When public health is working, it is a nonevent: A 7-year-old does not catch measles because she was vaccinated at school. People in a car crash do not have major injuries because they wore seat belts. A teenager does not get sick from drinking contaminated tap water because clean water regulations have been enacted and enforced.

At Monday’s General Session, “The Invisible Shield: Clips and Conversation,” health leaders talked about this paradox of public health. Inspiring the conversation was a well-received four-part documentary streaming on PBS called “The Invisible Shield,” in which all the panelists appeared. 

“It is a fact that people notice disease and not the (clean) air they breathe and (clean) water they drink,” said Mary Bassett, director of the Harvard Center for Health and Human Rights.

Panelists agree that public health’s behind-the-curtain prevention efforts in keeping Americans healthy and safe leads the field to being undervalued, misunderstood and prone to budget cuts. Public health needs to be more aggressive in self-promotion, they said.

APHA Executive Director Georges Benjamin mentioned the 2023 derailment of a freight train in East Palestine, Ohio, that was transporting hazardous material. Toxic chemicals were released that threatened community health. Public health officials swooped in to evacuate the community, provide clean drinking water because of the possibility the local water supply was contaminated, and take air, water and soil samples to measure toxicity. Media and decision-makers largely ignored the efforts.

“We have to be more visible, and we have to control the narrative,” Benjamin said.

“The Invisible Shield,” created by RadicalMedia and supported by Bloomberg Philanthropies, traces U.S. public health history from the 17th century through the COVID-19 pandemic, showing how measures improved quality of life and increased life expectancy. The series also shows cracks in public health response during the emergency phase of the pandemic, when politics influenced actions and public health protections divided Americans. Distrust and doubt over science hindered uptake of the vaccine. 

Problems during the pandemic were compounded by a public health infrastructure that had been underfunded for decades, the series points out. 

Amy Acton said she learned in her former role as director of the Ohio Department of Health that state lawmakers voting to cut public health funding cared about public health issues — they just didn’t know it. They cared about pedestrian safety, urban green spaces, healthy aging, clean air, clean water, school vaccinations.

“Find the thing they care about, and you start there,” Acton said.

Because of budget cuts, low pay and pandemic stress, the field has lost 50,000 workers in recent years, said Brian Castrucci, president and CEO of the de Beaumont Foundation. About 80,000 workers are needed to meet public health demand, but finding money to pay salaries is a problem.

“If that were physicians, HRSA would give a ton of money,” Castrucci said. “But for us, no one cares.”

Despite the challenges and handwringing, panelists said the rewards of their job are tremendous.

“It is the good fight,” Bassett said. “There is nothing more rewarding than knowing you did something that improves the health of the population. We have something that everyone needs — everyone needs their health.”

Photo: Amy Acton. Photo courtesy EZ Event Photography.