Defunding Public Health? One County Tried. It Didn’t Go Well.

America Dissected is brought to you by the DeBeaumont Foundation. Good communication is the first step to good health. Improve your health communication in 2024 with the practical tips in Talking Health. A new way to communicate about public health. A book from the DeBeaumont Foundation.

This book will help you define public health more clearly, reframe common assumptions, avoid messages that backfire, and bring data to life through storytelling. To learn more, visit talkinghealthbook.org.

The CDC is considering eliminating the five-day isolation period following the COVID infection. A new malaria vaccine begins to roll out. in Cameroon. Two studies cited in a Texas judge's decision to ban medication abortion have been retracted. This is America Dissected.

I'm your host, Dr. Abdul El-Sayed.

Since the murder of George Floyd, there's been an ongoing call by activists and some politicians to rethink the choices we make about how to invest public funds. Perhaps, rather than invest so much money in buying military-grade weapons to deploy into our streets, we might instead figure out how to deploy social workers to the scene of domestic disturbances, or, better yet, figure out how to address the cycles of poverty that sit at the heart of too many of them. The redeployment of civic resources away from punishment and toward public welfare, that idea got absolutely demagogued by MAGA types. And it led even the most progressive elected officials to cower away from those kinds of policies. Mind you, all of this was in the wake of one of the most horrific acts of police murder ever recorded.

I raise this because it's a helpful contrast to our story today. You might not know it considering the political tenor of half of our country's population, but there was a pandemic in which more than a million Americans died in the span of three years. And at the forefront of that response were local health departments. You know, the ones that are underfunded because of how we spend civic resources. Yeah, those guys.

Over 3,000 institutions working nonstop in their local communities to trace infections, deploy vaccines, and educate the public, all while balancing the rest of their day-to-day responsibilities, protecting us from all the other diseases that affect us. The pandemic was no cakewalk for any of us. It was a brutal moment on our history, one that none of us ever want to relive. But the politics of our moment did something strange. Rather than orient us around the means of preventing the next pandemic from ever happening again, they did the exact opposite.

Donald Trump utterly failed the test of the pandemic. He failed to manage the vast federal public health apparatus at the outset. He failed the basic test of presidential leadership in communicating with the public about what was happening. And though his administration did spur the research and development needed to create a vaccine, they failed to create a plan to coordinate deploying vaccines in the earliest days. But rather than take responsibility for his failure, Trump and his acolytes turned their MAGA movement against the very institutions that could hold him accountable, the institutions of public health.

They spun conspiracy theories, blaming public health officials for COVID's origins or demagoguing vaccines as a tool for global takeover. And even as we emerge from one of the worst public health disasters in the last century, a whole half of America's public has turned against the very institutions that can protect us. It breaks the mind to have to think about. Police can murder someone, but we should make no effort to rethink policing. And, on the other hand, public health saved lives, but we should defund it?

Make it, make sense. You can't. And so today I wanted to bring you a story about what defunding public health looks like. Because it's one thing to talk about in the abstract, it's another entirely to look it in the eye, to talk to the folks who are set to lose their livelihoods, all for the crime of staring down the worst pandemic in a century and protecting their communities from it. Ottawa County is home to nearly 300,000 folks in suburban West Michigan.

Like many communities in that part of the state, it is staunchly Republican. It has been seemingly forever. And yet until recently, it had one of the state's best functioning public health departments. Then the 2022 midterms happened. It saw a MAGA takeover of the County Commission.

And item one in their agenda, installing an HVAC repair guy and avid Facebook anti-vaxxer as their new health officer. Except that the state public health code requires a health officer to have some basic credentials in public health. And, needless to say, Facebook anti-vaxxer guy isn't one of them. The public health code also stipulates that you can't just fire your health officer because you don't like public health. The county's actual health officer, Adeline Hambly, put her foot down, setting up an epic showdown over the future of the county's health department.

