Backlash against public health officials, including intimidation and threats of physical harm, has been widespread in the years since the start of the COVID pandemic and they face ongoing risk in a divisive nation, according to a new study.

“The backlash we’re studying is different than people disagreeing about wearing masks or getting a COVID vaccine,” said lead author Marian Moser Jones, associate professor of health services management and policy in The Ohio State University College of Public Health. “This is true hostility. Threats of violence. Undermining these people in ways that harm their ability to do their jobs.”

Of 109 leaders interviewed for the study, 76% were threatened or harassed, a category of backlash the researchers deemed “extraordinary.” About half experienced “undermining” backlash, which made it hard for them to work—things like overwhelming their offices with data requests, repeatedly demanding revisions to pandemic guidelines and publicly disparaging their qualifications.

The research appears in the American Journal of Public Health.

The research team interviewed leaders from 18 geographically and politically diverse states. Participants were from suburban and rural areas and included local and state leaders.

The good news? The research team identified some successful strategies officials used, approaches that could inform future fraught moments in public health leadership. Particularly in smaller areas, officials often had deep ties to the community and knew the people making threats and creating other challenges, Moser Jones said. Sometimes, they had success bringing upset community members or small business owners to the table for conversations or calling opponents and talking it through.

Amy Fairchild, senior author of the study and a professor at the University of Minnesota School of Public Health, said some health officials who weathered backlash involved local businesses in decision making. “They understood that they needed to explain not only the science but acknowledge the painful tradeoffs at stake and explain the rationales behind these tough decisions,” she said.

The researchers, whose work with public health leaders is ongoing, have identified some potential policy approaches as well, including:

• Criminalizing doxxing, the act of publicly revealing private or personally identifiable information about someone online without their permission. (In many cases, officials’ addresses or phone numbers were shared online to encourage organized backlash.)
• Requiring boards of health members to have backgrounds related to the field.

Outside of policy approaches, Moser Jones said health officials may build bridges outside a pandemic by building relationships with different groups in the community who have different values and viewpoints.

The project received funding from the Commonwealth Fund, the Mellon Foundation and the National Science Foundation.

The original version of this news article appeared on the website of Ohio State University’s College of Public Health