Welcome, welcome, welcome! Hello, everyone.
Welcome to year two of PHCC's virtual conference, Insights to Practice, a conference to inspire public health communications.
We are so happy you're here and are making the time for what I hope to be an engaging and informative day for you.
We had almost 3,000 people register for today's conference, which validates to our team that the importance of the topics we'll be discussing have a lot of weight and significance to what you want to be learning.
For those that are new to PHCC, welcome. The Public Health Communications Collaborative, also known as PHCC, is a learning and information hub for professionals who communicate about public health.
We create clear and timely resources, messaging, and learning opportunities directly informed by public health communicators like yourselves.
Before we dive in, just a few important housekeeping reminders. Feel free to stay for as little or as much time as you can based on where your schedule allows, and engage in a way that feels best for you.
Following today, all conference materials, including recordings of the keynotes and panels, will be published to our website so you can watch at your leisure.
Closed captions are available through the Zoom conference platform. If you'd like to use closed captions, click the more button on the bottom of your Zoom screen to enable Zoom's closed caption feature. You can choose to see subtitles in the meeting window or full view transcript in a side panel
With timestamps and speaker names.
ASL interpretation is also being provided by keystone Interpreting Solutions today, with Kyle and Liz as our incredible interpreters.
You will see them on screen with today's speakers. And so you are aware, today's conference is being recorded. Now it's going to be a thrilling afternoon. There will be a keynote followed by four distinct sessions. There will be breaks between sessions, so I encourage you to step away from your computer
For a little bit of a water break or a little stretch. For all of today's sessions, a Q&A feature will be live throughout. I'm already seeing 900 plus comments and chatter. Oh, hello, good afternoon from Texas, Vermont. This is awesome. So feel free to engage with the chat. That is for you
And lastly, we want to just express our deep gratitude and appreciation for PHCC's managing partners, which includes the de Beaumont Foundation, the Kresge Foundation, the CDC Foundation, and the Robert Wood Johnson Foundation, as well as Trust for America's Health
We could not do this important work without you.
So with those reminders shared with you, I'd like to again welcome you all to Insights to Practice, a conference to inspire public health communications. My name is Amanda Kwang, and I'm honored to serve as your director of the Public Health Communications Collaborative.
Since 2020, PHCC has become the country's largest information and resource hub for public health communicators.
This recognition and growth has allowed us to continue to deliver high quality tools, training opportunities, and community spaces like this one for free.
Whether you've been with us since the very beginning, does anyone here remember our staying safe while trick-or-treating social graphic from October 2020? Or if this is your first time you're hearing about PHCC. Our why has always remained the same.
Public health communicators have complex jobs, but with the public health communications collaborative, you don't need to go it alone.
During our time together, you will hear from 15 incredible public health leaders
These leaders do not shy away from a challenge. To give you a glimpse into the day ahead, if you're curious to learn innovative strategies for how public health can continue to operate with changes to federal funding, policies, or structures, be sure to join our session on soaring demands, declining resources
overcoming funding challenges to meet community and public health needs with Natalie, Rachel, Victoria, and Monica.
Let's be real polarized political discourse, online harassment, institutional uncertainty, and emotional fatigue. This work can take a toll.
But if you're looking to learn practical trauma-informed strategies on how to strengthen resilience at both the individual and the organizational level, look no further. Tune in to Stephanie and Pierce's conversation later this afternoon on resilience, a practical guide for public health communicators.
Did you know that the Robert Wood Johnson Foundation recently released a new research-based messaging guide on how to talk about structural racism and health? Then look no further than the conversation for later today with Alan and Ekta.
Wanting to understand what's the latest on the AI and public health conversation? You're in luck. We have Brinley, Erica, Krista, and Andrea. They're going to give you a 360 view on how they're thinking about this. From the landscape, relevant tools
And how public health communicators can use it to increase trust with communities and build critical efficiencies.
Now, with the world of public health communication moving at supersonic speed, I find myself looking for ways to stay grounded, reminding myself of the current zodiac sign is one way I anchor myself to my heritage, and why throughout the year.
2026 is the year of the horse, but not just any horse. Specifically for the Chinese zodiac, this is the rare year of the fire horse.
Which comes around only once every 60 years. The fire horse represents intense momentum, bold transformation, and
and unrestrained ambition
As you move forward through today's insights to Practice, I encourage you to ask yourself, what's propelling you forward?
What's fueling me through the significant time in public health? It's all of you, the many thousands of you that are here today. Thank you for your courage and persistence to do the good work.
And now with that perspective in mind, I'd like to introduce our next speaker who will provide a local perspective to today's opening remarks.
Brandon Horvath is the assistant program manager for the Philadelphia Department of Public Health's Bioterrorism and Public Health Preparedness Program, known as BTPHP.
He has been with BT PHP since June 2018, serving previously as a communications health coordinator and manager.
In his current role, Brandon oversees emergency communications activities for the program, issuing mission critical information to staff, response partners, and healthcare providers.
I've also enjoyed seeing Brandon dive headfirst into all that PHCC has to offer, including serving as a PHCC ambassador, as part of our inaugural cohort in 2024.
Brandon, thank you for championing PHCC to your community in Philadelphia.
A certified health education specialist, Brandon's passion lies in ensuring everyone has access to the information necessary to make informed decisions about their health.
Brandon, welcome to Insights to Practice.
Thanks, Amanda, for the great introduction and for the opportunity to share some perspectives from the local level. I spent a while thinking about how I could best start out these remarks, and I think it's only right to take a moment to acknowledge the great work that's continued to happen at the state, local, territorial, and tribal levels, even at times
When uncertainty was at its highest
Through each of these changes, our mission has remained the same, protecting and improving the health of people and the communities they live, work and play in. This happens in several ways through communication, education, and outreach, through improved access to care and services
And through policies, programs, and partnerships.
The way people communicate, access, and share information will continue to evolve, especially as we become more aware of new and emerging tools, their advantages, and their complexities. We've seen this with social media, and more recently with AI. Staying open to new perspectives and technologies is important because it will help us as communicators
As well as our organizations and the communities we serve to remain informed, resilient, and curious.
I think it goes without saying that public health is undergoing a rebrand of sorts. Our mission and vision remain unchanged, but the ways we've approached our work have.
As we continue to strengthen partnerships, rebuild trust, and center our work in and around communities, it's important that we also emphasize how public health happens around us every day. Through water and food safety, disease prevention, emergency preparedness, and reproductive health, among other things
And also to emphasize that public health is for everyone. Local public health has approached this rebrand with care through collaboration, adaptability and accessibility, resilience, and an immense amount of energy and enthusiasm. The challenges we face daily are complex
and best addressed in the company of others. As many of our agencies operate with limited staff and funding, partnerships allow us to share resources more effectively, respond faster, and ensure people receive information in an accurate way that supports them and helps them connect to services.
The levels at which we've been able to collaborate may vary from one organization to the next, as do the ways in which our organizations, teams, and roles are organized and operate.
But as time has gone on, there's been a noticeable shift away from working in silos towards building bridges. Silos can be strong and efficient, but they also limit communication, collaboration, and trust.
When we worked in isolation, information sharing can be fragmented, increasing the likelihood of misunderstandings. Bridges connect people, teams, ideas, and organizations in ways that otherwise might divide them.
Pathways to information sharing are more pronounced and different perspectives can be shared more freely, leading to more creative, effective, and long-term solutions.
These collaborations have allowed us to adapt communications in real time based on feedback from staff, partners, and community members, and a shift to new strategies as needed.
By meeting people where they are, we can continue to ensure the resources we share are accessible, relatable, and meet the needs of the communities we serve.
With an openness to adapt as we go, communicators have been able to respond to misinformation and rumors quickly
and tailor messages to different cultures, age groups, and communities. Adaptable communication has gone beyond merely updating materials and messaging to knowing when it may be best to take a step back and ensure resources are accessible and available for trusted sources to reference
Deliver and adapt as they go.
How we develop and maintain partnerships will likely continue to differ from one organization to the next, but one shared lesson that we've learned is even small creative changes can lead to better outcomes, stronger relationships with community and thought leaders, and new opportunities.
It goes without saying that public health at all levels is resilient. Despite the challenges we face both during and after the pandemic response, we've continued working to prevent disease, promote health, and support vulnerable populations within our communities. We've adapted to new challenges, responded to a variety of events
Including natural disasters, disease outbreaks, and environmental threats, and prepared for major events such as Super Bowl 60 in Santa Clara, and the NFL Draft in Pittsburgh earlier this year
As well as for the FIFA World Cup in America 250 celebrations this summer.
As we look ahead to the many special events public health will support and respond to in and beyond 2026, it's important that we continue to demonstrate how much we care
By continuing to break down silos and build bridges, channeling creativity into our work and communications, staying curious and committed, as well as connected to one another, make meaningful partnerships and empower communities along the way.
There's still so much work to be done, and today's conference is just one of the many opportunities for us to come together to learn, share best practices, foster collaboration, and build deeper connections with our peers and fellow communicators. Thanks again for joining today's conference, and I look forward to learning alongside you this afternoon
Now, I'd like to transition us to our keynote speaker, Dr. Craig Spencer. Dr. Spencer is an emergency medicine physician and associate professor of the Practice of Health Services Policy and Practice at Brown University School of Public Health.
For nearly two decades, he has worked at the intersection of global health, humanitarian response, and community-centered public health.
His field work has span Africa, Southeast Asia, the Caribbean, and Central America, and his projects have included community-based pregnancy monitoring and maternal health programs in Burundi and Ethiopia
Child separation surveillance in Congo and South Sudan, hepatitis E outbreak investigation in Chad, and coordinating MSF's National Epidemiological Response during the Ebola outbreak in Guinea
He has also provided emergency medical care aboard MSS Mediterranean search and rescue vessel.
At Brown, he focuses on the historical determinants of public health and humanitarian response
His writing has appeared in the New England Journal of Medicine, the New York Times, The Atlantic, and other leading outlets
He was elected a life member of the Council on Foreign Relations in 2024 and serves on the Board of Advisors for Doctors Without Borders USA.
Please welcome Dr. Greg Spencer.
Thank you for that introduction, Brandon, and thank you to everyone for having me here today. I want to talk to you about the opportunity I see in entropy. And I want to start by
Sharing a little bit about
my own experience
Let me just see if I can control the slide here.
And
There we go. So a bull has been back in the headlines these past few weeks. I'm not sure if you've heard. And I'll be honest, it's been a little bit hard for me to watch.
12 years ago, I was in Guinea taking care of Ebola patients. Here you see a picture of me with Dr. Modet in front, an infectious disease doctor from Guinea, and Dr. Keita next to me as we're getting ready to go in and take care of patients.
These are two of the best physicians I've ever worked with. And
I remember spending every day with them in a really tough environment, taking care of patients, nearly half of which, unfortunately, did not survive
And just a few weeks later, I myself was in a hospital in New York City being treated for the same disease.
Now, I will be honest, and I've been asked a lot over the past couple weeks, what was it like? Let me tell you, those 19 days were tough
But honestly, the thing I remember fearing the most was this press conference I had to do after I'd already survived Ebola.
I was asked to speak publicly to talk about my illness, about the care that I received, and all I could feel was just like deep fear, knowing I'd be speaking to millions of people, the headlines, the panic, how the country had reacted to one sick doctor in New York City
And how it took away from the real focus on where the problem was in West Africa.
As you can see by this photo, this is a picture of someone who does not want to be talking publicly. This is maybe my shining moment. After this, I skirted out, went home, and I vowed I would never speak to the media ever again.
And I didn't.
Until COVID
I spent the pandemic on the front line working as an emergency physician in New York City
I watched the Apocalypse unfold in March of 2020, and I watch public health communication prove its incredible power in the initial days of the pandemic.
But like you all, I soon saw its limits.
In the aftermath of COVID and the seemingly endless challenges it has presented for public health, we find ourselves in a moment of incredible upheaval, asking the hard question, how do we get people to trust us
Again.
Our field is full of many conferences on exactly this, some of which I've spoken at, many of which you've hosted and undoubtedly many of you have actually spoken at as well.
And what I keep hearing from a lot of these really important conferences amongst us and our colleagues is that the answer is we need to communicate better
And I'm here at PHCC, Communication Matters. This group knows it better than anyone
This conference is full of the best communicators in the country
But I've recognized over the last year and a half that even an army of you, if you have a Caitlin Jedelina or a Megan Ranney in every single department or at every public health school
This won't be enough if we've misdiagnosed the real problem and prescribed the wrong treatment
The call to rebuild public health assumes we've assessed the foundations of what truly went wrong
It assumes we understand the backlash of the last few years and that going forward, we can just communicate our way to a better future.
I'm not convinced that that's right
And Maha, the movement we've all been tempted to dismiss, explains why.
I know the mention of Maha can cause a lot of anger and consternation, particularly amongst this crowd
I've seen how the reflex amongst my colleagues in public health and medicine is to explain Maha's poll as one of ignorance. People are gullible.
Anti-science. People are hooked on conspiracy
And that is the comfortable story. But I'm here to tell you it's wrong. And the comfort is part of the problem.
What I've heard from talking to people over the past year in Maha and outside of it
is that people are drawn to the movement because it does something. It fights loudly, in plain language, and it names who's to blame
Maha does very well, but public health used to do at its origins and at its core.
That used to be us. Public health was born as a fighting force. Clean water, safe workplaces, decent housing
But somewhere along the line, we traded the podium for the p-value
And we rebranded ourselves as the invisible Shield
But as we've learned over the last few years, no one trusts the shield that they can't see
To protect them
Over the past year, I've seen how we've created a narrative that gives us purpose when it feels like purpose has been pulled away from us.
It's easy to dismiss Maha and our field's greatest attractors as maybe just anti-vaxxers.
Now that's partially true
But that reductive framing lots us off the hook.
It makes our job easy. It focuses most of our efforts on communicating truthfully about vaccines, with the conviction that if we just do this better, eventually people will come around.