But that didn't stop the commission from trying to flatline the county's budget for public health, cutting vital programs across the county, including a critical food access program that served thousands. It turns out that defunding public health hurts people. Who'd have thought? Today, I wanted to sit down with the public health leaders at the heart of the fight to protect public health in Ottawa County, health officer Adeline Hambly, as well as the department's deputy director, Marsha Mansoury. They joined me to describe what happened, how they fought back, and what it means for the future of public health in counties like Ottawa across the country.

Here's my conversation with Adeline Hambly and Marsha Mansoury. Can you all introduce yourself for the day?

Take us back to those bad old days in 2020, 2021.

. What's going on? Obviously, there's a raging pandemic, but give us a little bit about the context and the way that it was experienced in your community.

And people were scared, and we actually felt like we had a lot of support and compliance, and people wanted to do whatever they could to stay safe. And that changed over time. And I think Marsha can probably speak to that more. She was in the deputy role when things, we didn't have that support in the community. And I know that she was far more involved with some of the negative impact and blowback that we had for school closures and some other things, mask mandate in our schools.

And I had what turned out to be the unfortunate.

consequence or coincidence, I guess I should say, writing a cease and desist order for Libertas Christian School, which happened to be Joe Moss's children's school. And he's also on the board of, and the foundation for, and he is now the chairperson of the board of commissioners in Ottawa County. He became angry at that moment when we received in all total about 15 complaints about this teeny tiny school. And I might get maybe one or two for a huge public school district. And so it was pretty serious.

People were pretty scared. They didn't want to tell their names. There was a lot going on there. And I started working with the school and with the headmaster, and we just were not getting anywhere. And they felt that to mask or not to mask was a parent's decision, and they would not enforce that at their school.

They set that point blank. Although I was pretty sure they had rules that they did enforce, but not that one.

And that return to school after like the aborting of what would have been the 2019, 2020 school year, the beginning of that fall of 2020 was one where there were a lot of really hard decisions to make. And a lot of those decisions were actually, actually ended up being made at the state level to be enforced at the county level. And you have this beginning of a pushback, sort of driven at the top of a, we'll just call it an anti-science.

deeply right-wing movement. And you're starting to hear a lot more and see a lot more conspiracy theory type stuff online. And that was this moment. And now you're in a position where you have to enforce this mandate and it puts you right up against a school, a private school and a private religious school in a way that sort of sets up this circumstance. You talked about 15 complaints.

Where did it go from there? Walk us through sort of what happens after this first folly in what would turn out to be a much bigger kind of conflict.

I don't know how they're related to the school, but they're related in some way. Can you tell me more about this and explain? is this really true or not? Are you masking, et cetera? So I had a really nice conversation, but they were firm that they were not gonna do this.

And I said, well, you know what? I'm not gonna do anything about this right now, but if I get additional complaints or if there is a situation where we have evidence of an outbreak at your school, I'm gonna have to get a lot more firm and this is gonna change. So hopefully I won't hear any more from anyone and you won't hear any more from me, but it just took a week, I think, before I got another one. And within a month, I would say, I began getting complaints telling me that there were people with COVID-like symptoms, staff with COVID-like symptoms that were at school when they were sick. And so the headmaster felt that they'd had COVID the year before.

So they were pretty much immune in the school. So this was gonna be fine.

When I got that tip, the person left a name for me on an answering machine. And so I was able to look up that name and found out that we did actually have a lab that was positive COVID, but they would not identify their employer. And then I got some additional tips about children and I was able to look them up and their parents were not identifying their school. So these are people that would not have come on our radar because we would search by school or by employer to see if we had something that was getting out of hand. And so there was an agreement, or at least some kind of tacit, something going on and understanding there.

that you don't tell.

But somebody was, people were, they were reaching out to me.

And it became clear that we had someone at the school who had been teaching while they were symptomatic. And we knew that COVID was infectious two days before you're symptomatic. And so I needed to call the school.

And that didn't go very well. And then we got a report of a second teacher that was just a couple days after the first one. So we knew that they were holding chapel every morning, where they would gather in one room, all of the students, so 12 grades, and they would sing and recite things without masks. So I felt that it was a matter of, just a short matter of time before this would happen. But we knew that there would be easy spread throughout the school because there weren't any significant precautions being taken except hand sanitizer was available.

