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Closing Keynote: Utah Public Health Association’s Carrie Butler and DHHS’ Dr. Lisa Nolen highlight the importance of public health

By

Maddie McCarthy, Alex Nelson

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Dr. Leisha Nolen, state epidemiologist at the Utah Department of Health and Human Services (DHHS), and Carrie Butler, executive director of the Utah Public Health Association, discussed public health issues at the 2024 Utah State of Reform Health Policy Conference in March.

Nolen said there is currently mistrust in public health authority.

“[To improve public health], we need to have data, we need to have people engaged, and we need to have people willing to work with us. And we’ve definitely seen since the pandemic—and even truly before the pandemic—that there has been this decreasing trust in public health and really authority and scientific authority throughout.”

— Nolen

When the COVID-19 pandemic began, the state made lawsuit settlements related to the national opioid crisis. Butler said this fostered more mistrust in public health.

“There were pharmaceutical companies who were adjudicated in national and federal court to have lied to us as a population. And we expected communities that were devastated in ways that I maybe will never understand by the opioid crisis to then take vaccinations. 

We didn’t say, ‘Hey, we get this might be scary for you.’ We said, ‘You take this, or you’re a bad guy. You take this, or you’re not welcome here.’ That was maybe not the best way to handle that, and I think we have a lot of work to do to restore trust and I think that starts with meeting communities where they’re at.”

— Butler

Nolen said the medical and scientific communities need to talk more with the general public, not just with other professionals. This would help increase engagement in public health, she added.

“We need to get better at talking like a normal human being. We need to talk like we’re talking to our next door neighbor when they ask us how work was and what we did today.”

— Nolen

The state needs to consider public health workers when looking at the healthcare workforce shortage, Butler said, including community health workers, epidemiologists, and more. She added that social determinants of health (SDOH) are part of public health.

“We also, I think, are starting to think of public health as anything that touches SDOH. So education, safe routes to school, bus drivers, and anybody who is engaged in community efforts to provide safety to the communities—those are also public health workers. I don’t know if they always think of themselves as part of public health, but I think it’s important that we consider them in the public health system.”

— Butler

Clinicians should be considered public health workers as well, Nolen added.

“The truth is, all our data comes from clinicians. So if we don’t have clinicians out there well-documenting their cases, we can’t tell what’s happening. If they don’t call us when they see that fourth really weird infection, we’re not going to know something.”

— Nolen

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