Now, I will be honest about what is real. Everyone here knows this. There is a loud, litigious anti-vaccine wing. And the damage that has been done over the past year is real. Rolled back recommendations, slashed research, exemptions rising, measles cases at their highest level in decades.
And we all have anger at that, and that anger is earned.
Last year, I went with the team from Why Should I Trust You to the Children's Health Defense Conference in Austin, Texas.
It was tough to walk into those rooms and it was tough to hear the conversations that were being had.
But it was amazing to see the amount of purpose that they've created amongst the community
And it made me realize that one public health probably doesn't recognize fully what it's up against, but also that there are incredible tools that we can leverage to regain trust in our own field
At the Children's Health Defense Conference, there was the father of Daisy, the 8-year-old girl who died of measles in Texas last year. And he was up on the stage
And I remember just being fully taken aback
when he said he wanted to thank RFK Jr, and he wanted to thank
Children's health defense
And I couldn't believe this, I'm watching this dad talk about his daughter as pictures of her
are displayed around the room. This girl who died and could have been saved by a measles vaccine.
And he said he wanted to thank those people because despite what happened to his daughter, Children's Health Defense and others came to his community to ask him what they needed
They didn't ask about vaccines. Everyone else, the public health authorities, the Atlantic, the Washington Post, who they called out by name, came to that community and asked about one thing and one thing only
and demonize them for one thing and one thing only, whether or not their kids had received a vaccine.
I will be clear that there is an anti-vaccine part of this movement, but we also need to understand that that wing is one corner of a much larger tent.
For most of the MAHA movement, vaccines actually aren't the point, and for many, they aren't important at all
The polling bears that out. A movement that's barely a year old draws support from roughly 4 in 10 Americans, and even amongst supporters, only a sliver name vaccines as their main concern.
What animates the majority is the same thing that animates the majority of us
The quality of food, the cost of care, environmental exposures, and this deep-seated conviction that the institutions meant to protect us have been captured by the industries that we're supposed to regulate.
The bigger part of Maha and those that feel frustration with public health outside of it, is the frustration with a system that seemingly works for no one. And that is where we need to focus more
The things that people are actually frightened about get the least airtime. What healthcare costs, whether they can get the treatment they need when they need it. Why a zip code can mean a 15-year difference in life expectancy in many places across the U.S.
Now, this is not to paper over the differences and the destruction, and it certainly isn't a call for a kumbaya. It's a call for accuracy. I want to name the right problem and the right solutions.
So what are those solutions, and what do I propose for us going forward?
One thing I think we need to reframe our fight. Our fight shouldn't just be against Mahai. It must be a fight for what Americans want and what they have been telling us clearly. And that involves three different steps.
The first one is engaging
This is a still from a conversation that, why should I trust you, hosted over a year ago between folks in public health and people in the MAHA movement
We were all incredibly nervous getting on this call, whether we should even have it, whether it would be weaponized against us, what the hell were we doing? Was this even safe? Were we legitimizing a group
That didn't need to be legitimized
But what I've learned over the past year is that engaging is not a concession. It doesn't mean that we agree on all things, or even on many things, but it's absolutely essential
Right now
It also creates the conditions to do more
Some of you may have been at a conference a few months ago at ASPPH in Washington, D.C, where on stage, myself, Dr. Megan Ranney, and two supporters of the MAHA movement talked about public health
And one of those supporters who had helped RFK Jr.'s campaign in Colorado got on stage, shared his opinions, and wrote this piece for Sat News about how as a MAHA activist, he went into the public health lion's den and it changed how he thought.
Similarly, just a few weeks ago, as I was doing messaging on hantavirus, one of the supporters of Maha Ohio, now a friend, shared my post with her MAHA community
This is the way we open up conversation, and engaging is absolutely critical.
I think the other thing that we need to do is that we need to recognize legitimate criticism that has been lobbed at public health over the past year. I think we're wonderful, but I don't think we're perfect.
One of the things that I think we keep giving on, that we shouldn't is criticism around the role of pharmaceutical companies and the concern around pharma capture
I think pharmaceuticals have been life-changing. I work in a hospital, I see the impact it has. If you follow the information about the treatments for pancreatitis or pancreatic cancer that have just been revealed over the past few days, like, absolutely amazing.
But I remember in med school 20 years ago.
the no free lunch movement compelled us all to take no money from pharma, to take no lunches from pharma, to cut off our engagement
But over the past year, I've looked at the criticism about pharma's role in health and in medicine
And as we look deeper, it's pretty clear that a lot of pharmaceutical companies are supporting a lot of our biggest medical societies.
More than half of our medical societies offer closed-door access to donors, including pharmaceutical companies. And so when RFK, Junior and others in the MAHA movement criticize organizations like AAP who have been incredibly critical for pushing back on this administration's
assault on vaccines
Their criticisms
fully empty
If you look at the AAP's website, many of the vaccine manufacturers, as RFK Jr. posts over and over again, are supporters of AAP. Now
You can say that this isn't a conflict
But in a low-trust environment, the environment that we're in, the appearance of conflict is enough. And we've handed MAHA and RFKG an argument we didn't have to
And I think the last thing is we need to recognize
about the importance of fighting
Over the past year, I've become close with a wonderful woman from Cincinnati, Ohio named Nancy. We've been on a bunch of calls together
She has a few kids with neurodevelopmental disorders, including one with autism. She doesn't know whether it's environmental, doesn't know whether it's vaccines, but she told me, Craig, what I like about Maha is that Maha fights
I don't know that they're going to uncover something different, but I like knowing that I have someone in my corner asking questions when I feel like for the past few decades, I've been told the same old story over and over again
I also want to share that when we fight, we can do so together
About a month ago, I hosted along with Brendaqari from the Why Should I Trust You team, with the team from StatesForm
a meeting in Columbus, Ohio
Ami Zota, who is a public health researcher at Columbia, joined us, and she wrote about her invite and about showing up at this conference.
She was nervous going in because we had deliberately invited public health experts, we had invited politicians, grassroots supporters from East Palestine, Ohio, and we had also supported people from the MAHA movement
Over the span of a day and a half, we got into a room, we had conversations, and we came up with policy solutions. We didn't agree on everything
But we were able to respectfully disagree and find alignment for policy solutions that we can push forward on environmental health. It's created a new community, new collaborations, and I think has created a new sense of purpose and a way forward for us.
As I end, I want to say that there's a comfortable story right now that maybe we can just wait out the next three years and we can restore what was
But I want to remind us that what was is what got us here
the trust deficit, the entanglements, the gap between our research and people's lives, our own invisibility. None of this started a year ago, and none of it ends in three
I understand that the last year has felt incredibly destructive.
But we must recognize that there is opportunity and entropy. So I say to all of you today, our task is not restoration, it is to show people visibly, vocally, why public health matters in a way that only you all know how.
This is exactly what Maha understood. Imperfectly and yes, sometimes dishonelessly
That public health is not.
People do not trust institutions because those institutions have good data. They trust them because they feel like those institutions are in their corner.
Thank you.
Fantastic. Thank you so, so much, Dr. Spencer, for that incredible keynote and all of those slide visuals and all of the stories. There's been so much appreciation and gratitude for everything you've shared. So want to make sure you see that in the chat
Thank you.
So thank you again for coming and serving as our speaker or our keynote speaker for this year.
Yeah.
I have some questions queued up, that I would love to get your take on. So, as I've shared with you, kind of getting ready for this keynote, Craig, over the past year or so, spent a lot of time on the road and in communities speaking with and listening to public health professionals.
I know that you've also been engaging in a variety of ways with communities as well, and I'm wondering like if you have a few observations you can share with us. Like, what are you seeing among public health professionals and public health communicators that is catching your attention as particularly creative
Noteworthy or effective when it comes to championing public health right now.
Thank you, and thanks again for having me, and thanks for
Yeah.
what I'm seeing in, what I'm seeing in the chat, and I hope that this
opens up the same curiosity that honestly, it took me over the past year and a half to kind of reluctantly to wade into. What I'm seeing that is incredibly encouraging for me is the people that recognize that the foundations
Upon which we are rebuilding trust may not necessarily be as strong as we think that they are, or the people who are saying
There was comfort in what was in 2019, before the pandemic. There was comfort in what was before this last election, and that if only we can go back to that
But I have been saying to them and I'm saying here as well, speaking with people in these communities.
Maha is an umbrella for frustrations that so many of us have felt for so long. I've worked in emergency medicine for 18 years. I've heard for nearly two decades the frustrations people have about this healthcare system
And I see so many of those coming together at a time right now when
It feels like there's an assault coming from every direction
It also feels like the way that we need to engage is, like, listen on social media and find better ways to communicate. What I have found, and I think this is hard for folks that might be under 40, is that the best way to communicate is to communicate, is to get together with people
People that you disagree with. I have been in so many rooms with people
I have very little overlap with, particularly in public health. It hasn't dramatically changed the way that I feel about a lot of things, but it has opened up my own understanding and my own knowledge. One, about what I think and why I think with such certainty, but also my ability to engage with others. And I am
profoundly impressed with how so much of that narrative has changed over the past year, where we went from being rightly harmed and angry with the destruction we've seen of our field, to understanding that there is opportunity in this moment, that entropy is uncomfortable, but it represents an opportunity for us to think about and do something different
for a way forward
Thank you. So it's biggest thing you recommend here is just get together with people, people that you might disagree with, see differently than you and engage in conversation, even when it's hard, like it's going to, like, really drive significant change for public health communications. It might feel
uncomfortable at first, but, like, it's a start, and it's getting somewhere.
It is. Look.
I have found, and it's really hard to come off social media where people are yelling and there are bubbles, and if you're not aligned with the mainstream message, whatever it is on your side, it feels like your anathema. Every room that I've gotten into, even at Children's Health Defense, I did not agree
I did not agree with the diagnosis, I didn't agree with the treatment, I did not agree with the plan. But I was able to speak with folks and distinctly understand what it was that was pushing them.
to try to better understand where we need to communicate. And I have not had an interaction in a year and a half
Including in spaces with people that I feel think
polar opposite of me on a whole host of things. I have not had anything other than respectful, curious, inquisitive. Now, that is not going to be the case every time. I'm sure there are people here in public health departments all around the country that have had a challenge over the last 6 years, and again, probably over the last 6 months
But I do think this is an opportunity for us to think about how we can better engage, and once we get offline and we get in person, it creates so many opportunities for honest, respectful discussion and honest, respectful disagreement. And I think that's the only way. That type of engagement is how we move forward.
So zooming out a little bit, we've been speaking about the nature of communications within the US
That's right.
I know much of your career has also focused on public health, humanitarian response outside of our nation. You've done work in Africa, Southeast Asia, as a field epidemiologist on projects examining access to medical care and human rights
Yeah.
Many people in the US are monitoring the current Ebola outbreak in Congo with heightened concern. What would you say public health communicators who want to communicate about the realities of the outbreak share with people in their community?
Yeah.
This is something I thought a lot about over the past year, connecting my global health life and my domestic health life, because they've been separate components. I would go work abroad for six months in an outbreak, and then I would come back to the US and work for 6 months in an emergency room and didn't think about the overlap.
But what I've learned, particularly for things like this, is number one, a lot of
what we learned the hard way in global health is unfortunately coming true and unfurling here in our domestic health space. As one example.
Everyone knows it's not a treatment for Bundabugio, the strain of Ebola virus, but there is a treatment for Zaire Ebola virus, the one that I was infected with. These were created with US funding. They were trialed in the Congo before FDA approval, and they were created from the blood of a Congolese survivor
But despite that, only about a third of all Ebola patients in Africa have received one of these treatments since these medications received FDA approval because they primarily sit in the strategic national stockpile in the US and the US owns them.
What I've learned in the conversations about this inequity and access to these countermeasures is not that people aren't anti-science. They know that science is incredible. They just don't see science working for them
And I feel like over the last year, I've seen the exact same thing in the conversations I've had domestically. I talk to people who say, sure, you tell me that every dollar invested in the NIH gives us back $2.50 or $8 back, you know, in economic benefit. But what I see is I pay taxes to an institution that then creates a bunch of drugs that are then sold to pharmaceutical companies
that charged such high amounts that I can't afford them. They don't it's not that they don't trust science. They just don't see the science working for them. And I think the thing that we can do, whether it's Ebola in Congo
or access the medicines here in the U.S. is better articulate how that science is actually working, as well as find ways to make sure that science actually works for people.
Thank you. It provides the humanity element to it. It connects
That's wonderful. I have one more question for you, and then we've been collecting some questions from folks that are here attending this conference. So, one more question that I had for you, and then I'll move into maybe two questions from the group here.
Yeah.
But as we head towards the start of the World Cup, which I can't believe is in 9 days, there will be people… I know, it's awesome, but also, wow, it's here. There will be people from all over the world coming to major cities in the US
What recommendations do you have for public health communicators who live in communities that might see a dramatic influx of tourists in the coming weeks?
This is a great question. I've gotten a version of this 15 times for the last few days, primarily around, are we worried about Ebola coming into this country? Let me tell you, if you have Ebola, the last thing that you want to do is get on a plane. I can tell you that from personal experience. I'm not worried about Ebola coming to the U.S.
I am worried about measles, for example, and I'm worried about the decline in measles vaccination, and I am certain that there's going to be importation of probably dozens, if not more, measles cases throughout the country. So I think that's something for us to all be
attuned to and to prepare for. Look, this is
This is an important and timely reminder
And we've said this, it's so cliche, diseases don't respect borders, but they don't respect World Cups and they don't respect cruise ships either. This is the time that we need to be talking not about how we just end importation of cases. Travel bans are the oldest tool in public health. Quarantines have been around since Ragusa in the late 1300s
And there's not an incredible base of evidence that they do all that much to help, for all the reasons that many folks understand.