So that began some conversations around, we believe there's an outbreak, we would like your assistance.

and you all are trying to make sense of what these new electoral outcomes are going to mean for you all?

And so when we got to 2022, when the board of commissioners was up for a reelection, that faction of Joe Moss, who has runs a school or is on the board for the school, and some of the other commissioners that he had run under this Ottawa impact umbrella, they ran on the idea the old board needed to be removed, that they were corrupt, that they allowed this to happen, that the board hired her, the board can fire her was the statement that I think was kind of stated over and over with the health officer in regards to the health officer. And this is after the court had already ruled that that's not the case, that the health officer has certain protections under law in Michigan. But they were able to organize and ran. And I think it's important for people to know that Ottawa County is a very, very Republican County, that people vote Republican. And I think it's been since, I don't know, 100 years since there was a Democrat that was voted on by the county or won the votes.

So they were able to run a pretty organized, well-branded, they all looked at, all the materials looked the same. Again, they ran on this anger for public health and personal freedoms and against vaccines.

and parental rights, I think was something that came up a lot. But when they were able to run because of that Republican history and a lot of people just voting Republican ticket when they ran as the primary, they were able to primary the other commissioners. And so even by the time we got to November for the election, there weren't even opposite, there wasn't another candidate available to in that race in certain areas. So it was a challenging time. And I can say that our long-term health officer, Lisa Stofanowski, who was involved with Libertasin, had issued the order for closure, announced that she was gonna be retiring.

And so the health officer position was posted and they did a national search in the fall and we had a hiring panel and we went through all of the, I went through all of this interview process and was hired on in the board cause in Michigan. there you have to be approved by the state for the position cause. you're an officer of the county, you're not just an at-will employee. And that went through in December. And then immediately on January 3rd, when this new board was sworn in and took an oath, they immediately voted to demote me from my position and appoint someone that was.

similarly anti-science and anti-vaccine into the role.

And much of what brought this person to the commission's attention was, in effect, just their social media posting about vaccines, masks, et cetera. So you got HVAC, I'm not, I'm just gonna step back. Let's just say like whack HVAC guy. And they're trying to replace someone who's come up the ranks of the public health department, knows the county with whack HVAC. And this is when the story starts to really sizzle.

I mean, I remember this is when I heard about it. And I live on the other side of the state. Spent quite a bit of time in Ottawa County back when I was wearing a different hat. But it was kind of wild. And what was crazy about it was, from my vantage point, this is a whole county commission that wants to defund public health.

I mean, like that was their explicit goal. From the top on down, they wanted to install someone who had no business being a health officer and cut funding to a department, because that department was trying to protect people from the pandemic. And, Sarah, I imagine that at some point, this is when you enter the scene. Can you tell us a little bit about your experiences with this whole situation?

And they had made a lot of threats like this one. I have to say that I did not think they would take any action against the health officer, since those legal issues had really been decided with respect to this particular county. So I didn't think they would directly attempt to violate the law in the manner that they did. I mean, we all knew they would fire the DE&I director. They had talked about that.

We knew they were probably gonna fire the county administrator, the county attorney, but the health officer is protection under public health code. And I didn't think they would do that. So I, like the rest of the county, was pretty surprised. Even though I was anticipating something along these lines, I was pretty surprised by the bloodletting in their first moments, in their first meeting on January 3rd, when they started this coordinated firing left and right of people. And so I was not surprised when I started to hear from various employees of Ottawa County about employment level concerns.

And that is when I first met Eddie and Marcia.

They're dedicated to thoughtful craftsmanship that stands the test of time and looks good doing it. Article offers fast, affordable shipping across the U.S. and Canada. Plus, they won't leave you waiting around. You pick the delivery time and they'll send you updates every step of the way.

