¹ For further discussion of these ideological dynamics in public health professions, see Pollack, Harold, “Why Public Health Experts Aren’t Reaching Conservatives on Covid,” POLITICO, August 12, 2021, https://www.politico.com/news/magazine/2021/08/12/conservative-public-health-covid-conservative-affirmative-action-503448 Google Scholar; Graboyes, Robert, “Conservatives and Public Health: A Warm Welcome into a Cold Climate,” Discourse, September 17, 2021, https://www.discoursemagazine.com/politics/2021/09/17/conservatives-and-public-health-a-warm-welcome-into-a-cold-climate/ Google Scholar.

² “About APHA,” American Public Health Association, https://www.apha.org/About-APHA.

³ “Vision, Mission, Values,” Public Health Foundation, https://www.phf.org/AboutUs/Pages/VisionMissionValues.aspx.

⁴ “SOPHE Premieres a New Brand Logo and Tagline,” Society for Public Health Education, October 7, 2021, https://www.sophe.org/news/sophe-premieres-a-new-brand-logo-and-tagline/.

⁵ Institute of Medicine (US) Committee on Assuring the Health of the Public in the 21st Century, The Future of the Public’s Health in the 21st Century (Washington, DC: National Academies Press, 2002), https://www.ncbi.nlm.nih.gov/books/NBK221233/.

⁶ See, e.g., how the prominent journal Public Health Ethics defines the field: “About the Journal,” Oxford Academic, https://academic.oup.com/phe/pages/About.

⁷ Another way of understanding what I mean by a “statist ideology” is what psychologists describe as authoritarianism. In the wake of the pandemic, Joseph Manson finds that both left- and right-wing authoritarians supported authoritarian pandemic policies, but support for public health authorities was only correlated with left-wing authoritarianism. Joseph H. Manson, “Right-Wing Authoritarianism, Left-Wing Authoritarianism, and Pandemic-Mitigation Authoritarianism,” Personality and Individual Differences 167 (2020), https://www.sciencedirect.com/science/article/pii/S0191886920304402Google Scholar.

⁸ As Faden, Ruth et al. write: “At its core, public health is concerned with promoting and protecting the health of populations.” Faden, Ruth, Bernstein, Justin, and Shebaya, Sirine, “Public Health Ethics,” Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta (July 8, 2020), https://plato.stanford.edu/archives/spr2022/entries/publichealth-ethics/ Google Scholar.

⁹ This tendency is consistent with research that finds that a strong sense of national identity (as well as political ideology) is correlated with support for public health interventions. Other research finds that libertarianism and anti-egalitarianism are two distinct elements of political ideology that were associated with dismissal of public health guidance during the COVID-19 pandemic. Choma, Becky L. et al., “Ideological and Psychological Predictors of COVID-19-Related Collective Action, Opinions, and Health Compliance Across Three Nations,” Journal of Social and Political Psychology 9, no. 1 (2021): 123–43CrossRefGoogle Scholar; Clarke, Edward J. R., Klas, Anna, and Dyos, Emily, “The Role of Ideological Attitudes in Responses to COVID-19 Threat and Government Restrictions in Australia,” Personality and Individual Differences 175 (2021): 110734, https://www.sciencedirect.com/science/article/pii/S0191886921001094 CrossRefGoogle ScholarPubMed; Peng, Yilang, “Give Me Liberty or Give Me COVID-19: How Social Dominance Orientation, Right-Wing Authoritarianism, and Libertarianism Explain Americans’ Reactions to COVID-19,” Risk Analysis 42, no. 12 (2022): 2691–2703 CrossRefGoogle ScholarPubMed; Van Bavel, Jay J. et al., “National Identity Predicts Public Health Support during a Global Pandemic,” Nature Communications 13, no. 1 (January 26, 2022), https://doi.org/10.1038/s41467-021-27668-9 Google ScholarPubMed.

