A Model For Public Health In the Age of Mistrust
This week, we learned what happens when a Yale researcher joins forces with a MAHA organizer to support an American community. We heard one word repeatedly on today’s conversation: "relationships."
Could this serve as a model, a new way of doing public health - using research + advocacy + building relationships and trust - at a time of great division in our country today?
(Nicole Deziel from the Yale School of Public Health and Elizabeth Frost from MAHA Ohio in East Palestine, OH this summer)
On this podcast we have recorded about a dozen conversations between supporters of the MAHA movement and people from mainstream science and public health.
Just having the conversations feels productive in and of itself — these aren’t groups who often engage with each other.
(WSITY team with guests on today’s episode)
But what happens when the conversation continues off the show — and then turns into a collaboration, to support the residents of a small American town facing the fallout from a big calamity? And could this serve as a model, a new way of doing public health and building relationships and trust, given our country’s divisions today?
On this week’s episode, we heard a story that convinced us that yes, it could.
Listen here:
A Yale School of Public Health researcher has teamed up with a grassroots MAHA organizer. Yes, you read that right—and this podcast was the bridge between them.
(Watch today’s conversation here.)
By combining traditional public health methods and deep area expertise with community outreach and a strong local partnership, that researcher is now an integral part of a newly granted NIH-funded project to support a community that, for very good reasons, doesn’t always trust experts these days.
We go into our conversations between traditional public health and MAHA knowing that some fights must be had. There are profound disagreements over things such as vaccines, research cuts, over the role of public health itself, over expertise and medicine.
But at the same time, there are communities that need help right now.
(2023, East Palestine, Ohio/Associated Press)
“There were just these little, little clues that came over time that just made me feel more and more that I wasn’t getting the whole story.” - Stuart Day, nearby resident
The research we’re discussing here aims to give answers to the people of East Palestine, Ohio, who, more than two years after the infamous train derailment, chemical spill, and fire, still have urgent questions about the safety of their drinking water. But that’s just one goal.
The other, in some ways more ambitious, is earning the community’s trust on what they find. And to achieve that, this unlikely group is thinking way out of the box—and doing something radical these days: trusting each other.
So, how are they doing it? And what’s the formula? Inspired by this story, we’re going to try to use the language of science and combine it with storytelling.
Step 1: WSITY connects N ↔ E
│
Step 2: (N + S) x (E + S) + → SP
│
Step 3: L → N’s Scientific Questions
│
Step 4: N × S + E’s support → NIH Grant
│
N → R + (E + S) sharing → T
│
∴ Knowledge that helps the people of East Palestine
(The key:)
N = Nicole Deziel (Yale School of Public Health)
E = Elizabeth Frost (MAHA Ohio)
S = Stuart Day (Ohio Valley Allies)
WSITY = “Why Should I Trust You?” Podcast
L = Listening
SP = Shared Purpose
R = Results
T = Trust
So here is the story version of the formula:
“I don’t think there was really any hesitation on my side. I’m looking at the residents of East Palestine who are benefiting that we have an Ivy League research institution that genuinely wants to hear what the residents are most concerned about” - Elizabeth Frost, MAHA Ohio
“I tell a lot of people about this collaboration, I think it’s novel, I think it’s important for people to hear in these times that we are so divided.”.” - Dr. Nicole Deziel, Yale School of Public Health
Step 1: WSITY connects N ↔ E
Our podcast has hosted some honest, difficult, and revelatory conversations between members of the MAHA movement and traditional public health and science. One of the many positives to come from these exchanges has been connections with very different communities, built on trust.
(Brinda and Elizabeth in Ohio)
Long story short: Elizabeth of MAHA Ohio told Brinda that residents of East Palestine, Ohio, despite the media’s attention fading, were still raising health concerns more than two years after the infamous train derailment involving toxic cargo. Brinda flagged this to Dr. Megan Ranney, the dean of the Yale School of Public Health and a frequent guest on the show, who introduced Brinda to Dr. Nicole Deziel, a Yale Associate Professor in Environmental Health Sciences with expertise and a track record in assessing exposure to environmental contaminants in this region. Finally, Brinda connected Nicole of Yale with Elizabeth of MAHA Ohio.
Meanwhile, the NIH had invited researchers to apply for grants to study the long-term health conditions of East Palestine.
We asked Elizabeth—given the tensions between MAHA and the establishment—what it was like for her to collaborate with an Ivy League researcher.
Elizabeth: “I don’t think there was really any hesitation on my side. I will credit some of that to having built a personal relationship with Megan Ranney and understanding the kind of culture she has created and fostered at Yale School of Public Health. I can’t say for certain that if it were a situation where I didn’t know anyone associated with the program, there wouldn’t have been some what I consider a healthy dose of skepticism. But knowing Megan definitely helped understand, I think, the heart of where this was coming from.”
