Whatever one’s politics, it should be plain to all that this is a humbling moment for the righteous cause of public health. An essay by John Tierney in The Atlantic says public health has discredited itself. Tierney describes the state of things in stark terms:
“Although many skeptics have overreacted, rejecting sound science in favor of quack theories, they’ve gotten one thing right: A noble profession has been corrupted by politics. This became obvious during the pandemic, but the politicization of the discipline has been going on for half a century. The modern field has redefined the very meaning of public health, and in the process, it has made so many mistakes that it has itself become a hazard to Americans’ health.”
Overreach and Bias
Tierney specifies many health concerns where public health authorities followed cues for what was seen as righteous more than they followed the objective truth of science.
In regard to obesity and nutrition, the examples have been many. Whole milk is banned from school nutrition programs even though objective data tells us at the very least it does no harm. It might even be better for health than low-fat milk. The result of this stubborn righteousness? Bipartisan support for overriding nutrition guidance through political means.
We have been through many righteous cycles of calling out the dietary villains causing obesity: weak willpower, fatty foods, carbs, sugar, and now, ultra-processed foods. Politicians are happy to seize upon this righteous indignation to advance their partisan agendas. And thus, we have a MAHA movement fueled by anger at the mistakes of historical overreach by public health.
Tierney also calls out the mistake of persuading three quarters of Americans to falsely believe vaping is equally or more dangerous than smoking. This is a dangerous lie. But it is one that feels righteous to many in public health.
Unfortunate Fallout
The unfortunate fallout from righteously shading the truth is cynicism that has taken the credibility of public health to a low point. The current administration is slashing virtually all support for work at CDC on obesity, nutrition, and physical activity. Evidence-based dietary guidelines will soon be replaced by four pages of glib advice to “eat the food that’s good for you.” This yields poor guidance – like suggesting people eat more french fries made with beef fat.
Measles cases have exploded and to hit a record high since the U.S. eradicated the disease in 2000. People will suffer and die because of all this cynicism about public health.
This indeed is a humbling moment for public health.
Click here for free access to Tierney’s essay in The Atlantic.
A Johann Sebastian Bach Humblement, painting by Gerda Wegener / WikiArt
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July 10, 2025 at 7:13 am, Bobby C MD MPH said:
I’m baffled that ConscienHealth chose to highlight this piece. What’s presented as an argument about the politicization of science instead deploys political talking points dressed as analysis ironically accusing public health of politicizing science while doing exactly that.
Public health has long been the quiet architect of collective well-being. Its legacy is built on compassion and evidence, not ideology, from vaccination campaigns and maternal health programs to sanitation and environmental stewardship. Yet The Atlantic article risks eroding this heritage by reframing public health as a partisan battleground.
The author’s narrow definition that “health is just the absence of disease” is not only regressive, but factually incorrect. Since 1948, the World Health Organization has defined health as a state of physical, mental, and social well-being. This holistic understanding has shaped decades of progress in addiction recovery, mental health parity, and social determinants of health.
Instead of focusing on scientific nuance, the article veers into divisive terrain—invoking Black Lives Matter, cultural wars, and Donald Trump—while selectively citing studies. It fails to reference the substantial evidence that vaccination of older adults with multiple comorbidities could have prevented thousands of excess deaths in the U.S. The omission is glaring.
Yes, mistakes were made during the pandemic. We were navigating uncharted waters, recalibrating guidance as new evidence emerged. But these missteps should prompt growth, not serve as ammunition to dismantle institutional trust. The article wrongly implies that public health has become partisan simply because it embraces equity and systemic reform—principles that have always anchored the discipline.
Public health has weathered political storms before: from resistance during the HIV/AIDS epidemic to controversies over tuberculosis isolation policies. And most infamously, the Tuskegee Syphilis Study, where hundreds of Black men were deceived and denied treatment for decades, under the guise of scientific observation. That tragedy wasn’t just a failure of ethics, it was a betrayal of trust that still reverberates in communities today. It reminds us that public health must be rooted in transparency, dignity, and accountability.
It endures by prioritizing human dignity, not political expediency. This backlash risks turning hard-earned lessons into culture war fodder, feeding social media conspiracy theories and scapegoating healthcare and public health professionals who bore the brunt of the pandemic response under extreme stress.
There is one point of agreement. The article correctly notes inconsistencies in dietary guidelines. Nutrition, obesity, and metabolic research are rife with confounders—precisely why I continue to read your newsletter. But cherry-picking this complexity should not become a license to discredit public health wholesale.
The Atlantic piece manufactures controversy. Public health deserves better: a conversation rooted in reflection, rigor, and respect.
July 11, 2025 at 3:30 am, Ted said:
Thanks for your thoughtful comments, Bobby C.
While I disagree with some of what Tierney wrote in The Atlantic, I think he has some interesting points to consider. Does his writing “manufacture” controversy? I don’t think so. The controversy is plain to see, playing out before us, and causing great harm because of ill-advised policies it is spawning. Neither ignoring it nor encouraging people to stop talking about it will not make it stop.
July 10, 2025 at 7:31 am, David Brown said:
This excerpt is from the Preface to Food for Nought: The Decline in Nutrition by Ross Hume Hall, PhD (1973)
Food for Nought
Preface
Nourishment of the American populace has undergone a startling transition since World War II. A highly individual system of growing and marketing food has been transformed into a gigantic, highly integrated service system in which the object is not to nourish or even to feed, but to force an ever-increasing consumption of fabricated products. This phenomenon is not peculiar to the American scene and occurs in every industrialized country. The United States, however, has progressed furthest in the transformation. Man can never be more than what he eats, and one would expect that a phenomenon with such profound effects on health and well-being as a radically changed system of supplying nourishment would be thoroughly documented and assessed by the scientific community. Such is not the case. The transformation has gone unmarked by government agencies and learned bodies. Government agencies, recipients of the public trust charged with protecting and improving the public’s food, operate as if the technology of food fabrication rested in pre-World War II days. Scientific bodies, supported by public funds and charged with assessing and improving the public’s health, completely ignore the results of contemporary methods of producing and marketing food. https://www.amazon.com/-/es/Food-nought-Ross-Hume-Hall/dp/0394717538