I want to see whether it's for the World Cup or whether it's for Ebola in Eastern Congo. Preparation is key. Sustained preparation, like for the centers we have around the US capable of preparing for and taking care of high consequence pathogens
but also a lot of the structures that we've torn apart over the past year, we're seeing the impact of losing them, the slow response on the ground, how flat-footed the international response has been. So I think it's a time for us to, one, kind of prepare and catch up, but also a time to remind everybody, both domestically and around the world, how important this preparation
is because when people need it, when we really need it, we only then realize how much we're missing.
important best to lay the groundwork or, you know, build off of like what has been established and there's so many emergency response folks here on the
Yeah.
session, we had Brandon, who… that is his focus within the Philadelphia Department of Health, and so certainly a lot of activation for those that are in the emergency crisis response space leading up to the World Cup.
Yeah
All right, moving into two audience questions. What we've been seeing in the chat
All of the people in the audience today, recognizing the impact and value of public health. You alluded to this during your keynote. But we also had a few folks in the audience ask questions about measuring and communicating that impact more broadly.
Yeah.
What are some ways we can champion the importance of public health work in the midst of decreased funding and increased scrutiny?
We got to be out there. We need to be visible. Public health was born of a fight
it was born of a fight, and over the last 100 years, we have moved to the footnotes
We need to fight more, and I think people are going to give us a lot more leverage and leeway when we don't get things perfectly right, when they feel like we're fighting for them. It means being more visible. We can't be the invisible shield.
People, you know, I don't know why there's this continued discussion about whether public health is political or not. Of course it's political. Pretending that it's not political, like, overlooks everything we've learned in the past year and a half. And so I think fighting is one thing, but also recognize
that we cannot allow
The need for more data to become an alibi for inaction. It is so often that we say we just need to understand this a little bit more before we can speak with full certainty
I think that is a cover-up for the fact that people just don't see us, and don't see the work that we're doing enough. And once people find out that we are the reason that there's not cyanobacteria on their cauliflower at their grocery store, or we are the reason that folks
can get outside and get on trails or whatever else public health does in your community, there needs to be a label. People need to know that's what we're doing, because it's not about just putting restaurant grades on the door of, you know, of the restaurants. Like, public health is everywhere, it is everything. We need to remind people everything that it does
Yeah.
Clear examples beyond just restaurant inspections. The air we breathe, the water we drink, it is all public health, safe sidewalks.
Yeah.
Thank you.
Amazing. I have one more question for you before we move through to the next phase of this virtual conference, but just wanted to say thank you so much again, Craig, for all of this insight and goodness and all of your amazing work that you're doing
But one member of our audience shared, if we continue training public health communicators in our past mindset and communication practices, it will be a challenge to establish a new communications approach.
Yeah.
So the question is here is like, how do we shift the way institutions and universities are training public health communicators to incorporate some of the fresh ideas you shared with us today?
I think that's a great question. Look, I think
Yeah.
I think academic public health is incredible. I love academia. I love teaching. I think academic public health often public health more broadly. I would love to hear more from our CHWs. Man, I want, like, community health workers on every billboard
And every road, like, those are the folks out there doing the work that I want to hear more from. The people not necessarily writing the papers, but on the ground, putting policies into place. So I would love if we as communicators can find ways to leverage their voices
their skill, their experience, and their perspective, that is, like, such a people connectivity, like, it just works so well. And so, let's do that.
Yeah.
Shout out to the community health workers. And there's a lot of shout outs here in the chat. I love that.
Dr. Spencer, thank you so much again for being with us this morning, afternoon, Pacific and East Coast people really appreciated your time and insights. Thank you again.
Thank you for having me. Thank you so much.
Yeah.
All right. Well, you've heard it here, everyone. We've had an amazing start to this conference with opening remarks from both the national, local level and hearing from Craig Spencer on some incredible remarks in his keynote.
I'm now excited to introduce our first session of the conference featuring an outstanding public health communicator. Please join me in welcoming Stephanie Friedhoff, co-founder and co-director of the Information Futures Lab
And a professor of the practice at the Brown University School of Public Health.
As she shares insights related to a newly created and recently released guide from the Information Futures Lab and PHCC.
This guide offers practical trauma-informed strategies to strengthen resilience at both the individual and organizational level. This guide draws from lessons learned in public health, journalism, and emergency response to help communicators sustain themselves and their teams
while continuing to serve the public.
This topic is vitally important for public health communicators today, and we're so grateful to have her here with us to share her practical insights
Following her presentation, Pierce Nelson, Chief Communications Officer at the CDC Foundation, will moderate a Q&A with Stephanie. Stephanie, welcome to Insights to Practice.
Thank you so much, Amanda, and thank you, everybody, for being here. I am so excited and what a great keynote we just heard from Craig. I think we have a good professor of the practice of Brown showing here this morning, and it is fantastic to
be connected.
I am here to speak about the resilience guide that we built together. Let me just ask one quick technical question. Can I share my own slides?
Or do these have to be shared by you guys?
You have control, Stephanie
then you have to stop sharing
Well, let's not get stuck here with technology.
It's been fabulous to see you all in the chat here and to see how many of you are here. You're here to
Listen to some hard-heard truths, as we just heard from Craig. And also to learn and to grow. And that is part of how we build resilience as a community.
If you keep advancing the slide with two more clicks, thank you. I added this slide here not to share about all the great things I've done in my career, but rather because our conversation today is about resilience and how we build it and keep it in public health
And our identities are actually really important to that. It was fabulous to see the different introductions and the context you all have already shared. And our identities really matter when it comes to understanding how we are communicating with each other
What the impression is that other people have of us when we engage in our work as communicators. And also how the work that we do is impacting us personally as we keep doing it.
And I apologize, I am working on the technology here
So
Let's face it, it's a challenging time to be a public health communicator. This is really the reason why we created this guide together with PHCC and our great partners
It's been happening since the pandemic for a lot of us in the United States. It's been happening globally for a lot longer. But we're not always welcome where we show up. And Craig has laid this out beautifully for also the Maha context in the US right now
You see an image here of people protesting lockdowns and you see an image of the CDC shooting, which was a watershed moment in the US.
What is happening is really that uncertainty is now the norm for all of us, and defunding leads to difficult and hard-to-communicate realities, and some of you have already put some of them in the chat. Disdain for public health has really been normalized in us society
And harassment is now an occupational hazard for health communicators. So this one is really important, and I come from the world of journalism in which it was really surprising to me 25 years ago when I first moved to this country as an immigrant
To hear that the trauma and the things that we witness and see in our work is actually part of what we do and that we need to understand them as such.
This means that we can all be tired and sometimes it's hard to keep a loss of purpose. And there's such a thing as moral injury. When what is happening in the world is really out of sync with what we think is morally right. And some of that is also part of this unique moment
So here's a question. How are you doing in all of this? We have a little poll we wanted to hear from you and bring you in on this conversation. So if we wanted to bring up the poll, if you wouldn't mind taking a minute, we would love to know from you, sort of in your work as a health communicator
What is it that you are experiencing? And if what is on the list here, you know, or what you want to say isn't on the list, please put it in the chat for us. And then we'd also like to understand a little bit better
If you feel like you're pretty resilient right now or you need help and you would like more help.
So we're going to give you all a minute
To fill out the poll
You should be able to see the poll and you can scroll down to get to the second question.
Can some participants confirm that you can see the poll here?
Yes, excellent. Thank you.
Wonderful.
So maybe let's look at the results here together
Okay, in my work as a health communicator, I have or I am experiencing more uncertainty. 66% higher workloads for half of you, fewer resources, more than half
Some online harassment, some offline harassment
Some of you feel that you're not trained for this moment and there's a lack of leadership support
And some of you are sharing in the chat about feeling overwhelmed
And finding cuts and lack of resources that are causing a challenge.
And then how prepared are we for this moment, really?
I love to see that a lot of you feel that you basically have some stamina in this moment. And some of you would like to have a lot more help.
And some of you feel that you really have what you need
So thank you for sharing with us.
What I'm going to talk about for a couple of minutes and then we'll get into a conversation about all of this is that this is a moment where it's also time for a bit of a reset for all of us. And knowing what to expect and how to respond are key building blocks of resilience as we continue to do this work. You'll know we don't have to do it alone and we don't have to go it alone
And this is already a community that is coming together to be with each other, to support each other, and to learn together. And I hope that lots of connections are being built here that you can take back into your into your work. But I'll also speak a little bit about how we can adapt learnings from others who have been here before so that we can get back into the driver's seat
As we move forward. So this guide that we created together has four building blocks. The first one is emotional literacy, knowing what to expect. I mentioned earlier that this was a key concept that I accounted for the first time 25 years ago as a journalist coming to the United States. When people were just building a movement for trauma journalism and how to prevent dropout from burnout as we do this work
this work, and what this is really about is being
informed about how trauma works and how resilience works. The second part is respecting our needs and how we integrate self-care in our routines. The third part is about being prepared to access to assess our threads and make a response plan
And the fourth part is about building community and how we can foster trauma-informed practices in our workplace.
So let's talk a little bit about this concept, emotional literacy, and what to expect. I'm sure you've all seen a stress curve and you understand a little bit about, you know, there's something as too little stress when we're just not quite sure how to get out of bed
There's good stress that keeps us motivated and adrenaline is flowing, and, you know, we're excited to do the work. But a lot of us really live in this orange part here, where, you know, the good stress turns at times into exhaustion, because there's so much of it
And it's sometimes hard to know how to keep the boundaries. And then, of course, it can go into negative stress and also toxic stress, which comes from exposure to trauma for a longer time. And I wanted to just briefly walk us through some very basic concepts, because they're really important to this question of resilience
And that is that psychological trauma in its base is really our individual and also our collective response to extremely negative experiences, either one specific event or a continued
succession of events.
In the aftermath of that, our sensory memory and needs are processed and integrated. And psychological trauma then is really a mix of universal and individually very specific responses. We don't all respond the same. And all of this is shaped, as I mentioned earlier, by our culture's lived experiences, social norms, and more.
So, we're all different in our trauma response.
But what is true is that it impacts our biochemistry in very similar ways.
Resilience, then, is an individual or a community's ability to recover from traumatic events and adapt to sustained challenges.
It's not about being unaffected by negative emotions. I think we can all say that we've, you know, we've felt the weight of what has happened over the past 18 months. This isn't about negating that this… that we have these emotions, but rather, it's the process that helps us balance negative emotions with positive ones and
Choose coping strategies that prevent long-term negative impacts. This is a concept that's really important and that really plays into the self-care also, that when we face a lot of adversity, the emotions that we feel are very normal, because the adversity is not. But at the same time
This really impacts our actual biochemistry. So creating positive events and experiences is really important.
So resilience then is about emotional flexibility and integration over time. It's about post-traumatic growth. And it is not forgetting or getting over it or returning to the person that we were before.
Which brings us to the second part of the guide, which is about self-care and daily routines. So what is self-care in a nutshell? It's not a chore, but a habit of mind. If your self-care is binge watching Netflix, that's okay.
It's these actions that help you balance and bring you moments of joy, and it's important to have them in every day, no matter what. If it's the walk outside, if it is the time with the dog or with family and friends
If it is listening to a song and, you know, listening to some music more intently, whatever it is for you. And there's a lot of scientific evidence that actually shows how these different tools, laughter, exercise, yoga, reduce our stress response
put us back into balance and restore positive biochemistry in our bodies.
We all know that sleep is important and hydration maintains cognitive function. We all forget to drink, and it is catastrophic. And I do wish I could read the chat right now, because I love how you're all commenting and sharing your own experiences.
This is just a list of things that help. You can also put in the chat some things that work for you to share with others. But peer support is incredibly important. Having people in your life that you can rely on
Feeling safe is important and making sure that you have an environment in which you feel safe, keeping routines, laughing, and of course, sometimes also medications can help.
The third part of the guide is really about being prepared.
Trauma and feeling not safe is really about a loss of control and being prepared brings control back.
So preparation is an important part of self-care, and you can ask these key questions, you know, why might I become a target? How are we in my institution or organization being perceived online? Who might target us? How may I be targeted because of my identity? So again, going back to this question of who we are and what that means for how others might perceive us
You also want to build a personal safety network. You want to let trusted people know what you do and where you think you might be at risk. Create a personal support chain and establish ground rules with your family.
So it's that kind of protection that gives us agency, and the guide is full of more tips about all of this.
The fourth part is about building community and fostering trauma-informed practices in the workplace. And that is mostly about workplace culture.
There are five pillars of this trauma-informed leadership, which is provide a safe environment for your coworkers, being trustworthy, offering a lot of collaboration and creating peer support environments, and empowering people
And modeling honesty and transparency and normalizing well-being as a goal. And we can talk a little bit more about that in the Q&A if we want to.
And with that, I will close my presentation and ask Piers Nelson to join us, who's the Chief Communications Officer at the CDC Foundation and will facilitate our Q&A.
Well, good afternoon, and thank you much… so much, Stephanie, for creating this wonderful resource, and for your willingness to take a few questions about it and for your presentation.
So Stephanie introduced me. So I'll just add that the CDC Foundation is one of the founding partners of the Public Health Communications Collaborative, and we are very appreciative of all that PHCC is doing to bolster public health communications
And communicators, including today's event
So it's a pleasure to be with you today, and for this discussion we'll have over the next 10 min or so
And as we get started, I have a quick reminder to our audience that I have a set of questions prepared for Stephanie, but we'll also do our best to bring in one or two questions from our audience, and you can use the Q&A function
On the conference platform to submit your questions, and one of our team members will see if we have time to address a few of those that you submit. So, Stephanie, in the guide and in your presentation, you talk about the four building blocks of resilience
The first of those is building emotional literacy and knowing what to expect. And what caught my attention in that section of the guide was this line, and that is emotional resilience is not about being unaffected by emotions
getting over it, forgetting or returning to the person we were before, emotional resilience is about our ability to integrate the adverse experiences into our lives and identity over time. So I was hoping you could explain a bit more about what you mean there
And share some tips on how we do that integration, which I think can be tricky for those of us working in high-stress, high-consequence areas.