Article's knowledgeable customer care team is there when you need them to make sure your experience is smooth and stress-free. Article's offering our listeners $50 off your first purchase of $100 or more. To claim, visit article.com.ad and the discount will be automatically applied at checkout. That's article.com.ad for $50 off your first purchase of $100 or more. Did you know that less than half a percent of all philanthropic funding goes to Native American causes and only a fraction of that reaches Native-controlled organizations?

Native leaders are sounding the alarm and demanding change in a powerful new anthology called Invisible No More, Voices from Native America. The book features stories of various Native nations, highlighting the continuous pursuit of justice. It delves into the historical and present-day consequences of genocide and settler colonialism, as well as the theft of Native land and resources. These issues contribute to the racialized concentration of wealth in philanthropy and beyond. This month, join the Marguerite Casey Foundation Book Club, reading for a liberated future, for an important conversation with some of the essayists featured in Invisible No More.

Sign up to join the club for free today and tune into this virtual event honoring the release of Invisible No More. Sign up at caseygrants.org slash book club, that's C-A-S-E-Y-G-R-A-N-T-S dot org slash book club, and save the date to join the conversation on Wednesday, February 21st, at noon Pacific, 3 p.m. Eastern.

Marcia, you'd been in your role for some time. Yeah. As you learned about what the commission was planning to do, what was going through your mind? Walk us through some of their plans and what that would have meant for folks, or what that means for folks in Otto County.

And people were crying, all throughout the county, but they were crying at the health department. And gosh, these are people that we love and work with and have worked with for so long and have worked so hard together during COVID. We're sort of like battle-worn and tested and real comrades. And I knew how vulnerable that we all would be right now. And if Adeline lost her seat, I just, I could not imagine what was gonna happen to the community.

I was worried about the public health code in Michigan.

And I was worried about the decades that were spent in establishing a wonderful culture in the community and in the department, with experts that were so committed so that in this heavily conservative and Republican community, people would come from other communities in Michigan and say, holy cow, like you guys are so conservative. All I can see are churches, but you do really progressive things, really innovative things to help your community. And I just saw that vanishing, just my whole career, a legacy, the legacy of the woman who had been there for 32 years, right before Addie.

And we all worked together. One thing I knew, though, that Adeline Hambly was smart, experienced, wise, measured, and super brave and super ethical. So I felt very, very comfortable like walking through this with her. And I knew that, like we would see things eye to eye and we could maybe get through this, but I didn't know what was gonna come and I was frightened. And I, yeah.

And then she did something unexpected, but it took a few weeks, and I did something unexpected that took a few weeks. And it was probably because of the courage that Sarah Howard gave us.

And so I thought it could happen.

When it did, it was, yeah, it was a little bit of a scramble. Again, I think it's really important, coming out of COVID, we had staff that would work so many hours, so many hours to try and protect their community. I think it's important to note that the staff that we have, they're highly educated, highly trained, in high demand fields. Nurses can go to a hospital system around here and get a huge signing bonus and another job. but they stayed here because they were committed to their community and they felt like what they were doing mattered.

And so, to come out of COVID, everybody's feeling a little battered. To have that immediately happen was just terrible for the morale of people that are really trying to help their community. And so, as that unraveled, I think that we had a brand new administrator who had never been an administrator, who was also a sort of John Gibbs, who had lost his current congressional race that they installed. And so there were these meetings that happened in the first little bit after this, and there was nothing done as far as leadership wise, as far as the board or anything else, to reassure any staff in the county. So, and of course, the board members and the administrator had no experience at county government, so even knowing how anything ran.

So it was, I don't know, uncharted water and there was just no boundaries, it didn't seem like. I think I routinely got referred to as interim health officer at that time that they were gonna submit for the HVAC. I think he was a safety, HVAC safety person who they appointed or tried to appoint to my role. And then, as things went, I had been in discussions with Sarah pretty immediately as that happened, because Marsha and I are familiar with the public health code. Again, I think I've seen in the news around here, it should be noted that I think that I'm some activist operative and I think it's really important to note that I've been at the county for almost 20 years now and started as an inspector and worked my way up.

