Hastings Center News

Navigating “Wicked” Disagreement in Public Health

Public health is now facing a kind of disagreement that’s particularly hard to resolve. In the past, people argued about values (“Should the government do this?”) or facts (“Does this work?”). Today, political identity shapes both what people believe is true and what they think is right — making traditional tools like appeals to expert authority or shared values far less effective.

This is “wicked disagreement,” discussed in a new article in the American Journal of Public Health by Safura Abdool Karim, Ruth Faden, Anne Barnhill, Virginia Brown, Jeff Kahn, Nancy Kass, Anna Mastroianni, Stephanie Morain, Vardit Ravitsky, and Reed Tuckson.

They cite the Covid lab leak debate as a prime example. People’s positions were driven more by political loyalty than evidence, and the U.S. government’s official stance changed between presidential administrations. “Under President Joe Biden, scientific agencies reaffirmed natural origin explanations of [Covid] while, under President Donald Trump’s administration, the lab-leak theory has been adopted as the federal government’s official position,” they write.

The authors argue that public health can’t simply wait for the polarization to go away. Instead, they say the field needs to be honest about scientific uncertainty, build relationships with diverse communities before crises hit, and be willing to publicly admit mistakes. The goal isn’t to win everyone over — it’s to remain trustworthy enough to protect people’s health even in a deeply divided world.