Yeah, thank you so much for the question, Piers. And I just need to make a shout out to the amazing comments in the chat. I love the person who shared that you're knitting and I want to encourage all of you to be knitting or doodling or doing whatever it is, right? That's good for the body as you're listening and sitting here in this webinar. What does it mean when we say it's not about forgetting, it's about integration? In part, it's a response to some of these old myth about the stiff upper lip
And, you know, when you face adversity, you just need to be tough, and you toughen it out, and you toughen through it. And I can narrate this a little bit through my own history. I'm the child of children of World War II, and in our family, we had a lot of conversations, intellectual conversations about the war and not one emotional one
So we all carry these emotional histories, both of the past and of the current work that we are doing. And in that context, what integration really means is if you are in a job right now where communications are hard, I was speaking to the team in Michigan recently where
Some folks, or when they go out to events to communicate about vaccines, the conversation is never about vaccines. That word doesn't get mentioned. The conversation is about immunization and the immune system. So when you try to address vaccines, people have gotten
accosted, and people have experienced, you know, folks are walking around with guns, they have experienced for themselves a sense of, am I still safe here? Is this environment still safe in which I am doing my public health work? So, that is disorienting and potentially traumatizing
And those events, especially if they happen more over time, you can't just repress them. You can't just say, okay, shoot, that happened, I'm going to try not to think about it. Because as we mentioned earlier, they're now part of your body's history, right? The body keeps a score. And from that on, it's really about, yes, that happened, but I can integrate this. This is part of the work that we do, I am safe. Here are some other ways in which we can go out there, for example, by changing our narrative and by knowing how to engage with
people. Here's my self-care plan for how I take care of myself. And over time, really incorporating these experiences into sort of who we are and what we stand for and why we go out and continue
to do the work
Yeah
Thanks, Stephanie, and I think it can be also particularly difficult when specific aspects of a job such as engaging in social media
bring about and sustain some of the very stresses that you've talked about today, as well as in the guide. But for those who have not yet picked up the guide, or for those who will as a result of today's conference.
Are there a few things that you could highlight for the health communicators in our audience about self-care when it comes to work that involves social media and social media monitoring?
Yeah, appreciate the question, Piers. This can feel such a tough one because we all know social media is important for our work. And we also know much better today the potential harms of spending a lot of time on social media. So I think there's two different things for us to think about. One is just in general, spending too much time on social media isn't great and we want to create a work environment in which we can shift, where we have shifts, just as our interpreters have here, because it's
really hard to do this interpretation all the time. Same is true for social media. The other part is that depending on the kind of work that we do, potentially the comments and the things that are
towards us on social media are very negative and are hard to witness. So there's a long history here, both from trauma journalism, but also from content moderation on platforms where we know that this impacts us as people. There's only so much time you can spend reading negative
Commons before you don't start getting sad, feeling all kinds of emotions depending on what this is. So what we do need to do here then is have an understanding amongst the team. A, we understand this is the impact that this can have
So how can we plan for it? How do I understand my own warning signs when I need to take a break? That's really important. That's part of that emotional literacy piece. How can we create shifts for each other? So take, you know, do time limits, don't look at it all the time
Understand how you can build a bridge. So for some people, for example, it works not to do that when they're at home, to leave that in the workplace. There's something about physical spaces also that's important. That's a really hard one, because sometimes on social media, you have to be on it at all times, and you have to be on top of it
But it's important to understand how we can keep some boundaries between work and personal life, because that's important for our emotional system. And then we want to make sure we depersonalize all of this, like trolls seek reaction, not resolution, so we want to make sure we remind ourselves when we are feeling that we get enraged or sad or anxious or any of the other things.
That we try to depersonalize this again and let go. And then maybe most importantly, reaching out when you need help.
Yeah, thanks, Stephanie. And I'll add a reminder to our audience. If you have a question to put that in the chat and we will strive to get to one or two of those. But one question I do have, Stephanie, is in the guide, you know, it is designed really to
strength and resilience at the individual and at the organizational level. And given that, I'm wondering what you might suggest to public health communicators in our audiences who run their workplaces communications department
And want to champion the practices and approaches and the plans that you've discussed and outlined in the guide. What are some of the most practical ways they can help bring a resilience mindset into the culture where they work?
Yeah.
We approach this in two ways in the guide. One is for when you are a leader, but the other is also if you are a team member, you have a lot of options also to bring trauma-informed practices into the workplace. In general, when you are in a leadership role or you are leading a team, but also when you're on a team, a lot of this is about the tone we set. So making it okay to talk about these wellness needs
Not feeling like, especially, for example, if you're… if you're an older team member, to make sure the younger team members who are on the social media team understand that it is important and okay to set boundaries
Being transparent about your own needs as an example for what others can articulate. A lot of this, from my viewpoint, is about communication. So, building a team where we all know this can happen, we can all be emotionally impacted by the work that we do. What are the structures that we have in place for when that happens? Because nobody wants to drop a ball
And if the conflict is between I individually either drop the ball or I don't take care of myself, that's not a good spot to be in. We want to create a workplace culture in which we have a plan where I can say, oh, I can take these two shifts, I'm feeling good, I can do this, or where I can say, I can do only one of them right now. Is there a way we can adapt? And I see a lot of people step up for each other
When we create this type of structure, where people feel more empowered to share where they're at
Leadership is also about communicating with clarity what is expected, and communicating with clarity, what you can provide in workforce support. So what do I do? You know, where's my hotline that I can call? But also, can we set up a peer group for our team or across teams
of people who can support each other. Those are some things that come to mind. I also do want to respond to, Jennifer, I'm so sorry to hear, and I know you and I have been talking about some of these things, so we have a comment here from Jennifer Coco from Michigan about some responses to
Yeah, exactly
And the health department's Pride Month post. So this is the kind of stuff that we're talking about as part of this resilience session, because it happens.
You are in the role of having to deal with this, so we can talk about the strategies for how to deal with this, but this session is really about the resilience part of how do we make sure we have what it takes to do so.
And you, I know you were doing an amazing job out there, Jennifer, and so are so many of you.
Yeah, Stephanie, thank you for that. One more question. In the guide, there's a reference made that lessons on resilience in public health, that these are drawn from what's been experienced by those in journalism and emergency response, including your work in journalism. And are there specific practices or
Cultural shifts from this fields that you think are most relevant or instructive for the public health communicators and the challenges that they're facing today.
Yeah.
There were a couple of watershed moments for the journalism world for sure, when trauma and resilience training entered. When this was introduced both at universities and as part of the training and in newsrooms themselves. So, it's a good question. We hosted a session recently
of State Public health departments, and I was positively surprised how many of them have both training, but also yoga and other types of sessions set up. I think that's really important, and that's what we need to see. But if your department doesn't have that, or if it maybe has a self-care part, but it doesn't have a digital and physical safety type of training, or what? What is our response plan for harassment? I think those policies need to be in place in any organization that deals with
public health
Also creating peer support networks. I've mentioned this a few times now, is really important.
And then the other sea change that I've seen that made a difference connects really to what Craig was talking about, which is telling stories about this reality. We never, as journalists wanted to talk about our own trauma. We're here to witness and report and support other people. That is what connects us as health communicators. I'm now a health communicator. I started out as a journalist
But that's really what connects us in this work. We're here for the people, but we also need to tell people how this work impacts us. And that there's a price. There's all the negativity and the violence that happens on social media and in some other places. There's a price that people pay for it
And those stories also need to be told.
Well, Stephanie, we are at time and I just want to again, thank you for your presentation and your willingness to answer a few of the questions today. It's been a pleasure speaking with you on this topic of resilience
Before we go, though, I always like to offer the last word to the speaker, and is there anything else that you'd like to share as we head toward our first break?
Yeah, thank you. Again, it's great to be here with all of you. I wanted to share one quick last slide about self-care. And this is something that I do in all my training, so feel free to reach out at any time. I'm here to support all of you
But make a doodle, and make your own self-care rubric. One thing that happens when we're overwhelmed is we don't even remember what's good for us. So if you do this and you put it on your fridge, and, you know, or wherever, you know, your little post-it board, you have it ready for when you need it, and that's… I wanted to send you off all
With one of these great tools that we have in the toolkit. And you could do this over this break or later today, but put it on your fridge. Great to meet you all.
Yeah, that's great. And thanks again so much, Stephanie. To our audience, we're now at our first break in today's conference. It will be a 10 minute break followed by our first panel discussion, and we'll see you back here soon. Thank you.
So, hello. As we come back from this first break, we're now about 90 minutes into this conference, and I just want to thank everyone for joining us and welcome all of you who are coming into the conference for our first panel conversation
Of the day.
I'm Monica Valdez-Lupe, I'm the Managing Director for the Health Program team at the Kresge Foundation.
And I'll be moderating our next panel discussion. Joining me momentarily to discuss our session topic titled Soaring Demand, Declining Resources, Overcoming Funding Challenges to Meet Community Public Health Need
Our three leading thinkers and doers in the areas of public health funding, systems change, and capacity building.
Natalie Burke, founder and CEO of Common Health Action
Rachel Baird, Program Officer with the Episcopal Health Foundation, and Tori Cope, senior strategist
with initiatives at the Missouri Health Foundation will be joining us
A side note, Tori and Rachel are also serving as co-chairs of the Public Health Funder Network for the American Public Health Association. So we're really excited that we have our panelists and everyone is here
So I'd like to start our discussion
With a premise, I think that we can all agree on and build the first question from it.
Funding public health can have benefits like the potential for improved quality of life, reduced suffering, and in some instances, economic benefits when we think about keeping students healthy and in school
And workers healthy and on the job
However, you know, I'm wondering what advice you might have for how public health professionals can better communicate the economic case for public health so it can become increasingly hardwired and integrated into routine budget and decision-making processes.
So let's start with Natalie, wondering what thoughts you might have about this question.
Thanks, Monica. So one challenge for public health leaders is that we often talk about programs and infrastructure
If we framed public health as society's operating system, the question would no longer be whether we can afford to invest in public health
The question also wouldn't be whether we can afford for public health to fail. The question would be, can we afford for society to fail
Every major outcomes that leaders care about in terms of workforce readiness, economic growth, healthcare costs, educational attainment, community resilience, all of it runs through the health of the population. And the health of the population
As we all know, runs through the operating system, which is public health.
So public health is not a social service operating at the margins. It's the operating systems that makes everything else possible. We have strong evidence that public health interventions, when you think about it, actually
yield a return on investment of $14 for every $1 that we put in
So the more that we frame public health in terms of ROI and the nation's operating system, the easier it becomes for us to embed it into budget and into policy decisions. We have to make it a priority for other people, which means that we need to reframe the narrative and reposition it as the nation's operating system
Thanks, Natalie. I really appreciate how you've woven into your response framing the ROI for public health and ensuring that when we're talking about public health, elevating its critical role in serving as that operating system or the engine for all that's wrapped around it
So we know we have a lot of public health communicators joining us this afternoon, and so I wonder, as these communicators are helping their teams advocate for scarce resources, where demand for services are obviously soaring in our local communities across the country
What should public health communicators be aware of or focused on when engaging with potential funders, including
Community foundations, national foundations, public sector funders, or even private individual donors in their respective communities. And Rachel, I wonder if you could help us with this question.
I'll do my best. And thank you, Monica. It's a great question. I imagine everyone that's joining has probably heard a similar or even identical statistic to this, but I think it's just worth repeating that in fiscal year 2024, federal funding was close to $7 trillion, whereas charitable giving was a little under 600 billion
And so, obviously, private and public funders cannot come close to matching government funding. But there are still a lot of resources out there. Corporate giving, I know, has increased over the years, and many foundations are giving more in response to current events
Or shifting to more unrestricted funding.
And so I just kind of start with that and then some other advice if it's helpful is that program officers and staff at foundations may seem mysterious. I know when I was
A grant seeker myself, I was always worried about cold calls and, you know, will they want to talk to me and that kind of thing, but program officers and the staff of foundations are just people and
I say, don't be shy, ask for conversations, ask for connections, and push for meetings with them
And at the same time, just know that relationships do take time, and I'd recommend doing research ahead of meeting with potential funders so that you don't spend your limited time talking to funders that may not be a good fit. And of course.
We also don't want to ask funders questions that where their answers might be easily accessible on the website. You just want to make the best use of your time and the funder's time.
I'd also recommend asking funders to introduce you to their contacts at other foundations, or at least sharing ideas of other funders. I know at least for us and a lot of other foundations I know we kind of know all the main players in the geography or in the topic area. And so ask for those connections
I'd also recommend looking into groups of funders that have information sessions or open forums
As Monica mentioned during the introduction, Tori Cope and I are co-chairs for the Public Health Funder Network within the American Public Health Association. And each year at the conference, we host a social event and a business meeting that are open to funders, nonprofit professionals, public health professionals, and really anyone
So I'd recommend taking advantage of those whenever possible, and there are a lot of other affinity groups
focused on a specific geography or something like rural health. And so looking into those and what opportunities there may be for learning as well. Of course, some vendor groups will be, you know, more closed because there are spaces where just funders need to come together, like there are spaces where
Nonprofits just need to come together without funders, but it's still a great way to make connections. And then the last thing I will share for this answer is that there are a lot of great resources like Candid and Grantstation that can help you find potential funders. So you can typically search for
A funder based on geography or focus area, and download 990s to see past giving contact information, and if the foundation is accepting unsolicited applications.
Thanks, Rachel. And I'm just going to repeat those because I appreciate how you gave very practical guidance. The first word is program officers. We're human beings too, and we're people. Second, if you're looking for potential funding, definitely do your homework and dig a little bit deeper beyond what you might see
On our websites or our home links. The third, and I definitely do this a lot, I think we all do this a lot, is the importance of facilitating and making those connections, so it might not be aligned with our funding at our foundation, but maybe we can connect you with others, and then
Finding those group of funders who might have aligned interests, so really practical advice. The next question is about the environment, and we know that the environment has become increasingly challenging, particularly for our public health colleagues and the field over the last
year and a half. So I wonder what you would say is the single most important thing that public health communicators should know or do as they support their teams in maintaining or increasing access to the resources that they need
to be effective in doing their work. And so actually this we'll go back to Natalie. Do you want to take this question, Natalie?