So certainly if I had that level of like soothsaying, I would probably be wealthy enough that I wouldn't be working if I can see 20 years in the future that this is my secret agenda. And it's insane that I think the public health is, especially the public health officers, not political, right? We should be making science-based decisions that are the best decisions to prevent spread of disease. And so to have be tossed into this political waters and to be like a political punching bag is a challenge. And then when you defend yourself with science or good public health practices, it's interpreted as being political.

So it's been a challenge, and all of the time and energy spent, I'm a lifelong resident of this area too. So I'm invested in helping the community. It's just, so to have, in those first, that first month, to have that all questioned or accusations leveled that you aren't or that you are something completely different is a challenge. And at one point, I believe, because of that, there was a meeting changed to a weird time. And I think the new attorney that again, I believe, is some sort of family friend or relation to Joe Moss invited to that meeting is when I had given Sarah a heads up, that I think I'm gonna be fired today because it was just enough weird circumstances.

And so Sarah was, that's our first action that we took in court was to have some protective order in place so they couldn't remove me from my position. So that was kind of the first step.

The county government, through the commission, typically hires the health officer. The state department of health and human services has to approve of the qualifications of the health officer. And once they're hired, they have a number of independent powers to enforce the public health code. And that is because sometimes they are doing things that are incredibly unpopular, not just pandemics. They deal with all kinds of things that have the ability to create controversy.

And so they're subject to a just cause standard. They can only be fired for a good cause. There's a number of different misconduct, malfeasance, neglect of duty in the statute. And you have to provide due process to the person who's been accused of those things. And so when they demoted her on the first day and said, she's the interim, now, we're appointing this other individual.

We've held no interviews. We've not posted the position. We have not fired Addie. We've not found anything wrong with what she's done, because we've been in the job for about an hour at this point.

That is under the law, that's a termination. by saying she's going to be terminated. She's the interim, and we've hired this other person with no public interview, no posting at the job. We're just announcing to the public who he is. And so when they did that, they immediately violated the public health code.

You cannot remove a public health officer like that without a hearing and without just cause. And it became clear to me that what I think the immediate plan was, was to install this person to whom they'd promised the job, and have, Addie, do a lot of the work of the job.

And he would be the political figurehead and she would be doing a lot of the actual work of the job. And they were picking fights with the public health department regularly and over a lot of things besides the pandemic. So a lot of cultural issues that they felt the public health department was involved in was there began to be signs of immediate conflict all over the place.

And Marcia did an amazing job of analysis. Marcia is an Epi by trade. So her data analysis is top notch. And so she provided a bunch of data on our funding history and our over the years and showed that what they were proposing to go back to was pre-2001 numbers. And so some of the things that I think were originally proposed to cut, they wanted to cut immunizations, they wanted to cut STI testing or STI program, things that are mandated and enshrined in law in Michigan to be provided.

So, and then there's funding requirements around those. What was originally funded, I guess what we ran into over and over again is no matter how much information, data, rules, statutes, MCLs, mandates that we would try and explain and educate on it was not seemingly believed or heard. And so the funding that originally was suggested by Chair Moss was two and a half million dollars total from the general fund. And so that amount happened to be low, so low that it was beyond below our thresholds for all these minimum funding requirements that the state has for, to be a health department in Michigan, for Ottawa County. And so, after numerous times of trying to educate about that, Chair Moss put out his own PR, I suppose, about two and a half million, and this is where the budget's set.

And so at that point, we responded through our social media channels and my opinion as the health officer that this is a threat to public health in the community, and I have a duty to communicate that threats to public health, to the community under the law. And so when the funding proposed is going to close the health department and two and a half million would close the health department, we would no longer qualify for all the state funds for our mandated programs, we would no longer be able to operate, we would have to close. And so the loss of a local health department in the community is certainly a threat to public health. So now, when we communicated those things, eventually we did get our funding, at least they kind of moved back up to the minimum, the very minimum amounts that are required in order to receive that funding. So, but in the, I guess, in the course of that, they were not pleased about us communicating with the community, again, which we're, as health officer, I'm required to do in the law, and removed all of our access to all those communication channels as well.

