Verbal harassment was the most frequently reported experience. A total of 69.67% of surveyed operators said enforcement personnel had made them feel less than human, while most reported being shouted at, sworn at or insulted. Physical assault was reported by 24.6% of respondents, and sexual harassment by 4.1%. Demands for bribes were also widespread, with 78.69% reporting such demands. These figures describe the experiences recorded in the operator survey; the abstract does not provide details about survey dates, recruitment, question wording or statistical uncertainty around the percentages.

The authors interpret the survey alongside the officers’ accounts as showing that roadside enforcement cannot be characterized simply as interactions between powerful officers and powerless drivers. The focus-group material indicated that harassment could run in both directions, while bribery could range from a coerced toll to a transaction chosen by the operator. The researchers also report repeated bending of enforcement through elite interference. Drawing on theories of state-produced informality, street-level discretion and political economy, they propose a “discretion in exception” model to explain how unaccountable discretion within a weakly regulated environment may contribute to these outcomes.

The study offers an empirical account of what enforcement encounters can look like for informal transport workers in one Nigerian city, while also presenting a framework for examining relationships between police authority, discretion and informality. Its stated contribution includes documenting the bidirectional and elite-influenced character of Nigerian roadside enforcement and demonstrating how complementary data can be used to study a population that the authors describe as previously unmapped. However, this report is based only on the accessible abstract rather than the full article. The limited information available prevents assessment of the instruments, analytical procedures, subgroup patterns and broader generalizability, and the reported associations do not by themselves establish the causes of harassment, bribery or assault.

Subject of Research: Mixed-methods analysis of law-enforcement encounters experienced by informal transport operators in Ibadan, Nigeria

Article Title: The dynamics of power and vulnerability: an analysis of law enforcement interactions with informal transport operators in Ibadan, Nigeria

Article References: Akogun, O., & Popoola, A. (2026). The dynamics of power and vulnerability: an analysis of law enforcement interactions with informal transport operators in Ibadan, Nigeria. SN Social Sciences, 6(9), Article 381. https://doi.org/10.1007/s43545-026-01673-5

Image Credits: AI Generated

DOI: 10.1007/s43545-026-01673-5

Keywords: informal transport, road enforcement, harassment, bribery, police, Nigeria, Ibadan, mixed methods, street-level discretion, dynamics, power, vulnerability

The concept of psychological safety originated in the business literature, first described by organizational psychologist Edgar Schein and later popularized by Harvard professor Amy Edmondson, whose 1999 research showed that teams learn better when members feel safe to take interpersonal risks. The idea migrated into graduate medical education alongside competency-based training, interprofessional education, and the growing emphasis on diversity, equity, and inclusion. A parallel concept, the microaggression, was first defined by psychiatrist Chester Pierce in 1970 and popularized by psychologist Derald Sue in 2007, who described these as brief, everyday exchanges that send denigrating messages to individuals because of their group membership. The review underscores that microaggressions directly corrode psychological safety, silencing the very diverse perspectives that inclusive programs claim to want. In 2023, the Accreditation Council for Graduate Medical Education formally elevated psychological safety to a core principle of residency training, giving the concept regulatory weight.

The stakes are far from abstract. A widely cited 2018 survey found that 38.5 percent of residents experienced burnout symptoms weekly and 4.5 percent reported suicidal thoughts within the previous year. Residents who faced discrimination, abuse, or harassment at least a few times per month were significantly more likely to experience both burnout and suicidal ideation. The review also draws on evidence linking psychological safety to measurable performance: psychologically safe learning environments improve resident performance and have been associated with better patient outcomes both inside and outside the operating room. In surgery, where a junior team member’s hesitation to question a supervising surgeon can mean the difference between a caught error and a patient harm, the clinical consequences of silence are particularly acute.