I will, and I might regret it because I don't think that I can do this as one thing. So I'm going to try to make it seem like one thing, though. So I would say one lesson from the current environment is that public health can't always afford to stand alone
We need to connect our work to the priorities that communities, policymakers, and power brokers, frankly, have already decided are non-negotiable. We've got to connect to those things that I think of in my own mind as immovable objects. So, for instance, if workforce development is an economic priority
Then chronic disease, maternal health, disease prevention, behavioral health, and substance use prevention should be framed as workforce strategies. Public health isn't changing its mission, it's revealing that it's the operating system that makes everything else
possible. So one of the things that folks who know me will know is that I often get frustrated with the public health narrative that we are the helpers or the supporters. Can we stop saying that we help and we support? It sounds really soft, so soft, in fact, that we can be easily dismissed
So instead, I would really hope that we would lean into the fact that we make it all possible. And in that idea of connecting it to things that are immovable objects, I would encourage folks to look at Michigan's social determinants of health hubs as a model
for how you weave pieces together effectively. And another reason for that is, if I'm being quite honest, part of why it has been
Too easy for forces at work to dismantle public health funding is because we didn't integrate ourselves fully into other spaces. And so this idea of weaving or connecting ourselves to other things that are immovable objects
Also becomes a defense mechanism. It becomes much harder to pluck public health out when we demonstrate that we are that operating system, and that we are wholly integrated into the work of the nation. So I would just encourage people to begin to think about what does it look like
To work more collaboratively. And honestly, I mean, I've been in this for a long time now, and so for 25, 30 years, I've been hearing this message about collaboration. I'm going to be honest with you.
We lean into a form of collaboration that is about transaction, and that is not about relationship. And there is a difference. When you are in relationship, it again becomes much harder to pull it apart
And to break it down in the way that forces at work have tried to do currently. So lean into that operating system. It's nice to help, and it's nice to support, but help and support often don't get funded.
Thank you, Natalie. And nice segue, I think, into the next session. If we pull that thread around the importance of relationship, I'm wondering what are some of the most creative ideas or approaches that
We see when we're working with public health organizations in terms of maximizing the resources they have or advocating for the resources they need in this moment. And so I wonder, Tori, if you might have some thoughts in the work that you do with partners
Yeah, I think one of the most effective approaches and you know the community health assessments or community health improvement plans aren't new tools, but how we speak to them might be we could change that a bit differently. As Natalie was saying, we can use
how we are doing our work in a different way to show that we are strategic planners, we're strategic thinkers, and we work with community voices and have those partnerships and can lead strategic thinking and prioritize what the community needs are
The chas and the chips processes demonstrate that public health organizations are listening to their residents, can identify shared priorities, and can align the resources around community defined needs.
And that's really what funders are looking for. Are you a part of those conversations? Are you helping lead those conversations? And are you involving community voice and allowing community voices to lead your work to make it more sustainable to actually make it effective?
Another creative and necessary strategy is to increase the coordination among public health associations and partner organizations to
Deliver joint messaging. One example that's happened in Missouri is that our public health associations formed joint legislative advocacy strategies and work together with one voice with talking points to go meet with our legislators
unite on a shared messaging.
Thanks, Tori. And I think what I'm hearing you say in your response in terms of being creative is ensuring that you're demonstrating how you're co-designing and centering communities in the work that you're trying to promote.
No, there's… the next question, I think, is going to resonate with a lot on the audience, and certainly all of you on the panel
It's about what we know, what we're seeing in terms of evidence that suggests that, you know, funders are rethinking in this environment, their grant making and investments, which can obviously have impact on organizations that they're funding
And the level of support that they're providing. So what would you advise public health partners and professionals and the organizations they lead to be thinking and doing right now in the midst of some of these shifts in funding strategies among our funding
Among our funders. And so I wonder, Rachel, if you'd be willing to take this question.
Yeah, absolutely. And just to add a little context too, I believe that Chronicle of Philanthropy and mission partners recently repeat
Released a report and surveyed different foundation leaders, finding that one in five made significant changes to their grant making strategy in the past year, and also that half of the leaders surveyed reconsidered which grantees are best to advance their mission. And so that just sort of
to how much is changing right now, which we I'm sure all all know and see on our own, too.
I know a lot of funders are really grappling with how to meet the current demand
and or fund innovative ideas that lead to more systems change. I think we all know that both need to happen, and they are connected and influence each other.
But it's
Always a question of like, what do we prioritize?
I'd recommend kind of similar to what Tori was talking about before you approach funders, develop a theory on your own and determine where you fit into the larger ecosystem. Like, what is your organization
Why do they exist? How are you making linkages? What do you do best and how are you partnering with others who do different but complementary things?
And also in those conversations as funders how they're adapting to meet current needs.
I know this is very cliche, but when I interviewed for my first foundation role, I was told, if you know one foundation, you know one foundation. And so, although there are lots of trends, and it's clear that funders are making changes to try and meet this moment, and what they believe is the best way
Each funder is probably approaching it in a different way. For some examples, I can share that Episcal Health Foundation or EHF, where I currently work, recently adopted a new strategic framework. And while we were working on that, we focused our grant making on supporting current partners. And in 202
We gave unrestricted support whenever possible to partners facing federal
cuts and changes to programs. And then this year we opened our letter of inquiry process for the first time, and two years after this kind of strategic refresh, and of course we're seeing a very high demand that we're unable to meet. But at the same time it's serving as a great way for us to learn about current needs and the communities we support
learn about organizations we hadn't worked with before.
Ehf is still very much a project funder, but we're looking into when general operating makes sense as a tool for grant making, because we know that flexibility is always important, especially now.
Some other foundations I know have gone from having open application processes to becoming by invitation only.
So they can double down support for their current partners and also invite in organizations they've heard about. Some others are shifting to preventative efforts after years of funding treatment and responses to problems. I think this is another area that's
both-and, ideally. And then I guess the last thing I would share is that I'd recommend telling your funders or potential funders you talk to how you're being impacted by foundations shifting priorities and practices.
I think if they hear it enough, they'll elevate it, and hopefully the board and leadership team will be mindful of
What partners are saying, and do things like offer step-down grants if priorities are shifting, or just be more thoughtful in their giving decisions and strategies.
Thanks, Rachel. I definitely think if you do have current funding, that advice about making sure that you keep the lines of communication open and sharing what you need and asking for some flexibility is really good advice
A lot of us in the funder space have current grantees who may be doing work in the moment and we're doing responsive grantmaking. And I also know that there are funders that are thinking about the future
So when we think about public health through a lens of a three horizon framework and something that provides opportunities to invest in more future facing activities amongst our community partners, what are some of the critical ways that public health communicators, other public health professionals
And funders in this space can better coordinate to bring about a reimagined public health system as we move forward. And I can keep it open and see who wants to start. And I know we have some questions.
In the chat that we can get to as well.
I think a big piece is making sure that you're including community and defining what that dream state looks like. And throughout that process, you can find some co-collaborators to build a joint dream together.
And that could lead to more trust, more buy-in, and potential advocacy partners. And whenever you lead with a clear vision with those partners, that
shows funders that you guys are in line. There is a strategic and potentially sustainable work that is happening here. One example that we've seen is narratives for health. They've been working with public health practitioners to embed some of that narrative strategy into their policy planning and advocacy campaigns
And that's been pretty successful across the country. But I think ultimately a reimagined public health system will require shared ownership. And so opening that up and like with what Natalie said, it's not just a one person game here. We all kind of have to be in
together and where there's shared ownership and where there's practitioners, communicators, funders, and communities all working together toward a common vision, we can build systems that are more collaborative and responsive.
The other thing that I would throw out there is, and it's a bit of a shift and it was funny when Rachel, I think earlier you made the comment about if you've seen one foundation, you've seen one foundation. One of the early things that I can recall hearing
is about, the only time that people know what public health is is when it's not working
And I believe that we need to flip that on its head. And that we need to proactively demonstrate to lay people how public health is working every single day. We are honestly suffering from a crisis of humility in public health
And because of that, we tend to hang back. We're not very full-throated in how we state about the necessity, the fact that we're the operating system, the value and the benefit. And we don't do that with a degree of consistency. So the idea of us having a shared national narrative
That can operate at 50,000 feet and can operate on the ground with a degree of clarity that comes from public health leadership and that we all can then support and tailor to what we need locally. That's exactly what I think we need
More broadly, I don't think that we can do this in a way that is too individualized because we need collective power and a collective focus in order to bring that narrative forward.
I want to echo both of my fellow panelists. They had amazing answers and just to kind of add on a few specific ideas that could help
Organizations become that collective that Natalie was speaking to. There are quite a few different
organizations that offer like pro bono support or access to volunteers, especially for capacity building or technology assistance. Every once in a while, a foundation will pay like a lump sum to partner with one of those organizations, and then nonprofits can
Receive services for free. Other times it'll be like a sliding fee scale for nonprofit partners.
The ones that I know of, I'm sure there are more, are, Catch a Fire, Resilia, and Benevity
And I would just again, when you talk to funders.
about other resources, whether or not they are going to fund you because they might know of something that can kind of help
You get to where you want to be to be able to collaborate and do more.
Thanks, Rachel. And I know with that, with that last tip at Kresge, we have shared funding that's going to an organization that other funders are using called Nonprofit Secure. So that's for current grantee partners
In this time when, especially the smaller CBOs need technical assistance and support in terms of cybersecurity or physical security of their space or their staff, that that has been really instrumental
In terms of having a resource to partners. I think before we go to the audience questions, you mentioned some advice about other resources beyond funding. And so
I wonder, you've each actually provided a lot of ideas, but are there any other tips that you might offer or suggestions for our colleagues
participants today
You know, one of the things that we've heard from some of our public health partners was that there is a need for training and workforce development outside of just public health theory, but really getting into the realities of the day-to-day work and looking at what
Compliant medical release training looks like? What are the HIPAA basics and different necessities around legislative authority within different spaces and
At least in Missouri, Missouri Public Health Institute is offering different trainings to address those services and they've been able to
do it at a level that's affordable for some of our local public health departments. And I know that some of the other public health institutes have similar options available, and I think there are going to be more foundations that are open to supporting some of that larger training
approaches, recognizing that we have to support the infrastructure of public health in order for the true impact of their work to be effective sustainably.
The other thing that I would throw out there, I think a lot of times when we're looking for resources, we look outside of our own organizations and what we actually already have.
And so I would encourage people
to consider your own network and the, in a sense, do your own network analysis. I am often alarmed at how… I don't know if it's my natural algorithm or if it's the algorithm of LinkedIn. I'm not exactly sure
But I find my network skewing in directions over time that are not necessarily beneficial to my public health work. And so it's incumbent upon me to do a regular analysis of what is my network, how am I maintaining my network? Where do I need to grow my network? Where are there spots where it's sparse and I need to make a real effort to go out
And to create new and different relationships, not transactions, relationships. And so I saw that somebody asked about this thing with collaboration that is transactional versus relational. I can get together with you for a short period of time to achieve and accomplish a goal, but it doesn't mean that I'm in relationship with you.
It doesn't mean that I have a degree of knowledge, awareness, shared values, etc, that are necessary to maintain a relationship that is actually collaborative. And so I would just encourage people, think about what is the network that you have
Versus what is the network that you need? A lot of times, we're not doing that analysis to say, what is the network that I need? One of the worst things that can happen, and I've been in this situation, is when you want to send a proposal out the door in short order, and you realize
You have to connect to that person who does environmental health, who you haven't spoken to in 14 years. It's a horrible feeling to say, hey, haven't talked to you. Hope you and yours are well. Can you go in on this proposal with me? And so we have to do better work of tending to the relationships
building out the network and then leveraging it in order to access what we need.
Thank you, yeah. Oh, yeah, go ahead, Rachel.
Yeah, I was going to
add the, yeah, ideally building relationships before you need something is great, but obviously easier, easier said than done. And then, yeah, I think just
getting creative and encouraging funders and others to get creative. I can share for Episcopal Health Foundation in our grant applications, we ask if a grantee is interested in non-funding capacity building support, and if they mark yes, we have an engagement
team member reach out and learn about their needs and offer relevant supports and trainings. It could be, like, team building for a new organization that's still learning how to work together, or workshops to bring community voices into the work.
and program design, or it could be a connection to resilia, who we partner with for capacity building support. So I think, yeah, just looking inward like Natalie said, like, what resources do you have
already, and how can you leverage those is great.
And your visibility is a resource. Visibility leads to credibility, which leads to sustainability. If no one sees you, you don't get what you need. And so I would just encourage you to go into the spaces that actually feel uncomfortable. Be the only public health person in the room
You would be surprised at what can emerge from that. We've gotten work that way over the years with entities and organizations who had not thought about public health at all just because I pushed myself out of my comfort zone and went into an unnatural space for me
So I just encourage you, be visible. It'll help you to be credible, and it'll help to sustain your work.
Yeah, I think we're coming up on time, but let me see if I can squeeze this one question because I think it's important and it goes to the topic or the theme around authentic relationships and building those so that they're durable. The question is, how do we build an organic relationship while honoring our funders' extremely busy schedules
and limited time. Does someone want to take that before we wrap up as the last question.
From our audience.
I can give it a shot. I think
You are as busy, if not busier, than funders. So just
reach out, don't be shy about
persistently asking for meetings
Also look for connections if you're not hearing back from someone.
Look on Linkedin, see if you have a mutual contact, you know, just kind of have to get creative and be persistent. You can always invite funders to community events you have, or like tours, things like that. Some won't be able to to make that happen. But even the invitation helps
build a relationship. So I say just, you know
Do what you can to get an initial meeting, and then find how you align, and I think it'll just happen if both partners
have the same public health goals in mind.
Thanks, Rachel, for taking that. And I definitely think I appreciate that question from the audience, but our frontline partners are certainly much busier in terms of being on the front lines and appreciated that someone asked that question and we thank you.