So.

They're either brand new to our health department. They've never worked in public health before or they've been promoted because someone has left. So smart health departments in Michigan and surrounding states went, oh, out of county people. And so some of our staff went and got promoted and got great jobs elsewhere at the state and other health departments because they don't have protections. A union was started for the hourly staff.

It's not been ratified yet, but it puts some bit of some breaks on what the commissioners are trying to do. But our supervisors, our managers, our directors, they don't have that. And it's an at-will state. And so they knew that if the board felt they could get away with it without significant lawsuits, they would fire them.

And it's seems especially cruel in the fact that it does not seem as though there was ever any intent to approve the funding. I think a perfect example of what we're against here is that we had a suicide prevention grant, for it was man therapy. It was for educating and specifically targeting men, for to help prevent suicide. And so the grant that was ultimately turned down because one of the commissioners found a link to the Trevor Project, which is a suicide prevention for LGBTQ youth. And so, besides the fact of, like the staff, getting attacked anytime they go in front of the board, it doesn't leave people feeling like they're able to do the work they wanna do to help their community, when what is essentially being said is that, well, we can't support preventing suicide in men because it might also prevent suicide in LGBTQ youth.

I mean, that's essentially what's being said. And it's like, if you're truly a public servant that wants to serve your community, how do you do that in an environment like that? And so I think it's not just us, it's like these other things like that. Going to Pride Festival to, again, help people and be called groomers and pedophiles. I've never seen anything like this ever.

this has been from the relative vantage point that I have as a fellow health officer in the state. It has been quite a cautionary tale and there's a lot that I personally have learned and I think the public health community in Michigan has learned. But as you reflect on your experiences, what do you think are the real lessons about the risks of this moment for the broader work of public health, both in Michigan, but, most importantly, across the country?

When you have people that don't have goodwill, who don't feel that everyone belongs or that everyone deserves services, those loopholes are dangerous.

Whether you're a person of color, you're LGBTQIA, identifying, you're a person of minority faith or no faith at all, you're a woman. All of these groups haven't had the same kind of representation. But it's a new thing. to actively try to pull away the arms of government that are intended to protect the most vulnerable people. Like this is a pretty new thing, at least in the United States.

A lot of failed protections have existed, but this level is pretty new. And I don't say it's unparalleled in American history. I mean, we all have read our history books, or we all should have read our history books when it came to the rights of women and enslaved people and the Reconstruction period. But we're seeing a sort of resurgence and in our lifetimes, this is certainly new. And it is a scary thing to think about what it means to take the next step, right?

It's one thing to say, we're not gonna fund a grant that prevents suicide because it links to protections for LGBTQIA people. But that is the next step, right? And it feels like the next step is explicit targeting. And so there's huge amounts of bravery on your part to stand in and say that we're gonna continue to fight for a government that protects people, even when its elected officials are actively trying to do the opposite. And it is a really important message that you all send, because, unfortunately, Ottawa County is not unique in this country.

There are a lot of other communities, you mentioned school boards, that could face very similar dynamics and will put public health in the crosshairs.

As we step out, and I always wanna finish these conversations with a word of hope. And I wanted to ask, in this moment, you all are obviously standing in and you're facing the challenge. What gives you hope in this moment?

And I mean, we had people rally around us for the budget. We had people protest, I think, at the hearings. And I think you're seeing it now, with people announcing candidacies to run against these auto impact commissioners in the next election. I don't know that we've really ever had multiple candidates in our commissioner races. So the level of engagement from the community has really been a positive.

the fact that they show up at commissioner meetings with, nevertheless, she persisted, T-shirts and public health signs, and they're willing to be seen protesting, knowing that they're vulnerable, their jobs, their livelihoods, their families, their mortgages are vulnerable, is makes me so proud, makes me so proud of them.