Step 2: N × E + S → SP
Nicole from Yale collaborates with Elizabeth of MAHA and an organization called Ohio Valley Allies, a grassroots environmental and community empowerment organization in the region. Nicole knew them for years, going back to relationships she had built while researching the effects of fracking across the region. Ohio Valley Allies becomes a core partner in the research effort, with all participants wanting the same thing: answers for East Palestine.
(photo courtesy, Nicole Deziel)
Stuart Day, who works with Ohio Valley Allies, lives just 6 miles from East Palestine and experienced the plume of smoke from the controlled burn at the crash site, is part of Ohio Valley Allies. He is also the co-host of the Exposure Podcast, which investigates environmental health issues facing communities across the region. Ohio Valley Allies founder Jill Hunkler first connected with Nicole through that early fracking research. Stuart later met Dr. Deziel as executive producer of the Exposure Podcast, which he co-hosts with Hunkler. Through this collaborative work, Stuart and Nicole have built a relationship based on trust and respect.
(Stuart Day)
Stuart Day, local resident: “I was very interested in having somebody like Nicole take on this issue with East Palestine precisely because I trusted her personally and knew she would do a good job and wouldn’t be so inclined to bring in bias.”
Step 3: L → N’s Scientific Questions
On a sweltering summer day, Elizabeth and Nicole met at a Subway in East Palestine. Just days earlier, Elizabeth had invited Nicole to join some community canvassing to hear residents’ fears about their water. Nicole jumped on a plane and, after a veggie sub on wheat and a Buffalo Chicken Salad, the two were knocking on doors.
What Nicole heard helped her recast the questions she felt needed to be investigated. It is traditional public health fieldwork conducted alongside an untraditional ally, during very untraditional times.
Elizabeth: “Nicole wrote, ‘Hey, I’d love to get on the ground in East Palestine. Is there an opportunity you’d recommend?’ And I said, Come on out, we’re doing something like next week. And to my surprise, she didn’t waste any time, and about a week after that first email, we were in East Palestine together, meeting at a Subway.”
Nicole: “I did have a little trepidation. Being from an Ivy League, would I even be an asset showing up at people’s doorsteps? Would people want to talk with me? Would MAHA really be interested in having me come along?”
“I so appreciated being able to join her group and be part of those conversations with the residents. It completely changed how I was looking at my proposal and my scientific questions pre and post visit, it was extremely valuable.”
Step 4: N × S + E’s support → NIH Grant
Nicole and partners Professor Michelle Bell from the Yale School of the Environment, along with Dr. James Saiers, a hydrogeologist at Yale, combined with Ohio Valley Allies, led by Jill Hunkler and Stuart, dug into an extensive grant writing and application process and were awarded that NIH grant to study the water in East Palestine. They join a group of university research teams led by Erin Haynes of the University of Kentucky. Their application is strengthened by a letter of support from Elizabeth.
Did she get any blowback from others in MAHA?
Elizabeth: “I just get the sense that some people are more excited about branded MAHA wins than sometimes things that you have to read between the lines. And so for me, this is something I don’t have to read between the lines. I’m looking at the residents of East Palestine are benefiting that we have an Ivy League research institution that genuinely wants to hear what the residents are most concerned about, and would rather hear it direct from the residents rather than what folks with some sense of authority are telling them what the authority is.”
How about Nicole and the response from academia?
Nicole: “To me, I just try and look for alignment. This is an opportunity to center issues around the environment that haven’t really received enough attention in the past, so I kinda move through that quickly and highlight areas of alignment.”
“I tell a lot of people about this collaboration, I think it’s novel, I think it’s important for people to hear in these times that we are so divided.”
N → R + (E + S) sharing → T
Once the work is completed, the results (R) will be shared with residents through the support of Elizabeth of MAHA and Stuart of Ohio Valley Allies. This step emphasizes building trust (T) with the very people the research is intended to serve.
Elizabeth: “Overwhelmingly, the people in East Palestine have questions, and when you have those questions, it’s impossible to feel safe.”
“I see my role in this is to be the communicator with the residents and to help open that line of communication.”
We asked Stuart about what he worries most about when it comes to the train wreck and community exposure to chemicals.
Stuart: “Mostly, it was what we didn’t know that was the concern. We didn’t know what we had been exposed to, how much of it we had been exposed to.”
And then, as time went by…
“There were just these little, little clues that came over time that just made me feel more and more that I wasn’t getting the whole story.”
Since he knows Nicole and believes in her work, we asked: if she comes back with results showing nothing contaminating the water, will he trust that? Will he trust her?
Stuart: “Yeah, I will. You know, I will trust Nicole and the other scientists working on this, because I think they will be coming at it from a purely scientific perspective and not the perspective of managing narratives, managing politics and managing economics.”
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Great show!
I wish I could make all my medical student colleagues read this!