¹⁰ This is not to say, though, that all public health agencies advance a broadly progressive agenda. There are some major exceptions to this trend when officials can appeal to public health ideology in order to justify the criminalization of drugs or sex work. For example, in the United States, the National Institute on Drug Abuse (NIDA) advocates carceral policies that are likely more favored by Republicans than Democrats. So, too, for policies that criminalize sex work, which receive bipartisan support. Additionally, conservative and libertarian think tanks employ public health scholars. But these exceptions prove the rule. Ideological outliers in public health exist, but they are not integrated into the mainstream profession.

¹¹ For survey research in support of this claim, see Ringstad, Robin, “Political Diversity Among Social Work Students,” Journal of Social Work Values and Ethics 11, no. 2 (2014): 13–23 Google Scholar; Woodruff, Alex, “Are Public Health Schools Politically Diverse?” Public Health Post, January 24, 2019, https://www.publichealthpost.org/viewpoints/are-public-health-schools-politically-diverse/ Google Scholar; DeVilbiss, Elizabeth A. et al., “Assessing Representation and Perceived Inclusion among Members in the Society for Epidemiologic Research,” American Journal of Epidemiology 189, no. 10 (2020): 998–1010 Google Scholar.

¹² For further discussion of the reasons for discounting nuance in sociological work, see Healy, Kieran, “Fuck Nuance,” Sociological Theory 35, no. 2 (2017): 118–27CrossRefGoogle Scholar.

¹³ As one scholar observes: “That the government has a role to play in improving the health of the public is in some ways baked into a public health mindset, and that is going to clash with those who don’t believe the government has a role to play in the health space.” Frostenson, Sarah, “Health Shouldn’t Be Contentious, But It’s Incredibly Polarizing,” Vox, February 6, 2017 (updated March 23, 2017), https://www.vox.com/policy-and-politics/2017/2/6/14229276/public-health-contentious-polarizing-opioids-aca-obesity Google Scholar.

¹⁴ Here, I contrast a concern for establishing egalitarian relations between citizens and a concern for establishing more egalitarian relations between public officials and citizens. As I argue elsewhere, purported egalitarians often overlook inequalities between officials and citizens. Flanigan, Jessica, “Social Equality and the Stateless Society,” Ethics, Politics & Society 5, no. 2 (2022): 1–26 CrossRefGoogle Scholar.

¹⁵ Vesoulis, Abby, “Democrats Need Rural Voters: Can They Win Them Over by Fixing Rural Healthcare?” Time, November 1, 2019, https://time.com/5715649/democrats-rural-healthcare-2020/ Google Scholar.

¹⁶ Cohn, Nate, “How Educational Differences Are Widening America’s Political Rift,” The New York Times, September 8, 2021, https://www.nytimes.com/2021/09/08/us/politics/how-college-graduates-vote.html Google Scholar.

¹⁷ For discussion of ideological selection and discrimination in public health, see Pollack, “Why Public Health Experts Aren’t Reaching Conservatives on Covid.”

¹⁸ Pollack and Caroline Kelly make a similar point: “The public health community sometimes displays poor cultural competence in crossing this divide, in part because of the community’s own limited viewpoint diversity.” Pollack, Harold A. and Kelly, Caroline, “COVID-19 and Health Disparities: Insights From Key Informant Interviews,” Health Affairs Forefront, October 27, 2020, https://www.healthaffairs.org/content/forefront/covid-19-and-health-disparities-insights-key-informant-interviews Google Scholar.

¹⁹ For the example of ENDS, see, e.g., Mendelsohn, Colin Paul and Hall, Wayne, “Vaping Nicotine Is Far Less Harmful than Smoking Tobacco,” Chest 158, no. 2 (2020): 835–36CrossRefGoogle Scholar. For the example of sex work, see, e.g., Lyons, Carrie E. et al., “The Role of Sex Work Laws and Stigmas in Increasing HIV Risks among Sex Workers,” Nature Communications 11, no. 1 (2020): 773 CrossRefGoogle ScholarPubMed; Armstrong, Lynzi, “‘I Can Lead the Life that I Want to Lead’: Social Harm, Human Needs and the Decriminalisation of Sex Work in Aotearoa/New Zealand,” Sexuality Research and Social Policy 18, no. 4 (2021): 941–51CrossRefGoogle ScholarPubMed. For the example of the drug war, see, e.g., Klein, Alana, “Harm Reduction Works: Evidence and Inclusion in Drug Policy and Advocacy,” Health Care Analysis 28, no. 4 (2020): 404–14CrossRefGoogle ScholarPubMed.