Natalie, Rachel, Tori, thanks for such a dynamic discussion on a critical topic that's impacting so many of our public health colleagues and peers. I knew that it would go quickly and appreciate the guidance and practical advice that you've given
I want to thank everyone for joining us today and sharing your insights and perspectives with everyone. We're going to take a short break now, and we'll be back in 10 minutes with our next session.
titled Speaking Truth, Building Connections When Talking About Structural Racism and health. So we'll see you then
Everyone, welcome back from the break. It's great to see you all. I'm Alan Brooks-Lashore with the Robert Wood Johnson Foundation. And it's a privilege to be with a group of fellow communicators who are trying to work toward a future where health is no longer a privilege, but a right together. So thank you for the opportunity and for PHCC for setting the stage for us to come together
I wanted to spend a little bit of time today talking about a research guide that we released toward the end of last year that really how do you have a conversation about structural racism in health
It started with a question that we had several years ago at the foundation when we knew that we wanted to shift our focus toward health equity. The most enduring barrier to health equity is structural racism in health. We posed a question, how do you actually have a conversation with people about structural racism
and health in a way that expands the coalition of people who want to take action and do something about it.
During the course of this quick conversation today, I want to share just some highlights from the second round of research that we did on this. We first posed that question in 2022, and then we posed it again last year
During a season where conversations about diversity, equity, and inclusion had really shifted in the country, just to see, is there still an opportunity to be able to have meaningful conversations with people about structural racism and health
The guide, which I'm just providing sort of an infomercial for, talks a bit about messages that resonate with people and that move them, practical tips on what to do, and guidance on some of the common concerns and resistance that you'll encounter in trying to have these types of conversations.
So just a couple of headlines of what we learned in 2022 and in 2025.
Messages that resonated with people that race, class, and zip code should not dictate health. Voters were concerned about rising prices. We do have shared values, and there is a shared vision that people have about how our children and grandchildren and communities can thrive, and we wanted to tease that out a bit more in the research
So one, it's important to know, when we did our research in 2022, and again in 2025, we segmented our respondents into three distinct categories. People who already see the connection to structural racism in health
Those who reject the connection and those who are open to the conversation. And Amy, thank you for your question. The way that we define structural racism are enduring and systemic challenges that have to do with the public health system, that have to do with how healthcare is administered, how policy has been set, and the way it's delivered in an inequitable way
Enduring systems challenges that are beyond just personal responsibility that have cascading effects and health disparities that we see in people. So what we did was we segmented the audience into three categories. Again, those who see the connection
So these are folks when we say, do you know what structural racism is? Do you believe that structural racism has an impact on people's ability to enjoy health and well being? And they say yes, and it resonates very high. And we ask them questions like, what is the role of government
is racism still a present issue, or is it more an issue from the past? Also, when we pose questions of people about should government do more or should do less? That's how we were able to segment people into these three categories.
Some of the things, some of the questions that we pose to people, we wanted to see, again, what shifted between 2022 and 2025, and we listed just a bunch of statements that we repeated again last year to a mixed cohort of folks that included focus groups
We talked to independents in Arizona. We talked to Latino women, Latino men. We talk to folks in North Carolina. We talk to folks online, and we did a national survey again in 2025 just to really stress test some of these
What we see that even in the environment that we are in in 2025, a hostile narrative environment to issues related to health equity, there is still a strong belief that we can build a society where all people can move up economically and socially
We saw an additional 6 percentage points in people who believe that there are folks who face barriers to opportunity based on class and income
And this is the way we phrased it, when you layer racism on top of those factors, it makes it much harder to be healthy and to get ahead. And we saw a rise in people who believe that from 2022 to 2025.
Now, we also saw some numbers moving in another direction. So when we posed the question to folks about Black people and other minorities who can't get ahead in this country are mostly responsible for their own condition, we saw a slight uptick, 3 percentage points from what people said in 2025 to what they said in 2025 versus
What they said in 2022. And when we asked the question, is racism mostly in the past? We saw a slight increase, but that number is already pretty high of about 50% of respondents who generally believe that, who believe that racism is mostly in the past
This is really important, and it speaks to some of the things that we see in the chat already of, well, how do you have a conversation with people about something if they actually don't believe it's real, or if they don't believe it's happening? That's actually what we were trying to test.
A couple of things that I want to share very quickly about what we what we found, and I'll talk a little bit more about some of the enduring messages. We tested a bunch of things in focus groups. We did, we had a linguistic, a linguist, a psychologist and others that were really helping with
What messages are sticky? When we worked in focus groups, when we try to start with data, we found that we found that people largely would try to impeach the numbers and they would try to impeach the data. They would say, where did that come from and who is the source? When we started with a story
We saw, not always, but in many cases, people were trying to fix the person. But when we started with values, we found that that opened the door wide enough to be able to get to the stories and to the data and ultimately create sort of a positive condition for people who wanted to join together to take action
And I'll give just one example of this messaging ladder of how it played out. And this is a message that we test. We tested it in 10 seconds and 30 seconds.
Where we simply said, like, we can build a society where people can move up economically and socially, but that's not everyone's reality today. That is the values way of getting in the door. We have another message that we tested that started with, everyone has dreams for their children and grandchildren
But some face barriers today. Again, that is the entry point to get to having the conversation that ultimately will get more technical, that will include more data, will involve more stories, and ultimately will invite people in to be part of the solution
Just want to show a little bit about what we saw when we tested messages related to, you know, we all deserve a fair and just… everyone deserves a fair and just opportunity to health and well-being. And when we tested asking people about, we all have dreams for our children and grandchildren
And we saw that folks who were generally convinced the way that we tested that question is about 68% for fair and just, and total convincing for dreams was about 66%. Now, there were people who were not convinced at all or a little convinced
But, you know, it's important to see that we're dealing with a majority of people
where there's an opportunity to be able to have a meaningful conversation with them.
I want to show this slide just as a last slide, and then I actually want to save a lot of time just for Q&A.
The point of the research that we did in 2025 was not just to test things that we did in 2022. These messages about fair and just and about dreams and this values-based approach and this three-step ladder. It wasn't just about reproducing what we did before. It was actually stress testing it
So when we ran the focus groups, when we did the survey, we exposed people to opposing messages during the surveys and during the focus groups. And what we were trying to determine is
How does that shift them over time during the course of the conversation? So we asked a question at three points in the survey, and we asked it at several points in the focus groups. How important is it to you personally for our country to try to address the differences in health
by race. Now, there was a question about how do you talk about structural racism? What is the definition? Is health equity a loaded term? Is structural racism a loaded term? We tested this formulation of differences in health by race because we thought that was the simplest way of trying to convey the point
Without sliding into jargon in a way that wouldn't be meaningful for people. And we saw during the course of the conversation over time, even when exposed to opposing messages
People responded favorably, and in fact, we saw an increase in percentage points throughout the course of the conversation. As long as we kept it focused on values and really invited people into this future where they could see themselves and their family in it as well
I really blew through all of this and really appreciate being able to share this and just really want to look forward to the conversation with ECTA. I just want to say thank you. You know, we are dealing in a world right now where we are seeing the architecture of public health literally being dismantled in real time in broad daylight
And I just want to say thank you to everybody who is in the trenches that are trying to have these really difficult conversations, recognizing that if we can't have these difficult conversations, we actually can't get to this future that will serve all of us and all of our communities. So just thank you so much for all that you do day in and day out, and thank you for letting me be part of the
this conversation
And with that, I'm happy to welcome Ekta and answer any questions.
Sounds good. Thanks, Alan. And I just want to say thank you for that presentation about your updated guide from Robert Wood Johnson. I really loved how you framed it as not a solution in itself, but really a tool to help people with courageous leadership and principled communication and really help move them into this movement for change.
I'm looking forward to diving into some questions with you today, and I know we have a bunch of questions coming in from our audience members, so let's just jump right in.
Alan, in your presentation, you spoke about the 42% of voters who are considered open to conversation about the connection between structural racism and health
These are voters who really acknowledge existing inequalities, but they might have some lingering concerns about costs, government intervention, or even unintended consequences. But those perspectives can potentially shift with effective messaging
And it feels like moving even a small percentage of those people to see the connection group could feel like a huge win. So for our audience members, do you have any suggestions on how to best use the three-step messaging ladder that you talked about to help move those individuals into that see the connection group
Yes, and Ekta, thank you so much for that question. I first want to paint a picture about who the and I really blew through this. There are lots of cross tabs and background information on the website that they provided where you can dig really deep. We did dial testing on these messages based on race
What parts of the messages resonated with people at what point, what language did, and so there's a really rich background and backup to the things that I'm saying. One of the things I think it's important to think about, who is this open to the conversation group, and it's mixed. It includes every race, it includes every age group, it includes every political party. So I think sometimes we have sort of a shorthand of who we think is so-called with us and not with us
But what we see with the open to the conversation cohort is it's really mixed. So, for example, in focus groups with Black women, when we have conversations about the systemic nature of racism in the health system
They are 100% in the conversation and don't require a lot of convincing. And when we talk when they talk about systems change and needing to make systemic changes to the system, the message resonates very well and it doesn't require any convincing at all
And the focus groups with African American men, both cycles, there was this large agreement with
There are inherent racist elements in our public health and healthcare systems that have been enduring for a long time. They are barriers to people being able to realize their health and well-being, and then they always sharply turn
into a personal responsibility message. And then they say, well, people need to make better choices. I use that illustration to say that these audiences are nuanced. These cohorts, they're nuanced, and they hold sometimes competing views on
on issues of government, issues of racism. But what we found in the testing is that if you're able to engage with them over time, if you're able to start with values
Then list a problem statement, right? So if we start with everyone has dreams for their children and grandchildren to be able to live their best health and well-being, and that's just an example. And we say, but not all children start at the same place. Not all families or communities start at the same place. That's the problem statement
Then we get to what could be, and we say we can create a world where everyone's children and grandchildren have access to this. And then there is a unity statement and a call to action where we where we then invite people of what it is they can do to help make this real
That three-part ladder It's important to note that that's just not one conversation. So I think a lot of times when we think of issues of messaging, it's like, oh, like we got this guide, we're going to go through these three points or go through this ladder. It'll take one conversation.
What we saw in one of the focus groups with independents in Arizona was that in the very beginning of the conversation, these were folks who were open to the conversation
However, they were pretty resistant to the idea of structural racism in the beginning of the conversation
Where they landed though was when they actually talked about maternal mortality, particularly Black maternal mortality and Black maternal health issues, they essentially said, you know what? People actually have different experiences. And we can see that actually something needs to change. And one of the people in the conversation said
the insurance companies need to change, or, like, the hospitals need to change. But then they said, well, wait
That's actually like a broader issue. That's not about any one person. So they moved in the course of a one-hour conversation from a very individualistic frame where racism was an issue of the past to actually making the concession of, actually, you know what, now that I think about it, there are people who experience differences.
Yeah, thanks, Ellen. That's really great. And that touches on a few of my other questions, but I just want to lift up. I really appreciated your point about knowing your audience and understanding that audiences are very nuanced and that building trust takes time. And this is not something you're going to do in one sitting. So
Thank you for those great points. Towards the end of your updated guide, there's also a wonderful section that offers a really deeper Q&A. And since that's the essence of our conversation, I wanted to go deeper a little bit on one of the questions presented there that touched on what you talked about
But the importance of leading with values over data, facts, or even stories. And I thought that was really interesting because we so often hear humans are wired for storytelling, and stories can be a really effective way to connect with people
And so I just wanted to hear a little bit more about the importance, but also maybe the reasoning behind why we lead with values to make those connections.
So our actions, the things that we do are driven by our values, by our worldviews and things that are inherent to us. A lot of times when we work to communicate with people, we're dealing with a surface level, but we're not really getting at the things that motivate them, right? We're not really getting at the things.
You know, we did not originate values-based messaging and testing. We are building upon work that was done by a lot of people, including the race class narrative Initiative and Race Forward. But really looking at
Where is there the most common agreement, right? There's a lot of conversation now about, like, bridging and solidarity and interconnectedness.
People do generally believe that everyone's children and grandchildren should have access to health and well-being.
The thing that I say to folks is if you're trying to engage in a conversation with a person, you want to start with the widest invitation possible, and then sort of funnel into the things that, you know, once you're able to establish common ground, values are the common ground
And I think that we often bypass that because we want to get to the action, we want to get to the stats, or sometimes we want to start with judgment. And no one will join in solidarity with you if they feel judged by you. And no one will work toward a future that you're describing that they don't see themselves in
So it is really important that we start with a values-based approach where people can see themselves in the future that we're talking about.
I love that, Alan. I love you want to build common ground and values are the common ground. So thank you for that. There are a bunch of great questions coming in from our audience members, so I'm going to jump to one of those. The audience is particularly curious about the research that's shared in the guide
Can you elaborate a bit on the demographics of the people that we're surveyed?
Yes, so that there are two rounds of the research. The 2022 research included a national survey where we oversampled with African Americans, Asian Americans, Hispanic Latino community
Native Americans, and we did the same oversampling with our survey in 2025, and we intentionally did additional rounds of focus groups in 2025
Where we spoke with Black men, we spoke with Latino men, we spoke with Latino women. We spoke with a native cohort. We spoke with Asian Americans in different parts of the country and some of them online. There's far more detail that's listed in the actual research and in the guide in both guides, the current one and the previous one
And what we found in all of these were that the conversations were really nuanced, and they're much more complicated than the ways that sometimes we approach these conversations, even with people intuitively, you say, oh, they're with us or they're against us. And it's just a little more complex than that.
We found that there was an approach with everyone if given time. And if we start with a values-based approach. Now, it's not going to convince everybody. So you don't start with this three-point thing and say, okay, I'll say this and water will turn into wine
It's not that simple, but the idea is if we can just get at some of the people who say that they're open. That gets us to a majority of people in this country if we're able to have a meaningful conversation and move them from being open to the conversation
to seeing the connection between structural racism and health
That's great, Alan. And it feels like that jump is a big, like a very important one that we want folks to make. So that's really helpful. Several members of our audience are also talking about how difficult it is to bring up structural racism, especially when so many people refuse to acknowledge it. I know you mentioned that before
And the guide has a section about when to use the term structural racism and when not to use it. Would you be able to elaborate a little bit on that approach?
