The Experience of US Public Health Officers During the COVID-19 Pandemic as a Prelude to the Current Political Backlash Against Public Health: Canaries in a Backlash Coal Mine.

Abstract

The COVID-19 pandemic served as a catalytic opportunity for preexisting social and political forces to gain a foothold that unleashed a serious and sweeping backlash against public health. These forces fuel ongoing public health backlash and feed a broadening politics of backlash against the authority of the protective state. In this article, we describe backlash as a historically rooted political concept that helps to reconceptualize public health's pandemic experience. We use it to systematically code and analyze a unique and rich sample of oral history interviews with 109 public health officials (PHOs) from 18 geographically and politically diverse states during the COVID-19 pandemic. In each selected state, we interviewed PHOs who led departments in the largest 1 or 2 cities, local counties or districts serving rural and suburban areas, and at the state level. This study, which demonstrates how backlash operated in the context of public health, points out specific ways PHOs and health departments remain at risk for growing and increasingly severe backlash now and in the future. (<i>Am J Public Health</i>. Published online ahead of print September 10, 2026:e1-e12. https://doi.org/10.2105/AJPH.2026.308614).