To assemble the evidence base, the authors conducted a three-phase PubMed search covering US-based literature from 2014 to 2026, following the SANRA guidelines for narrative reviews. The first search targeted psychological safety in surgery and yielded 17 included articles from 88 abstracts; the second examined the intersection of well-being, DEI, and surgery, contributing 9 articles; and the broadest search on DEI in surgery added 20 more, with 8 additional studies identified through reference mining. The final synthesis comprised 12 quantitative surveys, 4 qualitative studies, 6 mixed-methods studies, 4 cohort or database studies, and 12 review articles, with the remainder consisting of perspective papers and program descriptions. The authors acknowledge the inherent limitations of the narrative design, including single-reviewer screening and the possibility of selection bias, but argue that the heterogeneity of the field, dominated by qualitative and perspective work, makes narrative synthesis the appropriate tool.

The barriers the review identifies cluster into three interlocking systems. The first is hierarchical culture. A qualitative interview study of surgical trainees identified four recurring threats to psychological safety: public humiliation, tension around questioning attendings, the culture fostered by faculty, and flawed system factors such as operating room staffing and leadership instability. A national survey confirmed that residents’ comfort in raising concerns to attendings varies with post-graduate year, program culture, and prior experiences with specific supervisors. Even morbidity and mortality conferences, designed as learning forums, can devolve into blame and shame when discussions are unstructured, discouraging trainees from engaging openly. When junior members fear retribution for speaking up, near misses go unreported and the entire team’s performance suffers.

The second barrier is harassment and discrimination, and the numbers are stark. In a national survey, patients and their families were the most frequent sources of gender and racial discrimination, reported by 46.3 percent and 47.4 percent of residents respectively, but attending surgeons were the most frequent sources of sexual harassment and abuse, at 27.2 percent and 51.9 percent. Overall, 72.2 percent of surgery residents reported experiencing microaggressions, most commonly from patients, followed by staff, faculty, and co-residents. Nearly one-third said microaggressions negatively affected their training, and 14.1 percent considered leaving residency because of them. In one national survey, 30.8 percent of residents who reported mistreatment experienced retaliation. Female trainees face implicit biases that actively discourage them from surgery, with higher expectations but fewer role models, mentors, and sponsors, while LGBTQ+ trainees report similar discriminatory experiences that leave them feeling unsupported.

These patterns are consistent across surgical subspecialties and fall hardest on trainees underrepresented in medicine, or URiM. Among vascular surgery residents, 36.3 percent of Asian and 56.3 percent of Black trainees reported racial discrimination. A multicenter study found URiM general surgery residents had higher anxiety, emotional exhaustion, and depersonalization, and comparable disparities have been documented in otolaryngology, orthopedic surgery, and pediatric surgery. In plastic surgery, 68.8 percent of residents reported microaggressions, with higher rates among female, Asian, and non-heterosexual trainees. The cumulative toll is measurable: URiM trainees reported burnout rates of 76 percent compared with 63 percent among their non-URiM peers. Structural barriers compound the interpersonal ones, including weaker academic support, scarce mentorship, social isolation, and the so-called minority tax, the extra emotional labor and time diverse trainees and faculty spend on diversity work itself.

The consequences extend to attrition, one of the most costly failure modes of surgical training. While the proportion of female residents in surgery has improved over the past 18 years, the percentage of URiM residents has remained essentially unchanged. A study of racial and gender disparities in attrition across surgical specialties found that female and URiM residents had significantly higher relative risk of leaving training, with the highest rates among Black and African American residents: 10.6 percent intended attrition and 5.2 percent unintended attrition, compared with 6.2 percent and 1.8 percent among White residents. A weak sense of belonging, which has been associated with non-White race, lower academic performance, and adverse health outcomes, appears to be a key mediating mechanism, creating a feedback loop in which isolation erodes belonging, which in turn erodes performance and retention.

Yet the review is not merely a catalog of dysfunction; it identifies concrete facilitators that programs can implement. Culturally concordant mentorship, pairing URiM trainees with mentors who share aspects of their background, emerges as a key driver of psychological safety, with institutional, national, and peer mentorship models all showing benefit. Structured mentorship has been proposed as a race-neutral strategy for improving networking, and dedicated roles such as chief residents for diversity and inclusion offer novel advocacy channels. On the curricular side, the review highlights Kimberly Manning’s Five Ds Upstander Training, which teaches individuals to Direct, Distract, Delegate, Delay, and Display Discomfort in response to bias, and the Microaggressions Triangle Model, which addresses microaggressions from the perspectives of recipient, source, and bystander. DEI toolkits for program directors changed recruitment practices for 31 percent of directors who used them. Institutional innovations range from Minority Housestaff Organizations that provide liberated spaces for URiM trainees, to embedded psychiatrists in training programs, to proposed Education Ombudspersons whose primary role is fostering psychological safety.