Yeah, so thank you for that question, Ekta, and for the audience members who posed that. So when we first shared the research back in 2022,
We got two types of reactions. One of people saying, well, this is a really awkward and difficult conversation, and I would feel uncomfortable having that conversation. And then two, we heard, well, why are we coddling it? Why don't we just call it what it is? It is structural racism. Why don't we just name it, and why don't we say it
First off, that term is hard for people to be able to internalize. Even folks, when you explain what it is, because it's defined differently with different people, which is why we tend not to use to start with that term. There's a video that you can find on our site where we actually describe it first
We say it's, you know, communities that have more toxic dumps than hospitals is people that don't have access to doctors who respect them. You know, when we say that some of these are based on class or income, but others are based on racism. And this is structural racism
So the formula for that is actually describing it before you label it, because you'll get people saying, oh, that makes sense. Oh, that's what structural racism is, as opposed to starting with the term, which in some cases causes people to freeze up
When you're trying to have a conversation with them.
Absolutely, yeah. I've definitely seen that in my own work, and I think that's a great suggestion to kind of paint that picture, even how you did earlier today. How would you approach this conversation among people who have been affected by racism but still have been very successful in life?
Noting that they may claim they have overcome structural racism with determination and hard work, and others can do it too.
Yeah, I mean, so first off, let me… I want to say that, you know, race is the most difficult conversation to have in the United States, and the Robert Wood Johnson Foundation did not come up with the solution of how to talk about race. Like, I want to be clear about that. Like, we didn't solve the race conversation in America
What we attempted to do based on past research and learnings from other people is just find an avenue, or find sort of an approach to be able to have meaningful conversation with people who could be with you, but maybe don't know that they are or think that they aren't at this time
I… I think that what we found is
that actually starting with values, and then talking about the barriers and then getting specific about how those barriers show up differently for different people. Like the concept of your zip code shouldn't dictate your health. That resonates really powerfully with people, and it is an opening to then say, Okay
Well, there is a difference between if you live a zip code here based on, you know, your race, you live here versus others in this zip code and look at the racial demographics there. How can you debate that? Now, there are folks who reject the connection, and we categorize them
They will not be convinced by this. And this isn't to say, well, don't go after them. It's to say just know who you're talking to. And if you're talking to folks that outright reject the connection, they are not going to be susceptible to any of these. They might greet a principal to some of the things that you say, but they are not folks that are inclined to actually
move toward the direction of seeing the connection
Yeah, that's totally fair. I'm sure all communicators here can understand knowing who you're talking to and really taking that approach. I'm going to jump us back to kind of talking a little bit about your research and some of the data you presented. You had said that
You shared some statistics around like two-thirds of voters who find the fair and just dreams messages to be pretty convincing, which is a really encouraging statistic. But there was also some other more daunting numbers that you shared, such as the persistent view that racism is really something in the past and not something folks worry about today.
How would you advise some of our public health communicators to really embrace this opportunity to share more unifying messages instead of focusing on divisive or discouraging data?
I think that
We
Well, and I appreciate that question. I think we spent a lot of conversation about what's wrong. And one of the things that we saw in the second round of research was that cynicism was really high. Cynicism spiked in 2025. I didn't talk about that, but that was one of the key findings
Where people were essentially like, you know, I don't think that anything can change. There's another thing we found in the most recent research. When we asked people, are you willing to take action about this? We saw a good number of folks who said, yes, I'm willing to do something about it. But when we said, think of your community
Do you think your community is willing to do something about it? We saw an immediate drop of about 20 points. So that means that there are folks who think, well, I want to do something about this, but no one else does. And if I do something about it, I don't think it even changes. What we need to be able to the stories that we need to tell are not just what's wrong with the system. We actually need to show people what is happening
When people actually take action to change the conditions where they live, folks need exemplars to make this real for them, as opposed to being reminded of what's wrong, which they know quite well
And then not, not providing any type of exemplars or examples of how they can model that in their own community. Folks are looking for who are the change makers happening in other places? How did they do it?
That's a great point. All right, I think we have time for maybe one or two more questions. So as public health communicators with us in the room today, they apply some tactics that you described, maybe look at the guide and use some of the tools that are available
What are some key tips that you'd love to leave them with and have them keep in mind as they develop public health messages?
Yeah, I think that the reason why, and I'm talking to a group of communicators who understand audiences better than I do
What we encountered when we had conversations with people, initially, we would think they were in one category, but the longer we had conversations with them, we would then… we would say, oh, actually, they're not reject the connection. They're actually open to the conversation.
Or we thought they were open to the conversation. They're actually outright reject, right? The more we have conversation with people. And I think the point of
One
The public health ecosystem does so much that people don't see. One, I think the value proposition of public health is critically important. You all are on the front lines in ways that in many cases, people don't see or aren't visible… isn't visible to them.
I think too
The mutual benefit of all of this, having a healthcare system that serves everybody is good for everybody. You know, having accountable public health and health care system for everybody serves everybody. And we have gotten so entrenched, and I could talk
about this at a different time on individualism. That is our national myth, right? The myth of individualism. It is so sticky that if someone starts with an individualistic frame, you can't move them to a systems frame where you think of we, where you think of us, where you think of systems, where you think of sort of collective solidarity and abundance
And I think that our ultimate goal is to really show these are examples of people who are making a difference in their community. And look, what looked like would have only benefited one person or one community actually benefited everybody because they had a better system that actually served people who weren't being served well at all
And I just want to, first off, we are willing to answer any questions that you have about the research. The research is not a silver bullet and is not sort of a solution to all of this. It is just an approach. It's a tool to be able to further the work that many of you will have been doing for a long time
to try to have these very difficult conversations.
Thanks so much, Alan. It looks like we're just about at time for our session. So I want to say first, thanks, Alan, for this important work that you and your team have advanced, and we're so grateful that you took to the time to kind of share that with us today. Thank you to our audience members who had incredible questions throughout this session
Thank you for having me.
And thank you for being here and for sharing your insights. We're now, of course, yeah, we're now heading into our third and final break for the day. So go have a stretch, grab some water. Be sure to be back in about 10 minutes for our final panel of the day, Exploring the role of AI in public health communications.
Welcome back and thank you for joining us in our fourth and final session today. And it's a topic I know that's on everyone's mind. It's one where the impact of the role of public health communications could be quite profound
That topic of a course is AI.
Hello, I'm Andrea Takash, Director of Strategic Communications and Policy Research at Trust for America's Health
And it's my pleasure to moderate today's conversation, exploring the Role of AI in Public Health Communications with three exceptional panelists. In just a moment, I will be joined by our panelists. But first, I wanted
moment to introduce them
First, we have Brinley Murphy Reiter, founder and CEO of Science to People.
Second, on our panel is Erica Guyton, Director of Impact and Innovation at Health Resources in Action. And last but not least, we have Krista Hysen, director emergency preparedness and interim regional public health coordinator
with Hamilton County Public Health
Thank you all for joining me. If it's all right.
I'm gonna go ahead and jump in with the first question that we have.
Let's level set a bit here as we start this conversation.
AI seems to be everywhere right now in our personal and professional lives. But when it comes to public health, I wonder if we could explore briefly where we really are in AI adoption and use.
What types of AI, generative or otherwise, are you seeing really come into the public health landscape?
Brinley, I'm going to ask you to kick us off with that question.
Yeah, thank you. Thank you so much for having me here, PHCC. It's been a wonderful conference today.
I think that there's really a wide range of offerings and experiences around AI that we're seeing kind of come into the public health, the science and the medical spaces right now. There's a lot of new kind of purpose-built tools for operations, data collection, sharing, infrastructure
communications around the workforce. There's tools for practitioners and clinicians. A lot of people are dabbling just dipping their toe in with major commercial models, your ChatGPTs, Claude's, all of that. They're testing those out
to various levels of effectiveness, I would say. I'm seeing a lot of slower adoption at the kind of institutional level. There's challenge in support. There's kind of this rapidly changing landscape of tools, difficulty figuring out with IT and
procurement, and then just general kind of lack of clarity around what's allowed even in a lot of people's workspaces. But that said, at the public level of public health, there's more and more data showing that the public kind of writ large
Are rampantly using these commercial chatbots to interact with their own health information, and that of their peers, their family, their friends, so I do think whenever we consider AI in public health, we have to consider the AI that the public is really using too
Yeah, that's super insightful. Thank you. Erica, from your lens, from where you sit at the Health Resources in Action, how do you see that question?
Thank you, and thanks for having me. This has been fantastic so far hearing from all of the panelists and all of the presenters. You know, when I think about this question, I'm really thinking about our last session that Alan and Ekta were saying we really need to know our audience, and that's such a core goal as communicators of being very clear of who our audience is. And so when I think about this question, I'm trying to resist answering it
If it's a single landscape in public health, because we know that in public health, there's enormous range when we're thinking about federally funded health departments with good data infrastructure, a lot of resources versus community-based organizations who may have more limited budgets and constraints
Those are going to be two very different stories. Likewise, as we're thinking about our academic medical institutions or community health worker groups, I think who we're talking about is what is going to depend on what AI looks like in adoption right now
But beyond that, I think beyond generative AI, there's been a long history of using these technologies in public health. And so when we're thinking about machine learning or predictive AI with syndromic surveillance
Outbreak to detection or risk scoring, there's a longer history here that's just bigger than our conversation about generative AI and chatbots that we need to take into account. And so the big question for us, a lot of us don't know that these technologies have been part of our work for quite a long time now. And so I think the big question for us and for the audience isn't like, are we using AI
But really knowing what AI is already being used by whom and to what end in our organizations
Yeah, that… no, that's super great. I think people forget about that, right? It's just like, oh, this is so new. And it's like, really, it isn't. You know, Krista, you know, looking, you're in my home state of Ohio, and you're at the local level. So, from your perspective, what are you seeing in Hamilton County
Yeah, so my position's a little unique, but first I just want to say thank you for having me and I am so glad this conference exists. Communicators are the best kind of people. I am partial, but we truly are the backbone of public health
But from the local level across Southwest Ohio, I really feel like epidemiology is where I'm seeing the biggest use. So for things like data analysis, making sure we're able to identify those areas where there are higher needs, whether it be SBI data
A chlamydia outbreak or something else. It's really important for locals, especially. I think of those smaller rural health departments where resources are not plentiful. So we want to make sure that they have the best data and the best data analysis
to serve their population the best way.
I also feel like crisis comms. You know, I know some health departments with multiple comm staff, and I know some health departments where comms is everyone's job and no one's job. So it's really, really hard to make sure you're staying on top of those content calendars and that social media posts. So
Where are those things that AI can plug into to help those smaller, especially again, rural health departments? And then I also think of like public health, our evergreen reminders. So things like, hey
What are we doing to prepare for heat emergencies? What are we doing to remind people of you know Ohio. Hey, what are ticks doing right now? Are we seeing an increase in tick bites? How are we preventing that? How are we communicating that? So making sure those evergreen public health messages
are flowing, are easily accessible, and can be translated into so many things. Like, I'm so happy to see ASL on this conference, and I want to make sure that our other AFN populations are not left behind.
And that's great super helpful. So switching gears a little bit, you know, sometimes I think we can learn a lot by looking beyond ourselves and our own disciplines of work. You know, we're all communicators, but looking beyond that to really better understand technologies and trends
Whether in the public or private sector, where are you seeing really smart uses of the different kinds of AI that could be instructive for how public health professionals and public health communicators consider using it?
For that, I'm going to turn Erica, if you can take the first stab at that question.
Sure, I think that
The smartest uses happen when we have specific problems and are using specific tools for those problems. When we think about medicine, we think about precision medicine, and I'd like to take that framing to AI. What is precision AI look like?
Doctor Suresh at Brown Center for Responsibility, Technological Responsibility has this great metaphor as thinking of a Swiss Army knife versus sledgehammer use cases, right? When we have our Swiss Army knife, we have very specific tools for very specific uses
But what's happened in the AI space is that we are having these sledgehammer tools that purports to do everything that we want, and that's possible. And I think there's space for those tools, those generalizable tools, but I think what we really need to move
towards in public health is thinking about how we're evaluating these tools, and we can't… it's much harder to evaluate these everything tools, right? And so we need to be precise in the problems that we're solving and the tools that we're using for that, so that we can move towards contextualized and really specific evaluations. Hopefully that are
community-driven. And so when I think about other sectors that are doing that well, I think about media and journalism, specifically there's a group in New Zealand called Te Haiku Media, and their ultimate goal is trying to preserve their indigenous language, which has seen a huge decline over the last generation due to urbanization and colonization
And so as they were thinking about how do we leverage these technologies, they went through a really intentional consent process, which I think is lacking in the AI space, with their elders saying, is this something that we want to move forward with? They then compensated their community members to annotate that data in three decades worth of archives of their oral language to annotate that data, make sure it's well structured so that the data that's going into this tool is clean and doing
what it's supposed to do. And then lastly, they had really strong data sovereignty protection. So thinking about how this data are owned on their own equipment, not training large language models that are open source and ultimately being the guardians of that data. But the owners of that data were still the folks who were contributing it. And so I think that's just one example, a really beautiful example of how we can think about AI
AI, machine learning, data sovereignty, all of these great principles and values that we should be holding close and learning from other sectors to do that.
Right.
I love that. Not only other sectors, other cultures, I mean, that's amazing to think of the history and the culture there. And Brinley, I know I was watching your expressions during this and you look so excited about Erica's answer. So I'm going to turn it next to you to answer that question.
