COLUMBUS, Ohio — More than three-quarters of public health leaders interviewed in a new study reported experiencing harassment or threats in the years after the COVID-19 pandemic began. These threats included physical violence, stalking, and intimidation, according to researchers who characterized the level of such incidents as "extraordinary."
The study, published in the American Journal of Public Health, included interviews with 109 public health leaders across 18 states, chosen for their geographic and political diversity. Of those interviewed, 76% confirmed they had been threatened or harassed.
Marian Moser Jones, an associate professor of health services management and policy at The Ohio State University College of Public Health and the study’s lead author, emphasized that the behavior observed went beyond typical disagreements over policies such as masking or COVID-19 vaccinations. Moser Jones stated, "This is true hostility. Threats of violence. Undermining these people in ways that harm their ability to do their jobs."
Researchers engaged with state and local public health leaders in urban, suburban, and rural communities, ensuring a broad range of experiences were captured from politically varied states.
Some officials faced threats so severe that law enforcement became involved. One participant recounted an incident where the FBI arrested an individual who had made repeated credible death threats. The official became frightened upon learning the person possessed over 100 guns in their home. Another public health official described being targeted by a "scary" and "obsessed" male stalker who sent an image depicting someone strangling a child the same age as the official’s own child. A separate participant discovered a note taped to their front door threatening to kill their dog, accompanied by a photograph of the animal in their backyard.
The study also highlighted that the backlash was not always direct threats. Approximately half of the interviewed public health leaders reported what researchers classified as "undermining" behavior, which directly hindered their ability to perform their duties. This included offices being flooded with excessive data requests, repeated demands for changes to pandemic guidance, and public attacks on officials' qualifications.
Moser Jones indicated that this sustained pressure has contributed to individuals leaving the public health field. She noted that while politicians might expect such scrutiny, most public health officials were not accustomed to being in the public spotlight or becoming targets before the pandemic, making the experience particularly difficult for the profession.
Despite the hostility, the researchers identified instances where public health officials successfully reduced some of the backlash. In smaller communities, officials often leveraged longstanding relationships with residents and business owners to engage directly with angry community members. Some officials actively involved opponents in conversations, rather than relying solely on formal government channels. Moser Jones explained that some officials directly confronted threats by highlighting the personal consequences, saying things like, "Listen, you’re threatening my kids," which occasionally helped to de-escalate tensions.
Moser Jones observed that "promoting civil discourse seemed to cut down on the backlash," noting that while it didn't eliminate hostility, it helped prevent officials from being fired or forced out. Amy Fairchild, a senior author of the study and a professor at the University of Minnesota School of Public Health, added that successful officials also acknowledged the economic and personal impacts of public health decisions, sometimes involving local businesses in their discussions. Fairchild stressed the importance of explaining not just the science, but also the "painful tradeoffs at stake" and the reasoning behind difficult decisions.
Looking ahead, the researchers proposed several potential policy responses for future public health emergencies. One suggestion is to criminalize doxing, which involves publicly posting private or personally identifying information online without permission. They noted that officials sometimes had their home addresses or phone numbers posted, encouraging organized harassment. Another approach would require members of local boards of health to possess professional backgrounds relevant to public health, addressing situations where individuals with little public health experience made key decisions. Additionally, the researchers recommended that public health leaders build relationships with diverse political and social groups before the next crisis emerges. Moser Jones suggested that bringing people together around shared concerns, such as the ongoing opioid crisis, could be powerful.
Moser Jones also connected the study's findings to broader issues of political polarization and public trust, stating there is "a lot of work to do to deal with the vicious polarization in this country." She suggested that public health officials might need to better explain their ongoing roles outside of major emergencies, including their work in areas like food safety, maternal and infant health, and smoking cessation.
The research project is ongoing and received funding from the Commonwealth Fund, the Mellon Foundation, and the National Science Foundation. Researchers from Ohio State University, New York University, and Syracuse University participated in the study.