The authors conclude that creating psychologically safe surgical training environments requires deliberate, multifaceted institutional commitment rather than isolated gestures. Leaders who respond to concerns with gratitude rather than annoyance, teams that emphasize interdependence, and faculty trained in inclusive teaching all contribute to a culture where vulnerability is normalized. Programs must recruit and retain diverse trainees and faculty, distribute diversity work equitably to avoid overburdening the marginalized individuals such initiatives are meant to support, and maintain multiple reporting pathways, including anonymous ones, that trainees can trust. Notably, only 32.4 percent of trainees report receiving formal training on managing microaggressions, and over half have received no training on explicit or implicit bias, suggesting an enormous gap between the evidence and current practice. As the review makes clear, psychological safety is not simply a matter of comfort; it directly shapes resident well-being, retention, performance, and the quality of care patients receive, and closing the gap will require sustained, systemic effort across every level of surgical education.

Subject of Research: Psychological safety, well-being, and diversity, equity, and inclusion in surgical residency training

Article Title: Psychological safety and well-being

Article References: Diaconescu, A., Arora, T. K., & Lindeman, B. (2026). Psychological safety and well-being. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 190. https://doi.org/10.1007/s44186-026-00607-2

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00607-2

Keywords: psychological safety, surgical education, resident well-being, burnout, microaggressions, URiM trainees, mentorship, DEI, harassment, attrition, operating room culture, ACGME

The bibliometric half of the study is a feat of patient data work. The team searched the Scopus database for English-language articles and reviews containing the terms “cloud physics” or “cloud microphysics” published between 1970 and 2020, filtered them to Earth and planetary science journals, and winnowed the initial 8,199 candidates down to 6,987 papers. For each one, they extracted author names, affiliations, countries, and funding information, then used an automated Python script together with the genderize.io service to assign a probable binary gender to first authors and co-authors, accepting only inferences with a certainty estimate above 75 percent. The authors are candid about the limits of this approach: name-based inference cannot capture non-binary or gender-diverse identities, and the survey itself confirmed that at least three respondents identify outside the gender binary. Still, the scale of the dataset makes the broad patterns difficult to dismiss.

Those patterns are stark. Women first authors barely appear in the cloud physics literature before the mid-1990s; only after roughly 1997 does their presence as lead authors become clearly visible, and even by 2020 just about 17 percent of studies in the field were led by women. The geographic skew is even more pronounced. Seventy-seven percent of all analyzed papers were led by authors from just seven countries: Canada, China, France, Germany, Japan, the United Kingdom, and the United States. Scientists based in the tropics, defined as those living and working between 23.5 degrees north and 23.5 degrees south, accounted for only about 5 percent of publications, with most of those coming from India, Brazil, Taiwan, Mexico, Indonesia, and Thailand. For a region that drives much of the planet’s precipitation and convection, the numbers amount to a scientific blind spot with colonial roots.

The most provocative finding concerns what the authors call parachute science. Of the 6,987 papers analyzed, only 44 were explicitly performed in the African tropics or used data from that region, and just seven of those, a mere 16 percent, included a tropics-based scientist as a co-author. In other words, when wealthy institutions send researchers to sample the atmosphere of lower-income countries, the local experts who make that work possible are frequently left off the byline. The pattern echoes a broader analysis of the Nature Index, which found that between 2015 and 2022 only 2.7 percent of articles across 82 natural science journals featured collaborations between higher-income and lower-income countries, and that in those articles richer countries contributed three authors for every one from a poorer nation. The study’s authors caution that excluding non-English papers may have shaped this conclusion, but the signal is consistent with decades of documented extractive practice.