Yes, I love when anybody argues for using a, you know, I say a can opener instead of a Swiss Army knife, but yeah, a scalpel, can opener, something precision and purpose-built, I think is really how we need to look at AI going. That's what
We're seeing in the tech industry, I think unlike almost anybody else maybe on the conference today, I actually don't have a background in public health, but I've always been really passionate about figuring out ways that we can leverage technology to impact
public well-being. And, you know, that's what we're doing at science to people. I saw an opportunity to leverage AI technology and purpose build it for science and health communications with the public and luckily, the Beaumont Foundation, you know, one of the groups that is the leading supporter of the public health communications collaborative
saw that, too. They saw that the AI tool that we were building could really be valuable for the public health workforce as a precision and purpose built communications and research support assistant. And so they enabled us to build that with their really generous funding
We've actually just finished an 8-week pilot with some PHCC members who got a first look at the tool that we built for PHCC members, which is called comms companion. Krista was actually a member of the pilot, so it's been a really incredible experience
I think we have a picture of the homepage. It's coming soon. Really excited to get to show all of you and give you all access to PHCC as this kind of purpose-built for public health research assistant and content creation partner, and I think that that
A way that you can leverage people like myself that came from tech who kind of see how trends are going and can try to grab them quickly and harness them and then build them into the workflow that we can do with public health.
That's great. I bet you
You gave a little bit of a tease there. I think there's going to be some… some… just a little bit of excitement with this now. I'm de-exaggerating. There's gonna be so much excitement when this platform comes out. I've been trying to, like, not talk about it publicly, so, like, when are we gonna let the cat out of the bag? So, I know everybody's super excited to launch this soon.
Yeah
Krista, you know, what is your perspective, again, kind of at that local level, what are you seeing?
Yeah, so I think we all know that public health has been so historically underfunded, underappreciated, undervalued, even though it's, you know, the air we breathe. But I really feel like, and yes, Brinley said, I was one of the co-pilot testers, but one of the interesting things I really liked is
As I was testing this tool
I was like, oh my gosh, if only I had this during COVID, because the regional alignment of communication, the ability to shape messages in your own voice. But I think for me, what I have personal issues against OpenAI and how, you know, I'll test something. And I remember I was building something for an mpox clinic
And they told me that monkeypox was a mythical disease. And I was like
I'm never using you again. So with public health communications collaborative and this tool, I was like, oh my gosh, everything in it is vetted. It is evidence based. It gives me the source, it cites the source, and it says, here's where it is from this article that I can pull from like New England Journal of Medicine or something like that.
So I'm able to pull talking points with relevant scientific, evidence-based background. So to me, as a local that does not have time, those types of validated communication sources are everything because a lot of times we share messages across the region and we know we're more powerful with one voice
But I can tailor that voice for the rural community, for my urbanites, for different populations. So it is super, super valuable and also easy to adjust the tone, adjust the audience. So that's what I really, really valued of this one.
Yeah, that's great. Thank you. So we are getting a lot of questions in the chat around AI and the environmental effects. So I'm going to ask kind of it's a big question. So if you guys need me to repeat this, I will, but I'm going to start
There's kind of two or three questions within this. And Brinley, I want you to be kind of listening the most intent, because I'm going to pass this one to you first, just from the technology aspect.
So first, how are people balancing the benefits of AI within public health communications with the environmental impact of sustaining AI?
And then building upon that, could you expand on being mindful of over-reliance or overuse of generative AI usage where it impacts communities of color in terms of where data centers are located
And happy to repeat that because those are big ones, but I think it's a very important dialogue there.
Yeah, I'm happy to jump in. And I think that there was like kind of three questions there. The first I heard was about the benefits versus the very real concerns around the impact on energy use, the environment, and otherwise
Yeah
Then the second was kind of personal over-reliance or institutional over-reliance, perhaps. And then the third being impact on the communities where primarily data centers or other major sites of infrastructure for AI might be hosted
That's correct.
Yeah, okay. So
Sorry, there's a lot here, but I think that it's really important that we cover these because it's something that we all need to be able to respond to and understand as we work through these challenges as people that care about the public's health
and the public's well-being, right? So it's really important that we understand what the trade-offs and limitations of generative AI are when it's in these tools. So AI systems don't really exist in a vacuum. We're beginning to understand this. They inherit the structures, the incentives
The inequalities of the systems that produce the data that they rely on, right, including in our case at Science to People, we rely on peer-reviewed academic texts, and there's a lot of historical bias in that as well
And so you kind of have this base training data that holds a lot of bias and inequities from its major sources. And then, of course, the systems have real environmental costs, right? So there's a lot of ways that as smaller organizations and using these kind of
Precision-built AI or purpose-built tools that Erica, you know, gave us the opportunity to discuss, you can make more deliberate decisions about how the products are built and operated to reduce unnecessary usage and impact
So there's if you type in a question about hantavirus, you don't need to go search the world's information on Reddit or read the entirety of Mein Kampf to get a response, right? You hope that the model that you're using doesn't, in fact, do any of those things
So when you use a precision-built tool, it searches a very small database which uses a significantly less amount of power, energy, water, and all of the various kind of systems mechanisms that take up
A lot of the impact and the environmental strain that we see from large language models. So there's a movement to go towards what's SM, small language models, SLMs, right?
And then I think, you know.
There's energy intensive phases of AI development, which is really in training the frontier models that a lot of these things are built on. So whenever you hear about a new model coming out, you know, Opus 4.17 or whatever, like those are all frontier models that are being
actively trained and launched. With comms companion and what we're doing at Science to People, we're not doing that. So instead of running retraining cycles on user data, we build around kind of these retrieval based workflows rather than open-ended generation. So all of these things that we're doing technically
reduce overall token usage and avoid really unnecessary compute cycles.
And then I think, you know, the other thing is that as small public health organizations and not AI labs, at least on our side, our ability to completely eliminate the environmental impact is really limited. We have to be honest about that. Our commitment is to be as transparent about the environmental impact, the societal impact.
Personal cognitive impacts and keep our products footprints in line with our mission of doing good as much as we can at scale. And so I think that's kind of the pluses and minuses of the environmental and the community sides of things, but
On the over-reliance and overuse
This is going to be a learning curve for the whole world, anybody that is using AI actively is going to go through this learning curve together of jumping in too quickly, getting potentially reliant in a lot of ways, and then pulling back
I don't know who else has gone through a social media break personally, but I know that the amount of times that I've, you know, opted into a personal social media break since having access to things like Instagram and Facebook as a teenager
has gone in waves, and I think that just like any new technology, we're gonna binge on it a little bit, and then we'll be able to self-regulate. But
I may not be as worried about the cognitive decline impact on an individual use because our products really maintain human in the loop. We insist that every day communicators and users are actively interacting with the AI
reading the output, checking the references and sources. We offer opportunities for educational and academic literacy, public health literacy in the science communication output
So we're trying to build in places for humans to touch the thing and to be really deeply involved in the final output. But these are big sticky questions and I don't know if anybody really has the full answer to it, but I'm super interested to hear what
Erica and Chris to think about this.
Yes.
Yeah, and I think to your point, the human connection that came up in the chat that you're not going to replace that. I couldn't hear Erica or Krista, it sounds like one of you were kind of jumping to get to that question. So I'll defer to you if one of you want to take the next
at it
Sure, I can jump in. I think I want to build on Brinley's points about the environmental piece, but also in the chat I saw things about bias and misinformation. I do want to speak about those as well as the environmental piece because they are real concerns that a lot of us are thinking about
And so when I think about bias, we know that algorithmic bias is present. It's well documented. It's our reality, and that's partially because as humans, we're biased and we are teaching these systems and, you know, garbage in, garbage out, as many of you have probably heard. And so I think we really need to start
expanding our views of the social determinants of health, and including algorithmic bias in that thinking in some type of way. If algorithms are getting to decide who gets a housing voucher, who gets screened, who's pain registers as urgent, to me, those are upstream factors, and we need to be thinking about that as we're thinking about these things as digital determinants of health
Put those into our health equity and social determinants of health frameworks. So that's one piece on bias. The next is related to misinformation, and I think this one is so critical as communicators, because it's what we're facing every single day. And so I think there's the piece about us not being the primary source where information is gained anymore, like data shows that folks aren't clicking on our website, but information is being distilled by AI. And so our primary messages may not be what people are
But it's really a distilled version of my message with also a Reddit comment. And we need to be really mindful about that. And I think the other issue is that generative AI is always going to sound confident. It's always going to sound authoritative, regardless of the accuracy of that message. And so part of this, I think, is building
Our AI literacy as practitioners, so that we understand why the tool is producing what it produces, being able to have that discernment and that critical eye to say, this is not what I was intending to message. This is misinformation, and having those verifications within our workflows to be able to
Make sure that that is accounted for.
The last piece I want to talk about is the biggest, the environmental piece. And this is something top of mind every time I engage with an organization, it's top of mind for a lot of folks, and like Brinley mentioned, it's a very sticky, messy, nuanced conversation and question
And I think something that's been really helpful for me is Dr. Mary Gray at Microsoft talks about it in this frame that I think has been helpful, and that's about learning from past experiences and past learnings in tech. And I think most of us for more than a decade now have been using Google search and not thinking about the environmental impacts of what that looks like
But early on, Google ran tremendously energy hungry data centers that had huge, tremendous environmental cost. And that's mainly because of the heating mechanisms to cool down their hardware. And it wasn't until engineers decided that they're going to make these systems more efficient
and really lower the environmental impact of what it takes to do something like a Google search. And I'm not saying that Google searches still aren't producing some level of CO2. Every time we're doing a Google search, that's still happening, but that environmental impact has been a lot less
Partially due because of environmental, because of public pressure, excuse me, and regulatory pressure that made that happen. And so I think we need to bring those lessons and those learnings into how we're thinking about current day AI, because
As Brinley mentioned, training a large language model is huge. It takes huge amounts and produces huge amounts of CO2 depending on that model. And that cost gets paid every single time a new model is trained. And that happens often. And I think the reason for that is because there's
Almost no external pressure to stop it. These big corporations, these big tech companies, they're not incentivized to think about their environmental impacts. It's quite the opposite. And so while I think that the individual responsibility that folks are talking about in the chat, I think there is definitely a place for that
Where we need to be critical and have that discernment and think about mitigating our impact. I think there's also an organizational case to be made here about the tools we're using when we're thinking about retrieval augmented, generated RAG techniques
Where we're using well-annotated small precision level tools is another case. But I think ultimately when we think about the environmental piece, it's a structural issue. And it's a structural problem that exists because there are no incentives otherwise
So I think we really need to be mindful of that as a field in public health of like what are the accountability mechanisms that we are putting on at the structural level so that we can hold firms accountable as we're adopting tools, whether it's through our procurement practices
through our privacy, our RFPs, or through our policy and advocacy strategy. One example of that is at Health Resources in Action, we're thinking about how to leverage public benefit agreements when we're thinking about data center
citing, working with communities to hold that space and play the defense of what are the non-negotiables for communities as data centers are being cited.
So I know that was a long-winded answer, but I'm really thinking about this from the individual organization, and more important, the structural issue that the environmental impact is, and the pressure that we can use as a field collectively to put that pressure and the public
demand, really, for these tools to be more environmentally friendly.
Great, thank you so much, Erica. And we really don't have, I had my two minute warning. So Krista, I don't know if you had anything to add to what Brinley or Erica said before we wrap up
I think that we can't save the sea turtles by all using paper straws. So I will leave it at that and that we need to hold larger organizations that have the funding accountable for making sure they have policies and systems and environmental change built in
So that we're not looking at this at a lens 15 years from now with
major environmental damage further than humans have already done on this earth.
What a great closing comment. I will just note we had a lot of other questions from the audience, so hopefully at some point we'll be able to follow up. We probably could have used a full hour for this session. So thank you all three of you. We'll need to leave it here. You know, Bridley, Krista, and Erica. What a great conversation on this topic. I learned a lot today
And I know we'll continue to hear much more in the coming weeks and months. It's been very informative and thought-provoking, sorry, and I thank you for that. At this point, I'm going to turn the conference back over to Amanda Kwang, Director of the Public Health Communications Collaborative for her closing remarks.
Awesome, thank you so much, Andrea, and thank you, panelists for an incredible session to wrap up a fantastic afternoon. Thank you again.
I want to just thank the 15 incredible leaders that we've heard from over the last many hours, folks from health departments, leading health foundations, schools of public health and tech
I want to thank Mission Partners, PHCC's Communications Agency of Record. They are doing all of the puppeteering and the logistics on the back end. There's a whole backstage behind this, and it's been so incredible seeing them move through this conference so effortlessly with so many moving parts
I want to thank our ASL interpreters, especially Kyle and Liz. Thank you so, so much for your time. And I want to thank all of you. Thank you for sticking with us.
The main takeaway that I took from this day is continuing to lean on each other. We heard from Brandon Horvath delivering those local level opening remarks on how local public health has approached this rebrand of public health with care
Recognizing the challenges they face in complexities and not facing them alone, but instead with the company of others.
From our keynote speaker, Dr. Spencer, Dr. Spencer mentioned our fight needs to be what Americans want and what they're telling us. When we fight, we can do so together.
From our resilience conversation, what I was hearing was we must remember that rest and joy are forms of resistance as well, to have a lasting impact within our communities, we must also sustain ourselves and take care of ourselves and each other
From our overcoming funding strategies to meet community public health needs panel, what I was hearing is that visibility creates credibility and credibility leads to sustainability. I'm working on that together as a collective.
And from our last session just now on building or sorry, the session prior on building connections when talking about structural racism health, Alan mentioned, find an avenue or an approach to have a meaningful conversation and find the people that are with you or could be with you
And from our last session on AI and public health communications, we heard the role of how we can hold organizations accountable at the structural level with communities.
Now, a full recording of our afternoon together will be up on our website later this week. You'll also be delivered a survey where you can provide your feedback, help us understand what can be strengthened, what did you like about this conference? We'd love to hear
Thank you again, and we will see you soon, whether during our next webinar, PHCC Academy course, or through our brand ambassador program if you are a future applicant. Thank you so much again, everyone, for being here today, and we will see you very soon
Have a good one. Bye.