²⁰ Van Bavel, Jay J. et al., “Using Social and Behavioural Science to Support COVID-19 Pandemic Response,” Nature Human Behaviour 4, no. 5 (May 2020): 460–71CrossRefGoogle Scholar.

²¹ Albrecht, Don, “Vaccination, Politics, and COVID-19 Impacts,” BMC Public Health 22, no. 1 (2022), https://doi.org/10.1186/s12889-021-12432-x CrossRefGoogle ScholarPubMed; Adjodah, Dhaval et al., “Association between COVID-19 Outcomes and Mask Mandates, Adherence, and Attitudes,” PLoS One 16, no. 6 (June 23, 2021), https://doi.org/10.1371/journal.pone.0252315 CrossRefGoogle ScholarPubMed; Collins, Robert N., Mandel, David R., and Schywiola, Sarah S., “Political Identity Over Personal Impact: Early U.S. Reactions to the COVID-19 Pandemic,” Frontiers in Psychology 12 (2021), https://doi.org/10.3389/fpsyg.2021.607639 CrossRefGoogle ScholarPubMed.

²² Powell, Kerrington and Prasad, Vinay, “The Noble Lies of COVID-19,” Slate, July 28, 2021, https://slate.com/technology/2021/07/noble-lies-covid-fauci-cdc-masks.html Google Scholar.

²³ Contzen, Nadja, Meili, Iara Helena, and Mosler, Hans-Joachim, “Changing Handwashing Behaviour in Southern Ethiopia: A Longitudinal Study on Infrastructural and Commitment Interventions,” Social Science & Medicine 124 (2015): 103–14CrossRefGoogle Scholar; Ng, Wai Khuan, Shaban, Ramon Z., and van de Mortel, Thea, “The Effect of a Hand Hygiene Program Featuring Tailored Religion-Relevant Interventions on Healthcare Workers’ Hand Rubbing Compliance and Beliefs in the United Arab Emirates: A Cohort Study,” Infection, Disease & Health 24, no. 3 (2019): 115–23CrossRefGoogle Scholar; Judah, Gaby et al., “Experimental Pretesting of Hand-Washing Interventions in a Natural Setting,” American Journal of Public Health 99, no. S2 (2009): S405–11 CrossRefGoogle Scholar.

²⁴ Bavel et al., “Using Social and Behavioural Science to Support COVID-19 Pandemic Response.”

²⁵ See, e.g., McCright, Aaron M. and Dunlap, Riley E., “The Politicization of Climate Change and Polarization in the American Public’s Views of Global Warming, 2001–2010,” The Sociological Quarterly 52, no. 2 (2011): 155–94CrossRefGoogle Scholar.

²⁶ Gauchat, Gordon, “Politicization of Science in the Public Sphere: A Study of Public Trust in the United States, 1974 to 2010,” American Sociological Review 77, no. 2 (2012): 167–87CrossRefGoogle Scholar.

²⁷ McCright, Aaron M. et al., “The Influence of Political Ideology on Trust in Science,” Environmental Research 8, no. 4 (2013), https://iopscience.iop.org/article/10.1088/1748-9326/8/4/044029 Google Scholar.

²⁸ Lazar, Kay, “Prominent Doctor Faces Backlash amid ‘Fight over the Heart of Public Health,’” BostonGlobe.Com, September 1, 2022, https://www.bostonglobe.com/2022/09/01/metro/prominent-doctor-faces-backlash-amid-fight-over-heart-public-health/ Google Scholar.