The survey data add a human dimension to the statistics. Distributed before the 2021 virtual International Commission on Clouds and Precipitation meeting hosted from Pune, India, the 42-question instrument drew 231 responses, reduced to 198 after quality checks, covering an estimated 30 to 47 percent of the community’s active membership. Respondents skewed young, with 64 percent under 40, and 57.1 percent identified as men, 41.4 percent as women, and 1.5 percent outside the binary. Twenty-three percent of respondents identified as belonging to a historically and currently excluded group, and nearly half of those, 21 of 46, said that identity had negatively affected their careers through collaborations, promotions, publishing, funding, salary, or citations. Ten respondents reported disabilities, and six of them described feeling excluded because of it.

The numbers on harassment and hostility are difficult to read. One third of all respondents said they had experienced bullying or harassment from someone in the cloud physics community, and the burden fell unevenly: 44 percent of women reported such experiences compared with 27 percent of men, a statistically significant difference. Similarly, 37 percent of women versus 10 percent of men reported working in a hostile environment tied to their gender, ethnicity, sexual orientation, or disability, a moderate statistical association. Among LGBTQIA+ respondents, the share who did not feel included in the community rose to 44 percent, compared with 30 percent overall. The authors interpret these patterns through the lens of intersectionality, the framework developed by legal scholar Kimberlé Crenshaw, in which overlapping marginalized identities compound the likelihood of discrimination, while noting that small subgroup sizes limit statistical confidence in some of the finer breakdowns.

Not every result is grim. When the team traced individual Scopus author IDs to measure how long researchers stayed active in the field, they found that after 1995 there was no meaningful difference between men and women in how many years they remained, judging by publication activity. Women are not dropping out faster than men, contrary to the leaky-pipeline narrative that dominates discussions of academic gender gaps. The problem, instead, is at the entrance: even in the most recent five-year cohort, between 2015 and 2020, only about a third of scientists newly entering the field were women. The authors also found that papers led by women were published in journals with impact factors statistically comparable to those led by men, whereas papers from tropics-based scientists landed in lower-impact journals on average, a gap the authors link partly to language barriers, editorial desk rejections, and pressure to publish in local, non-indexed venues.

One intriguing secondary finding suggests a practical lever for change. Papers led by women included a better balance of women co-authors than papers led by men, mirroring a recent result from ice-core science showing that women-led studies had 20 percent more women co-authors. Tropics-based first authors likewise tended to bring in other tropics-based collaborators. Whether this reflects deliberate mentorship or homophily, the implication is the same: who holds the lead-author position shapes who else gets included. Putting more women and more scientists from the Global South into senior and leading roles may be one of the most direct mechanisms for diversifying the authorship base of the field, which in turn feeds into who designs the field campaigns and whose data enter the models.

The stakes extend well beyond fairness. The tropics host extraordinary biodiversity, biomass burning, dust emissions, and the vast convective systems of the Intertropical Convergence Zone, yet input observations for climate models are often calculated rather than actually sampled there. Excluding the scientists best positioned to collect those measurements is both an ethical failure and a scientific one, degrading the very data needed to validate satellite retrievals and improve projections for the regions already being hit hardest by climate change. The authors argue that an equity-centered approach, grounded in ethical responsibility rather than a business case for diversity, is what the moment demands, a stance aligned with the International Association for Promoting Geoethics.

The paper closes with concrete recommendations: institutional diversity training that extends beyond recruitment, funded participation of Global South early-career scientists in major conferences, unconscious-bias training for reviewers, gender-balanced hiring and editorial boards, journal policies against parachute science, and funding priorities for projects conceived and led by tropics-based researchers, alongside support for networks such as the Latin America Early Career Earth System Scientist Network and the cloudsfor.africa initiative. The journal’s editor went further, writing that the findings concern all of geoscience and deserve to be read by every geoscientist. For a community whose models must describe the whole planet, the message is unambiguous: the science of clouds cannot be done well by a fraction of the world’s scientists sampling a fraction of its sky.