And obviously, you got friends out in Wayne County. So we appreciate you, grateful for what you're doing and grateful that, in the midst of all this, you take the time to share your experience with all of us. Our guests today were Adeline Hambly, Marsha Mansourie and Sarah Howard. Adeline and Marsha are officials with the Ottawa County Public Health Department, and Sarah Howard is a civil rights attorney based in Grand Rapids. Thank you for your time and for joining us today.

The physics of this virus hasn't changed. It remains a highly transmissible, highly deadly virus. Now, someone might argue that influenza is as well. And to that, I'd say we do a lot better to have better isolation protocols for flu too. So what is motivating this?

Pressure from business groups who wish people would just come to work already. And there are two obvious issues with that logic. First, business groups shouldn't be making decisions about public health protocols. Sure, they're an important stakeholder, but caving entirely to their pressure? That would have led us down some dark paths in public health.

You know who really didn't want to see child labor laws? Yeah. But second, do you really want people to come to work and risk getting yet more of your workforce ill? Because there or not there, sick people don't do their best work. And as someone who runs a large organization by day, I really just don't want my sick employees coming to work.

Please stay home, get well, come back when you're healthy again, because I don't want to catch your illness and neither do any of your coworkers. I'd hope that, rather than try to bring COVID in line with recommendations for other illnesses, we'd use this opportunity to right-size our workplace policies based on what we learned during COVID. But hey, late stage capitalism, am I right? You probably haven't heard this news, which is why I'm sharing it. Cameroon began to roll out the new malaria vaccine, which can cut the risk of malaria by 75% over a year.

They're the first country, outside of the initial pilot program, to bring vaccines to their people at scale. Malaria takes tens of thousands of lives a year, mainly of poor children. For decades, the quest for a vaccine has been inconclusive, until now. This is a game changer. But there's always a catch, and that's that people actually have to take it.

Needless to say, we don't have a great recent history, with new vaccine rollouts, and the endless demagoguery over the COVID vaccines, coupled with the overwhelm of the public health infrastructure in lower-income countries, it's led to far lower rates of baseline vaccinations. So we'll wait and see, but with bated breath, because this could save tens of thousands of children's lives. Last week, Sage, the publisher of both the journal's health services, research and managerial epidemiology, retracted two studies cited by Texas District Court Judge Matt Kaczmarek in his ruling remanding the APA's nearly quarter-century-long approval of the medication abortion drug Mifepristone to take it off the market. The ruling has since been stayed, pending an ultimate decision by the Supreme Court. The studies were plagued with, and I quote, fundamental problems with the study, design and methodology, unjustified or incorrect factual assumptions, material errors in the author's analysis of the data, and misleading presentations of the data that demonstrate a lack of scientific rigor and invalidate the author's conclusions in whole or in part.

The decision, along with the spate of recent high-profile retractions, highlights the fragility of the academic literature. Ideologues and corporations have long exploited the porous peer-review process to pack journals with bunk or skewed studies to then be able to cite them as objective evidence. So I'm glad the publishers did the right thing here, but I'm not glad that they continue to profiteer off of a publishing industry that's so gameable by ill-motivated people. Come on, do better. That's it for today.

On your way out, don't forget to rate and review. It really does go a long way. Also, if you love the show and wanna rep us, drop by the Crooked store for some America Dissected merch. Don't forget to follow us at Crooked Media and me at Abdul El-Sayed, no dash, on Instagram, TikTok, and Twitter.

America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producers are Tara Terpstra and Emilic Frank. Charlotte Landis mixes and masters the show. Production support from Ari Schwartz.

Our theme song is by Taka Sazawa and Alex Uviera. Our executive producers are Leo Duran, Sarah Geismar, and me, Dr. Abdul El-Sayed, your host. Thanks for listening.

This show is for general information and entertainment purposes only. It's not intended to provide specific healthcare or medical advice and should not be construed as providing healthcare or medical advice. Please consult your physician with any questions related to your own health. The views expressed in this podcast reflect those of the host and his guests and do not necessarily represent the view and opinion of Wayne County, Michigan, or its Department of Health, Human, and Veteran Services.