Authors: Katelyn Jetelina, Nicole Deziel, Megan Ranney, Elizabeth Frost, Brinda Adhikari
A few months ago, some of us in public health began having conversations with grassroots members of the Make America Healthy Again (MAHA) movement, facilitated by a mutual friend, journalist and co-host of the podcast Why Should I Trust You, Brinda Adhikari. Every month, she’s been hosting conversations, and several of us have been regular participants.
To MAHA, this moment in America is filled with opportunity and momentum. To many of us in public health, in contrast, it feels like a collapse—whether of budgets, infrastructure, or evidence-based public health practice. In public health, we often feel like we are stuck triaging: What can we save? What must we let go? What do we need to reimagine completely? It feels like plugging holes in a sinking ship with paper towels.
Our conversations began with curiosity and uncertainty. Nonetheless, we continue to show up, asking whether and how we can move from conversation to collaboration. Could we find common ground? Could this strange alliance (like so many alliances in public health) actually do some good?
To our surprise, we suspect that the answer is yes. Here are two stories of how and why.
Medicaid is best known for providing healthcare coverage. But since the 1970s, some states have taken it a step further asking: What if we used Medicaid not just to treat illness, but to prevent it? What if we addressed the root causes of poor health—like food insecurity—and in doing so, saved lives and money?
One morning, over coffee, I (Katelyn) came across an op-ed about a program on the chopping block. It wasn’t just another budget cut. This program used Medicaid funds to pay for groceries for high-risk patients—those with diabetes, heart disease, or other chronic conditions.
Why groceries? Because food is medicine. Give people access to healthy food, and you can lower their blood pressure. Improve their blood sugar. Reduce ER visits. It’s a simple idea with strong evidence behind it. And it was working.
Early results showed promising outcomes: better health, fewer hospitalizations, lower costs. It wasn’t perfect, but it was exactly the kind of innovation we should be fighting for. Instead, it was being dismantled.
I then connected with a MAHA grassroots leader to see if this was something they would champion. The person I was working with from MAHA wasn’t MAGA—a distinction that matters—but was deeply committed to local wellness and upstream solutions.
Together, we connected with the broader MAHA grassroots network in the state. We co-authored a short policy brief. And next month, we’ll walk into the state capitol together, side by side, meeting with lawmakers as a united front: public health meets grassroots wellness.
I still can’t quite believe it.
A few states north, another unexpected partnership was forming.
In 2023, a train derailed in East Palestine, Ohio, releasing toxic chemicals into the air, water, and soil. The headlines eventually faded. But for residents, the concerns haven’t: fear of long-term health effects, distrust of environmental testing, anxiety, worsening chronic conditions, and the feeling that no one is truly listening.
I (Nicole) have long ties to eastern Ohio. Years ago, as a new professor, I brought students there to study fracking and its health impacts. We talked with farmers, community leaders, and residents. That work sparked a decade of research and relationships that far outlasted the initial project grant.
So when a new funding opportunity was announced to study the health effects of the East Palestine spill, it caught my attention. It required deep understanding of the issue and strong community engagement, and as I pored over data and measurements and articles, I quickly realized this was something that couldn’t be done from a desk in New Haven.
That’s when I got a surprising email. A few MAHA Ohio organizers had reached out to Brinda, who has spent time building relationships with them, to say folks in East Palestine were continuing to express concern and worry since the train derailment. Would Brinda want to do anything to further amplify or investigate their concerns? Brinda said she wanted to look into it and amplify this on her podcast. She then contacted Megan Ranney, Dean of the Yale School of Public Health, to see how they might want to be involved, and Megan flagged this opportunity for me. The ball was set in motion.
Elizabeth was planning a visit to East Palestine, OH and asked if I wanted to come along. They were going door to door, talking with residents and collecting insights. It wasn’t a press tour or a formal meeting. This was public health. And they invited me to join.
A week after that initial contact, I traveled to Ohio and met the team at a Subway in town. I wasn’t nervous to talk with people—that’s public health. But I’ll admit: I was worried about how my presence would be received—by both the community and MAHA. I’m from a northeast Ivy League university. I don’t necessarily talk like the community. I don’t always share the same views. Despite my Ohio connections, I worried: Would I be seen as an outsider? Would my expertise be considered out of touch? Would my academic background just emphasize institutions that have let people down?
Turns out, not at all.
It was nearly 100 degrees and humid. We knocked on about 50 doors, had real conversations with about a dozen residents, and heard stories that you’ll never get from a published study. One woman talked about her child’s worsening asthma. Another family showed us bottled water they had stacked in their kitchen, still afraid to drink from the tap. Several people spoke about their distrust of the existing data, and the worry that new research would yet again take advantage of them. They talked about how science could feel “extractive” unless paired with resources for the community.
Caption: Nicole (public health) and Elizabeth (MAHA) near the Ohio Derailment Train Site
MAHA approached these conversations not with clipboards, but with humility. They metaphorically, as well as physically, opened doors to researchers. And they approached conversations with me in the same vein, building connections between my work and theirs during our water breaks.
What I learned in just one day reshaped the research proposal I was developing—changing what questions we would ask, what resources we’d offer, and how we’d engage the community over time. Because the truth is: you can’t do responsive science from afar. Especially not in environmental health. You have to show up. Sometimes that means being present for a high-level briefing. Sometimes it means standing in someone’s driveway in 100-degree heat.
This wasn’t just data collection. It was relationship-building. And acknowledging and supporting the work of other teams like Ohio State University, plus government scientists and community workers.
And the person who helped make that possible wasn’t a federal agency official. Or a university partner. It was a member of MAHA.
That’s public health now, too.
(By the way, Brinda will be hosting a series of conversations on the WSITY pod tracking the work in East Palestine, elevating the stories and concerns of the stakeholders, and seeing where we can provide support.)
Public health isn’t just about technical expertise. It also requires relationships, humility, and a willingness to engage with stakeholders, even those who may oppose or challenge your work. It starts with listening and sharing ideas.
Public health takes all of us, and is for all of us. This alignment requires us to engage with folks who are doing and practicing public health in their own communities, with lived experience and moral urgency. Especially ones who can say, “I’m not a public health expert—but I am a mom, or a veteran, or a farmer, or a survivor, or a small business owner—and I know this program helped my neighbor.”
These new public health + MAHA + journalist partnerships are an extension of what public health has always tried to do, whether working to reduce opioid overdoses or childhood lead poisoning or car crash prevention. However, we recognize that people may not be aware of them and often feel excluded.
We don’t yet know the outcome of this particular policy battle or this particular research proposal. But we know one thing for sure: if we are successful, it will be because of unlikely coalitions—ones that defy the usual red-blue, urban-rural, expert-layperson divides.
And we’re hopeful that these examples, along with others’ work in cities and states across the U.S., can help remind us all of how and why we do this work. Together, we can advance the public’s health with good science, good communication, and most of all good action.
In a moment of so much uncertainty and division, the world needs odd bedfellows. This work isn’t easy. It’s slow. It’s uncomfortable. And it requires trust-building in a time when trust is in short supply. However, if the public’s health is to survive this moment—let alone thrive in the future—we need to lean in. Not just because we want to save a grocery benefit program. And not just because individuals deserve health answers about a toxic spill. But because this is what public health is: local, relational, collaborative.
And maybe—just maybe—more resilient.