Subject of Research: Diversity, equity, and inclusion in the cloud physics research community

Article Title: The state of diversity, equity, and inclusion in the cloud physics community

Article References: Ladino, L. A., Ardon-Dryer, K., Pereira, D. L., Proske, U., Ramirez-Diaz, Z., Velicu, A., & Kanji, Z. A. (2026). The state of diversity, equity, and inclusion in the cloud physics community. Geoscience Communication, 9(3), 415-436. https://doi.org/10.5194/gc-9-415-2026

Image Credits: AI Generated

DOI: 10.5194/gc-9-415-2026

Keywords: cloud physics, diversity, equity, inclusion, geosciences, parachute science, gender gap, Global South, tropics, bibliometrics, harassment, climate science

The scale of the underlying literature is staggering. The researchers searched four major databases — PubMed, Scopus, Web of Science, and APA PsycInfo — from their inception to July 23, 2025, and identified 11,260 records. After independent screening by two reviewers at both the title-and-abstract and full-text stages, 111 studies met the inclusion criteria. The methodological framework followed the classic approach of Arksey and O’Malley, refined with guidance from the Joanna Briggs Institute and reported according to the PRISMA-ScR checklist, the international standard for scoping reviews. Data extraction used a standardized form, and every factor reported in association with suicidality was classified into one of the four Social-Ecological Model levels. This systematic categorization allowed the team to see patterns that no single study could reveal on its own.

One of the most striking findings is how lopsided the evidence base is. The vast majority of the included studies — 80.2 percent, or 89 of the 111 — focused on medical students, while postgraduate trainees such as residents and fellows were comparatively neglected. Most studies were also cross-sectional, meaning they captured a single moment in time rather than following trainees over years. This design limitation matters enormously: cross-sectional data can reveal which factors are associated with suicidality, but it cannot establish whether a factor causes suicidal thinking, results from it, or simply coexists with it. The authors are explicit on this point, noting that the findings represent a heterogeneous evidence base and do not establish causal relationships. Still, the sheer breadth of the synthesis offers something the field has lacked — a unified map of where the risk factors cluster.

At the individual level, the picture is dominated by well-known psychiatric and psychological burdens. Depression, anxiety, burnout, psychological distress, and sleep-related problems were the most frequently reported factors, appearing in the overwhelming majority of studies. These are not surprising candidates; depression in particular is one of the strongest known correlates of suicidal ideation in any population. But the medical training environment appears to amplify each of them. Sleep deprivation is structurally built into residency through overnight call schedules, burnout is fueled by relentless workload and emotional exhaustion, and the competitive, high-stakes nature of medical education creates chronic psychological pressure. The consistency of these individual-level findings across countries and decades underscores that the trainee experience itself may be a potent generator of the internal conditions that precede suicidal thinking.

The interpersonal level reveals how relationships — or their absence — shape risk. Family dysfunction, poor social support, and harassment emerged as key factors reported across the literature. For trainees who spend long hours in hospitals and often relocate for training, social isolation is a real hazard, and the erosion of supportive networks can strip away one of the most powerful protective buffers against suicide. Harassment, whether from colleagues, supervisors, or patients, adds a corrosive layer of humiliation and threat to an already stressful environment. These findings align with decades of suicide research showing that connectedness to family, friends, and community is among the strongest protective factors, while interpersonal conflict and abuse are among the strongest risk factors. In medicine, where hierarchy is steep and reporting mistreatment can feel career-threatening, these interpersonal dynamics deserve particular scrutiny.

At the community level, the review identified academic pressure, workload, and workplace stressors as the dominant reported factors. This is the domain where the architecture of medical education itself comes into focus: examination systems, duty-hour demands, the pressure to publish, and the culture of perfectionism that pervades teaching hospitals. Notably, the authors observed a temporal shift in the literature. Community-level factors were reported in 27.6 percent of studies published between 2000 and 2015, but that figure rose to 35.4 percent in the 2016 to 2025 period. Individual-level factors remained dominant in both eras, reported in 72.4 percent and 76.8 percent of studies respectively. The gradual increase in attention to community-level drivers suggests the field is slowly widening its lens, moving beyond the individual psyche toward the environments that shape it.

