Abstract
The COVID-19 pandemic precipitated a deluge of scholarly publications and scientific outreach. Information about the novel coronavirus has spread rapidly through both traditional news and social media platforms. Timely scientific literature is paramount to public health, but it must be paired with nuanced and tailored outreach and messaging. Despite being a core public health competency, not all public health science students receive training in these skills. The media response to the COVID-19 pandemic reveals a fundamental misunderstanding by the general public about the scientific process and cultivates a narrative that too often places blame on individuals for structural inequities. An influx of research without audience-appropriate interpretations, coupled with a lack of representation in the news media, threatens to erode trust in science. To address these challenges, schools and programs of public health might reflect on their curricula and consider placing a greater emphasis on health communication.
The COVID-19 pandemic precipitated a deluge of scholarly publications and scientific outreach. Indeed, since January 2020, the Semantic Scholar team at the Allen Institute for AI has catalogued more than 130,000 articles related to COVID-19 (Semantic Scholar, 2020). Information about the novel coronavirus has spread rapidly through both traditional news and social media platforms (Schillinger et al., 2020). While platforms like Twitter and Facebook help keep the public apprised of new developments, they also have enormous potential for seeding and propagating misinformation (Kouzy et al., 2020). This “infodemic” jeopardizes the public’s health at a time when awareness and evidence-based preventive actions are of utmost importance (Mian & Khan, 2020). The media response to the COVID-19 pandemic reveals a fundamental misunderstanding by the general public about the scientific process and cultivates a narrative that too often places blame on individuals for structural inequities. To address these challenges, schools and programs of public health might reflect on their curricula and consider placing a greater emphasis on health communication.
Timely scientific literature is paramount, but it must be paired with nuanced and tailored outreach and messaging (Peters, 2013). Doing good science is simply not enough; we need to be educating public health students about how to strategically, effectively, and compassionately convey scientific findings to the general public. Good health communication lies at the heart of health promotion and is an important skill set for all public health students, regardless of whether or not their work involves infectious diseases (Bernhardt, 2004; Van Bavel et al., 2020). Basic principles of health communication, such as ensuring that messaging is accessible and actionable, are salient regardless of the disease, condition, or behavior in question (World Health Organization, 2017). Despite being a core public health competency (Council on Education for Public Health [CEPH], 2016), not all public health science students receive training in these skills. Past pandemics have highlighted the need for effective messaging for public health (Fauci, 2016), and the ubiquity of social media means that many public health students are likely already trying to engage in health communication (Holub, 2020).
As public health students, we learn that science is not static; uncertainty is inherent to scientific research, and we adjust our recommendations and guidelines based on the data we have available (van der Bles et al., 2019). For example, in February 2020, the U.S. Surgeon General advised healthy people to refrain from wearing face coverings, saying that there was insufficient evidence that masks protect the general public from the novel coronavirus and that wearing a mask may contribute to a false sense of security (Feng et al., 2020). Yet on April 3, the Centers for Disease Control and Prevention and the White House Coronavirus Task Force called for all Americans to wear cloth face masks to reduce the spread of COVID-19 based on evidence of asymptomatic transmission among the general public. (Fisher et al., 2020; Johns Hopkins University, 2020). Research suggests that nonpharmaceutical interventions, such as wearing face masks and social (physical) distancing in public, could substantially reduce the disease transmission (Chu et al., 2020), with one study modeling that hospitalizations would be reduced by 64% if 75% of the U.S. population were to wear cloth masks (compared to no mask use; Ngonghala et al., 2020). Some posts on social media neglected to mention that masking recommendations were based on the evidence available at the time, which may have raised doubts about the legitimacy of experts’ opinions (Ratzan et al., 2020). This example illustrates a failure to educate the public about the changing nature of scientific guidelines. What the public may treat as immutable is far more flexible than is often reported. As Sir Austin Bradford Hill (1965) said, All scientific work is incomplete. . . . All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us a freedom to ignore the knowledge we already have, or to postpone the action that it appears to demand at a given time. (p. 300)
Especially during a pandemic, we have an obligation to act on the evidence we have available to us.
Health communication training is also needed to address how we talk about health inequities related to COVID-19 and other health conditions. Are we framing health disparities as individual faults or, more appropriately, as the result of structural factors? Culturally sensitive messaging is critical to building trust with medically underserved populations (Michigan Department of Health & Human Services, 2020). As we work to improve public health communication, we need to address gender and racial biases in health communication. Training public health students in health communication may be an opportunity to diversify the perspectives being shared and center conversations about health inequities. News coverage of the pandemic has been criticized for prioritizing the work for White, male scientists (Buckee et al., 2020), yet prior research suggests that audience members who see someone with similar demographics may place more trust in that source (Kreuter & McClure, 2004). Recent research on COVID-19 knowledge among U.S. adults concluded that more efforts should be made to address knowledge gaps between different demographic groups (Alsan et al., 2020). Representation is important not only to motivate health behaviors of audiences but also to advance the careers of women and BIPOC (Black, indigenous, and people of color). Schools and programs of public health can support future public health leaders by helping them develop the skills to discuss the health inequities affecting their communities.
The COVID-19 pandemic has amplified the need for more rigorous health communication training, and accreditation bodies should consider strengthening their requirements around this competency to meet the moment. While there are several actions schools and programs of public health can take to improve health communication training for students (for examples, see Table 1), these changes may not be likely to happen without pressure from the CEPH. Public health accreditation criteria have changed before to better reflect the needs of the field. For example, in response to a 1988 Institute of Medicine (now the National Academy of Medicine) report recommending greater emphasis on public health practice, the CEPH began requiring a practicum experience (Institute of Medicine et al., 2003). Any actions taken by a school or program of public health should include concrete steps to ensure that diverse perspectives are represented.
Examples of Strategies for Schools and Programs of Public Health to Improve Health Communication Training for Students.
An influx of research without audience-appropriate interpretations, coupled with a lack of representation in the news media, threatens to erode trust in science. Polling has shown that scientists are highly trusted professionals; a Pew report found that in 2019, 86% of U.S. adults said that they had “a great deal or fair amount of confidence” in scientists to act in the public’s best interest (Funk et al., 2019). Furthermore, the more familiar Americans are with the work of scientists, the more trusting they are of scientists’ credibility and competence (Funk et al., 2019). Schools and programs of public health should capitalize on this moment—this increased national attention on public health—by making health communication a more central part of their curricula and equipping their students to engage in meaningful, effective science communication.
Footnotes
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
