What ‘Make America Healthy Again’ Gets Right About Communications

Many of the nominated advisers to the incoming Trump administration challenge the American public health status quo, our health outcomes, and what influences them. Some of these things need challenging, like the practices and influence of pharmaceutical and chemical companies, ultra-processed food manufacturers, and the oil industry. Other proposals warrant clearer explanations: Why would we want to get rid of a vaccine that helped tame measles outbreaks, or eliminate the water fluoridation that significantly reduced dental cavities?

As veteran health communications researchers and communicators, we believe we must pay attention to the Make America Healthy Again (MAHA) advocates: their messages, messengers, and media choices. Right now, much of what MAHA says resonates with many Americans.

Admittedly, it’s hard to pay attention when we don’t agree with a great many of their initial proposals. But significantly reducing the presence and consumption of ultra-processed foods from the American diet is a fine idea. So is a comprehensive strategy to prevent and combat chronic diseases, including addressing key commercial determinants of health, such as excessive use of food additives. We cannot tune this out.

But above all, we need to tune into how and why the MAHA campaign makes its arguments, learn what’s landing with the public, and then do a better job of leveraging scientific evidence to address people’s specific concerns honestly, openly, collegially, and head-on. We need to learn not to be so defensive in the face of criticism — no platform is free from it. When we respond to criticism by falling back on a rhetoric of demonization and tribalization, the situation will always devolve into a lose-lose proposition.

We can’t be stodgy or holier-than-thou when it comes to health communication. MAHA is a powerful reminder that data and numbers don’t communicate themselves. A recent survey found that nearly half of Americans do not know or are unsure if pasteurized milk is safer than raw milk to protect against food-borne illnesses. For many public health professionals, that’s an implausibility: there are decades of data from the U.S. and other countries that support pasteurization.

We need to see this as a reality check: if we are surprised, that can negatively influence how we respond to those who are uninformed. When was the last time any of us talked with conviction about the purpose of pasteurization, the scientific triumph it represented, and its continued relevance? And did so in the places where the appeal of raw milk is being extolled? Do we know enough about how people form these beliefs? Like all scientific inquiry, there is room for learning and for dialogue. There is no room for judgment or condescension.

We must admit to ourselves and the American public that we — the traditional public health sector — too often fail to communicate effectively about why the things we recommend confer real health benefits that people have reason to value. Everyone is entitled to make the health choices they think are most appropriate. But we must ensure they are equipped to make the choices that will actually make them healthier.

Many people do not accept, understand, or believe “traditional” health messages. Perhaps it is because these messages usually must go through a series of bureaucratic nitpicks before they can be shared on a platform, at a podium, or in a leaflet distributed at a health clinic. While that tedious process goes on, other voices will contribute and share dozens if not hundreds of pieces of related content. Those messages are louder and often easier to understand.

As a result, public health communicators — working for government agencies and in academic settings, often with scientific credentials — are hard pressed to communicate effectively, proactively, or with the same empathy as many MAHA leaders. In addition, the rise of social media, with its vast swath of information availability and expediency, has allowed virtually everyone to routinely seek and obtain readily understandable and often entertainingly presented solutions to their health problems. It is not difficult to see why the public often finds comfort and hope in unverified solutions, often delivered by influencers with uncertain evidence and undisclosed motivations.

We need to engage Americans more openly and more creatively. To start, we must listen and respond to public — not bureaucratic — concerns. We need to look at ourselves, and to honestly assess the quality of our efforts. We need to reconsider who frames health messages and communicates with the public, how they do it, and with what human and artificial intelligence support. Ultimately, the proof will be in whether the pudding we serve gets eaten — not in the step-by-step recipe nor the identity of the celebrity chef in the kitchen. We need to adapt our recipes to taste, as we go.

To improve our own understanding and to advocate for health messages and dialogue that resonate with real people, many of us joined forces a year ago to form a Council for Quality Health Communication. Quality is not just a part of our name; it is our passion. Quality is about more than being persuasive, it requires being consistent with the best-available evidence and concrete as well as compassionate about areas of uncertainty.

Although some are hesitant to admit it, MAHA knows persuasive messaging. Even if their messages do not always align with traditional public health values or data, MAHA advocates have delivered them powerfully and with conviction. Traditional public health leaders have some important lessons to learn about how to communicate, learning persuasive tactics from MAHA while rising to the standard of quality. The health of all Americans is the goal. To get there, we must all be vitally concerned with the quality of health communication: its content, its timeliness, and ultimately, its impact.

Heather Lanthorn, ScD, MPH, is senior advisor for the Clarity Foundation. Kenneth H. Rabin, PhD, MA, is a senior scholar at the City University of New York Graduate School of Public Health and Health Policy. Scott C. Ratzan, MD, MPA, MA, is the founding editor of the Journal of Health Communication and distinguished lecturer at CUNY Graduate School of Public Health and Health Policy. Lanthorn, Rabin, and Ratzan are all founding members of the Council for Quality Health Communication.

A special thanks to other members of the Council for Quality Health Communication who helped prepare this op-ed: Dana Chomenko, MA, Jennifer Dowd, PhD, Kathy Erb, MBA, and Rachael Piltch-Loeb, PhD, MSPH.

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