The societal level, the outermost ring of the Social-Ecological Model, exposes forces that individual trainees have almost no power to change. Financial pressures, stigma surrounding mental illness, and barriers to accessing mental health services were the most commonly reported societal factors, alongside societal disruptions such as the COVID-19 pandemic. Stigma is particularly insidious in medicine: trainees fear that seeking psychiatric care or disclosing depression could jeopardize licensure, fellowship applications, or employment. Licensing questions about mental health history in many jurisdictions have long been criticized for discouraging physicians from getting help. Financial pressures compound the problem, with medical students in many countries carrying enormous educational debt while earning little or nothing during training. The pandemic added a further layer of strain, thrusting trainees into overwhelmed health systems at personal risk.

The authors are careful about what this synthesis can and cannot claim. Because the evidence relies predominantly on self-reported data, reporting bias is a real concern — trainees may underreport suicidal thoughts due to stigma or fear of professional consequences, meaning the true prevalence could be even higher than studies suggest. The heterogeneity of study designs and measurement tools across the 111 studies also limits comparability, preventing any meta-analytic pooling of effect sizes. What the review delivers instead is a framework: proof that factors associated with suicidality among medical trainees span all four Social-Ecological domains, and a demonstration that a multilevel lens is both feasible and necessary for organizing this literature. By including both undergraduate and postgraduate trainees, the review also offers a broader perspective across the entire arc of medical training than most previous syntheses.

The implications for intervention are significant. If suicidality among trainees were driven solely by individual pathology, the solution would be screening and treatment. But a multilevel map demands a multilevel response: duty-hour reform and workload management at the community level, anti-harassment policies and mentorship structures at the interpersonal level, destigmatized and confidential mental health services at the societal level, and evidence-based care for depression, anxiety, and burnout at the individual level. The authors call for future research to examine contextual and system-level factors, particularly among postgraduate trainees, using longitudinal and multilevel designs that can finally untangle cause from correlation. Until then, this review stands as both a warning and a blueprint — a demonstration that the path from medical school to suicide is paved not just by personal vulnerability, but by the systems that trainees are required to endure.

Subject of Research: Multilevel factors associated with suicidality among medical trainees

Article Title: Suicidality among medical trainees: a scoping review of multilevel associated factors using the Social-Ecological Model

Article References: Goujani, R., Nakhaee, N., Heidari, M., Rezaei-Gazki, P., Dehesh, P., Abdollahinia, Z., & Haghdoost, A. (2026). Suicidality among medical trainees: a scoping review of multilevel associated factors using the Social-Ecological Model. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08711-9

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08711-9

Keywords: suicidality, medical trainees, medical students, residents, Social-Ecological Model, scoping review, burnout, depression, mental health stigma, workload, harassment, COVID-19

The study, led by Marian Moser Jones, associate professor of health services management and policy at The Ohio State University College of Public Health, with senior author Amy Fairchild, a professor at the University of Minnesota School of Public Health, interviewed 109 leaders from 18 geographically and politically diverse states. The participants came from suburban and rural communities as well as larger jurisdictions, and included both local and state-level officials. The breadth of the sample matters, because it demonstrates that the hostility was not confined to a handful of high-profile coastal cities or particularly contentious statehouses. It reached into small towns and rural counties, places where public health work had historically been conducted with little public attention and considerable community trust.

The headline finding is stark: 76 percent of the leaders interviewed reported being threatened or harassed. The researchers categorized this level of hostility as extraordinary, distinguishing it clearly from the ordinary friction that accompanies any contested public policy. As Jones explained, the backlash being studied is different from people disagreeing about wearing masks or getting a COVID vaccine. This, she said, is true hostility, threats of violence, and the undermining of officials in ways that damage their ability to do their jobs. In other words, the problem documented here is not the healthy noise of democratic debate but a sustained campaign of intimidation aimed at the individuals charged with safeguarding community health.

The specific experiences described by study participants illustrate how menacing that campaign became. One leader recounted the FBI arrest of a person making ongoing, credible death threats, an arrest that brought home the seriousness of the danger when the official learned that the suspect’s house contained more than 100 guns. Another described a persistent stalker, a man she characterized as scary and obsessed, who sent her a picture of someone strangling a child the same age as her own child. A third described coming home from work to find a note taped to the front door threatening to kill the family dog, accompanied by a photograph of the dog taken in the family’s backyard. These are not anonymous insults on social media; they are intrusions into the private lives and homes of public servants and their families.

