‘Public Health Needs Help on Capitol Hill’.
When Jennifer Grodsky set out on March 10 for a day of lobbying on Capitol Hill, she expected the halls of Congress to be subdued. The rapidly spreading coronavirus and calls for social distancing dominated the news and public conversation, and just five days prior, Congress had signed the first relief bill.
But when Grodsky, vice president for federal relations at Boston University, arrived to the Hill, she was greeted by the usual bustling scene of lawmakers and advocates congregating in the cafeteria and piling into elevators.
“The idea of so many people gathered in small spaces is shocking to me now, but at the time, it was business as usual on Capitol Hill,” Grodsky said during the third session of the School of Public Health’s Coronavirus Seminar Series, “Politics, Health, and Coronavirus,” held online through Zoom video conferencing on April 2. She was joined by a panel of legal and health policy scholars to discuss the role that politics and policy have played in the country’s response to this unprecedented public health crisis.
“Public health needs help on Capitol Hill,” Grodsky said. Policymakers tend to support issues that impact themselves personally, she said, and are less interested in issues that do not pose an immediate or tangible threat to their own lives.
“Legislators struggle to support things that seem routine and unchanging, that have few vocal advocates, and that seemingly won’t pose a problem until the distant future,” she said. “As a result, public health can get ignored until there is a real emergency.”
And when a crisis emerges, “throwing money at the problem” is nothing new—but it is also not the solution, she said.
“We need policy, planning, and leadership,” she said, adding that it will take a concerted effort to keep public health work “top of mind” once the COVID-19 crisis has been resolved. “If public health matters to you, please say so regularly to your friends, family, neighbors, journalists, and lawmakers at every level of government.”
Eduardo Gomez, an associate professor at the College of Health at LeHigh University, highlighted how President Trump’s personal characteristics have also hindered policy development around COVID-19.
“Trump never forgets those who have offended him, and this seems to have hampered his relationship with Speaker Pelosi and caused him to miss meetings on policy issues with her,” Gomez said. “Trump always stands by his personal beliefs on scientific matters, no matter what the science says,” he said, and Trump’s beliefs contributed to the federal government’s delay in taking the virus—and the need for increasing testing—seriously.
Gomez also said the administration “politics of marginalization”—specifically, its anti-immigration stance—creates fear among undocumented immigrants and can discourage them from seeking critical medical care if they experience COVID-19 symptoms.
Daniel Dawes, director of the Satcher Health Leadership Institute and an associate professor at Morehouse School of Medicine, expanded on this “crisis within a crisis”—a pandemic that has exacerbated the health inequities that remain a public health challenge in the US.
“COVID-19 does not discriminate, but our current economic and social policies do,” he said. “What we have is a perfect storm for a disaster: a serious health crisis, an inequitable method of health delivery, millions of uninsured and underinsured people, a politically charged approach to dealing with the pandemic, an upcoming election, and some of the most vulnerable people on the front lines of our country.”
Dawes said a regression of policies on health equity at the federal level will likely intensify health disparities among people of color, lower-socioeconomic status individuals, people who have disabilities, LGBTQ people, and more.
“The inequities that predate COVID-19 did not suddenly become inapplicable,” he said. As a result, “the US could experience major disparities in who dies from coronavirus.” Minorities and other vulnerable communities still contend with neighborhoods that are largely devoid of health resources, he continued, and many of those who do have access to these resources may harbor distrust of the medical system.
“Minority communities are particular susceptible to falling prey to myths and misinformation,” he said. “Many African Americans initially believed that they were immune to this virus,” or don’t trust the government to test them for fear of being inflicted with the disease. “We have to educate our community.”
The most important thing policymakers can do is address the social and political determinants of health through an equity lens. “We have to start shifting our efforts to better address the upstream factors related to health,” Dawes said.
David Jones, associate professor of health law, policy & management at SPH, shared his thoughts on how COVID-19 will impact the 2020 presidential election.
The pandemic “has reshaped Trump’s strategy,” said Jones. “His strategy was going to focus on a booming economy and high stock market, and all of that has changed overnight.”
He said Trump’s self-proclaimed title of “wartime president” is undeserving. “We are in a war without a clear enemy,” he said, citing Trump’s frequent quarrels with Democratic lawmakers and his penchant for calling the coronavirus the “Chinese flu.”
Jones said the timing of the pandemic impacted the Democratic primary race, adding that had it occurred before Super Tuesday, multiple candidates would likely still be in the race.
He also explained that the “geography of the virus” and confirmation bias both determine people’s exposure to, and absorption of, information about the pandemic. “We have segregated ourselves with people who think and vote like us, so we get information that is the same as everyone around us.”
Public health professionals can “appreciate that we’re divided, but we have to try to speak across that divide” and not expect that consistent facts and information will change people’s ideological differences when it comes to the role of government and what policies should be put into place, Jones said.
Sandro Galea, SPH dean and Robert A. Knox Professor, moderated a brief Q&A with the panelists at the end of the program. “What can students do to prevent such chaos from happening again, should we experience another pandemic?” he asked.
“The best thing you can do is introduce yourself to your local elected public officials,” said Grodsky. “Go to their meetings and public events, meet with their staff, and tell them about your expertise. Be a resource for them so that when there is a crisis, they will come to you.”