguided efforts to score political points and win future elections. They come at the very perilous cost of weakening the ability of health officials to use necessary and important mitigation tools to protect the public from future public health threats. These efforts should concern us all, regardless of political ideology or partisan perspective.
Leading a state or territorial health department is not an easy job on a typical day, let alone during a pandemic. Who would want the position when you may face legislative roadblocks to your every move to protect the public's health and relentless social media trolling in the best of times, and death threats in the worst? Add to the mix "moral injury," a term used to describe the cognitive harm experienced when what we think is right and helpful is viewed by others as wrong and harmful, and our ability to recruit and retain health officials in the future may be seriously compromised. Ward et al. describe the number of voluntary resignations and transitions in health department leadership during their study period. Although not explicitly stated, many were most likely a result of the cognitive stress and moral strain of repeatedly trying to do the right thing and being punished for it. Moral injury, typically reserved for the experience of soldiers returning from war, is now common in the public health workforce. This might also partly explain why a significant percentage of public health workers reported experiencing a serious mental health condition, including depression, anxiety, and suicidal ideation, alongside the COVID-19 pandemic.[12]
Am J Public Health. 2022;112(5):728-730. © 2022 American Public Health Association