Beyond the direct threats, roughly half of the leaders interviewed experienced what the researchers call undermining backlash, a form of hostility that made it difficult or impossible for them to function professionally. This took the form of overwhelming their offices with burdensome data requests, repeatedly demanding revisions to pandemic guidelines, and publicly disparaging their qualifications. Undermining is subtler than a death threat, but its cumulative effect can be just as corrosive. An official who must divert staff time to answering hostile records requests, or who must repeatedly defend basic credentials in public meetings, has less capacity to inspect restaurants, track disease outbreaks, run vaccination clinics or support mothers and infants. The study suggests that this second, quieter form of backlash may be at least as damaging to the profession’s capacity as the overt threats.

The consequences for the public health workforce have been severe. Many of the leaders interviewed have retired early or left the field altogether, according to Jones. She noted that politicians expect a certain degree of hostility when they enter public life, but that before the pandemic most public health officials had never been in the spotlight and had never been targets. The experience has been hard on the profession, she said, and the exodus of experienced leaders carries real costs for communities, because institutional knowledge about outbreak response, environmental health, food safety and maternal health leaves with every early retirement and resignation.

Yet the research is not only a catalogue of damage. One of its most valuable contributions is the identification of strategies that some officials used successfully to reduce the intensity of the backlash, approaches that could inform the response to future fraught moments in public health leadership. Particularly in smaller communities, officials who had deep personal ties to the area often knew the people making threats and creating other challenges. In some cases, they had success bringing upset community members or small business owners to the table for direct conversations, or simply calling opponents and talking the situation through. Jones recounted that officials would sometimes say things like, listen, you’re threatening my kids, and that this kind of direct, personal appeal would sometimes turn the temperature down.

Those personal interventions appear to have had measurable effects. Jones said that, anecdotally, promoting civil discourse seemed to cut down on the backlash. It did not stop the hostility entirely, but it helped prevent officials from being fired or forced out of their positions. Fairchild added that some health officials who weathered the backlash involved local businesses in decision making. These officials understood, she said, that they needed to explain not only the science but also acknowledge the painful tradeoffs at stake and explain the rationales behind difficult decisions. The lesson is a technical one about crisis communication: transparency about uncertainty and tradeoffs, combined with genuine stakeholder engagement, appears to build a buffer of legitimacy that pure top-down mandates do not.

The research team, whose work with public health leaders is ongoing, has also identified potential policy approaches. One is criminalizing doxing, the act of publicly revealing private or personally identifiable information about someone online without their permission. In many of the cases documented, officials’ home addresses or phone numbers were shared online specifically to encourage organized harassment. Another proposal is requiring boards of health members to have backgrounds related to the field, a response to communities where, the researchers found, people with little or no connection to public health are calling the shots. Both measures aim at structural fixes: one to raise the cost of coordinated intimidation, the other to ensure that the people overseeing health departments have the expertise to evaluate the professionals who run them.

Outside of formal policy, the researchers point toward a longer-term strategy of relationship building. Jones suggested that health officials may build bridges outside of a pandemic by cultivating relationships with different groups in the community who hold different values and viewpoints. Bringing people who disagreed about the pandemic together around issues that matter to them, such as the ongoing opioid crisis, can be powerful, she said. She also emphasized that there is a great deal of work to do to address the vicious polarization in the country, and that for public health officials, part of that work may involve explaining more clearly why they are relevant: the full range of work they do to keep people healthy, from keeping food safe, to helping mothers and babies, to offering people help quitting smoking. The study received funding from the Commonwealth Fund, the Mellon Foundation and the National Science Foundation, and included co-authors from New York University and Syracuse University. Its central warning is that the canaries in this backlash coal mine, as the article’s title puts it, were public health officers, and that what happened to them during the pandemic foreshadows a broader political crisis that the nation has yet to resolve.

Subject of Research: Post-pandemic harassment and threats against US public health officials and strategies to reduce the backlash

Article Title: Public health leaders report widespread harassment, threats after COVID-19

Article References: Public health leaders report widespread harassment, threats after COVID-19. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: public health, COVID-19, harassment, threats, backlash, health officials, American Journal of Public Health, doxing, civil discourse, polarization, workforce, policy