²⁹ Justin Fenton, “Another Man Charged with Making Threats against Former Baltimore Health Commissioner Dr. Leana Wen,” The Baltimore Banner, https://www.thebaltimorebanner.com/community/criminal-justice/another-man-charged-with-making-threats-against-former-baltimore-health-commissioner-dr-leana-wen-VIVS2HXP2BFINC2IX3KBAUOI6U/.

³⁰ Bavel et al., “Using Social and Behavioural Science to Support COVID-19 Pandemic Response.”

³¹ Husak, Douglas, Overcriminalization: The Limits of the Criminal Law (New York: Oxford University Press, 2008)Google Scholar.

³² American Public Health Association, “Addressing Law Enforcement Violence as a Public Health Issue,” American Public Health Association (Policy Number 201811), November 13, 2018; Dreyer, Benard P., “The Toll of Racism on African American Mothers and Their Infants,” JAMA Network Open 4, no. 12 (2021), https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2786943 CrossRefGoogle ScholarPubMed.

³³ DeVylder, Jordan E. et al., “Police Violence and Public Health,” Annual Review of Clinical Psychology 18 (2022): 527–52CrossRefGoogle ScholarPubMed; Cooper, Hannah et al., “Characterizing Perceived Police Violence: Implications for Public Health,” American Journal of Public Health 94, no. 7 (2004): 1109–18CrossRefGoogle ScholarPubMed; Obasogie, Osagie K. and Newman, Zachary, “Police Violence, Use of Force Policies, and Public Health,” American Journal of Law & Medicine 43, nos. 2–3 (2017): 279–95CrossRefGoogle ScholarPubMed.

³⁴ Matthews, Karen and Attanasio, Cedar, “‘I Can’t Breathe’: Eric Garner Remembered on the 10th Anniversary of His Chokehold Death,” AP News, July 17, 2024, https://apnews.com/article/eric-garner-death-anniversary-chokehold-dca9708c2dee062f95f35483e1e2cfed Google Scholar.

³⁵ For further discussion of how public health officials hold tobacco use to higher standards of risk reduction than other activities, see Flanigan, Jessica, “Double Standards and Arguments for Tobacco Regulation,” Journal of Medical Ethics 42, no. 5 (2016): 305–11CrossRefGoogle ScholarPubMed.

³⁶ I defend this claim in more detail elsewhere. See Flanigan, Jessica, “Can Social Costs Justify Public Health Paternalism?” in New Perspectives on Paternalism and Health Care, ed. Thomas Schramme (Cham: Springer International Publishing, 2015), 233–45CrossRefGoogle Scholar.

³⁷ Director, Samuel, “Public Health Officials Should Almost Always Tell the Truth,” Journal of Applied Philosophy 40, no. 5 (2023): 951–66CrossRefGoogle Scholar.

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³⁹ Goldberg, Emma and Anthes, Emily, “Hospitalizations for Children Sharply Increase as Delta Surges, CDC Studies Find,” The New York Times, September 3, 2021, https://www.nytimes.com/2021/09/03/health/delta-children-hospitalization-rates.html Google Scholar; CDC, “New CDC Data Illuminate Youth Mental Health Threats during the COVID-19 Pandemic,” Centers for Disease Control and Prevention, March 31, 2022, https://www.cdc.gov/media/releases/2022/p0331-youth-mental-health-covid-19.html.

⁴⁰ Flanigan, “Double Standards and Arguments for Tobacco Regulation.”

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⁵⁴ This description of the Cholera epidemic is especially informed by Casey Petroff’s unpublished work and by a discussion of the analogies between cholera and COVID-19 by Barbra Pfeffer Billauer. Billauer, Barbara Pfeffer, “The Future of Public Health Law Lies in the Past—and Lawyers Need to Learn It,” Bill of Health, May 2, 2023, https://blog.petrieflom.law.harvard.edu/2023/05/02/the-future-of-public-health-law-lies-in-the-past-and-lawyers-need-to-learn-it/ Google Scholar.