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Supporting the Public Health Workforce Requires Collective Actions to Address Harassment and Threats.

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Elsewhere in JAMA Network Open, Topazian and colleagues1 report the striking finding that more than 1 in 5 US adults believe that harassing or threatening public health officials because of… Click to show full abstract

Elsewhere in JAMA Network Open, Topazian and colleagues1 report the striking finding that more than 1 in 5 US adults believe that harassing or threatening public health officials because of business closures during the COVID-19 pandemic is justified. Specifically, the authors analyzed 2 waves of a nationally representative panel survey of US adults, in November 2020 and July to August 2021, and found increases in the share of adults who endorsed harassments and threats for public health workers, with 25% of respondents justifying harassing and 21% justifying threatening such officials. This important study not only documents the overall prevalence of these concerning beliefs, but it goes deeper to identify particular groups who are more likely to endorse either of these beliefs at 1 or more of the time points: men, those with lower income and education, Hispanic people, younger people, and those with less trust in science. Surprisingly, given persistent partisan differences in other types of pandemic attitudes and beliefs even very early in the pandemic, Republicans were no more likely to endorse holding these beliefs than were Democrats in November 2020. However, a partisan gap emerged in 2021: 34% of Republicans believed harassment of public health officials was justified in 2021, compared with a still sizable 19% of Democrats. Furthermore, the authors detected growth in reporting these views in 2021 among groups with higher education and more trust in science—findings the authors suggest may be because of the public’s “pandemic fatigue” with restrictions but could also reflect changes in perceived norms, such that respondents felt less social desirability bias in reporting their beliefs endorsing harassment as the pandemic went on. To be sure, readers might respond that these estimates are measures only of beliefs, not of behaviors; after all, these are study participants’ top-of-head perceptions when asked to respond to a survey on a topic they may not have considered before. Are these responses meaningful? Unfortunately, data from other sources strongly suggest these beliefs endorsing the permissibility of harassment translated to actions taken. In fact, the focal article of the May 2022 issue of the American Journal of Public Health quantified actual reported experiences of harassment and threats among workers at local health departments (LHDs) in 2020.2 Ward and colleagues2 found that of 583 LHDs that responded to their survey, 335 departments (57%) reported at least 1 instance of harassment targeting leadership or staff, ranging from social media backlash, broadcast of personal information, threatening messages, demonstrations, and vandalism. These experiences of harassment are consequential: they contribute to public health workers leaving the workforce3 and facing significant mental health challenges.4 A recent large-scale study of the national public health workforce (44 732 participants) conducted between September 2021 and January 2022 found that 56% of public health workers reported at least one symptom of posttraumatic stress disorder; 22% reported their mental health as fair or poor; 41% of public health executives reported being bullied, threatened, or harassed; and 32% said they are considering leaving their positions.4 It is important to contextualize these findings within broader trends in public attitudes about public health and about politics. First, the practice of public health, particularly the work of governmental public health officials, has always been political.5 However, for the most part, their efforts have been relatively invisible to the public. In fact, a truism in the field of public health is that when public health is effective, it is invisible. The COVID-19 pandemic rendered public health extremely visible, and as a consequence, public health as a field and public health workers became more visibly political. Indeed, the survey conducted by Topazian and colleagues1 suggests a + Related article

Keywords: health; harassment threats; public health; survey; health workers; health workforce

Journal Title: JAMA network open
Year Published: 2022

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