News teams swarm the shore near the MV Hondius cruise ship in the Netherlands in May after hantavirus was diagnosed among some of its passengers. While the outbreak was small and posed very low risk to the general population, fragmented communications and slow information-sharing fed panic.
Photo by Nicolas Tucat, courtesy AFP/Getty Images
A deadly virus appears on a cruise ship. A parasite that feeds on living tissue moves closer to the U.S. border. Thousands of people in multiple states report violent diarrhea.
For Americans checking the news or scrolling through social media, it can feel as if a new public health emergency arrives every few days. The threat may be real, but the coverage often leaves out what people need most: Who is actually at risk? How worried should they be? And what, if anything, should they do?
The nation's public health communication system is struggling to provide clear, consistent and non-alarmist answers in an information environment driven by speed, emotion, fear and algorithms. Cuts to federal health agencies have reduced the number of scientists available to investigate threats and the communicators available to explain them.
At the same time, experts say public health has contributed to its own credibility problems by relying on technical messages that do not always reflect what people care about and how they make decisions.
“The modern communication landscape is so complicated that it is very difficult to both create and receive good information,” said Nathan Orme, public information officer with the Nevada Department of Human Services and president of the National Public Health Information Coalition Executive Board.
Health messaging now reaches people through a fractured mix of traditional news and online voices. When news breaks, only 36% of U.S. adults turn first to a news organization for more information, down from 54% in 2018, according to a 2025 Pew Research Center survey. Another 28% turn first to search engines, 19% head straight to social media and 5% said they turn to family and friends for more information.
“When it comes to public health, the volume of available information from all sources — whether reputable or questionable — makes it incredibly difficult for a consumer who is trying to make good personal choices to know what or whom to trust,” Orme told The Nation's Health.
The difficulty begins with the sheer number of threats agencies must track, from infectious diseases and foodborne outbreaks to environmental contaminants and vaccine- preventable illnesses, according to Glen Nowak, PhD, co-director of the Center for Health and Risk Communication at the University of Georgia and a former director of media relations at the U.S. Centers for Disease Control and Prevention.
“Doing ‘really good' public health communications is really difficult to do under the best of circumstances,” Nowak told The Nation's Health. “And by really good, I mean communication that is timely, relevant and helps people protect themselves and their families from threats to their health and well-being.”
A woman shops for salad in Washington, D.C., in May. As cases of cyclospora grew this summer, federal health officials were criticized on their communication.
Photo by Al Drago, courtesy Getty Images
A frightening threat may require immediate action from one group while posing little danger to most, Nowak said. New World screwworm, for example, is a serious concern for ranchers, farmers, veterinarians and animal owners in places where the fly is spreading. Most Americans, however, face no immediate threat and there is nothing they need to do.
“That's why public health communication must be carefully targeted,” Nowak said. “Information provided with a recommendation, or advice as to what to do with that information, is often what is essential if you want to be an effective communicator.”
But federal, state and local staffing cuts make that work harder, experts say. When agencies lose scientists and epidemiologists, they have less capacity to determine what is happening, where it is happening and who faces the greatest risk. Cuts to communications teams leave fewer workers to update websites, answer reporter questions and explain changing evidence.
Such cuts can leave agencies speaking with less coordination at the very moment the public needs one clear message, said Amanda Kwong, MPH, director of the Public Health Communications Collaborative at the de Beaumont Foundation.
“The biggest consequence is increased fragmentation of a public health message during times of urgent need for clear communication to audiences,” Kwong told The Nation's Health.
But health agencies cannot blame all of their communication problems on shrinking budgets, social media or sensational coverage, she said.
“I encourage our field to look in the mirror,” Kwong said. “While misinformation is a massive challenge, our field bears significant responsibility for treating public health communication as an afterthought or an academic exercise.”
Agencies have too often released numbers and instructions without explaining what they mean for ordinary people, Kwong said. That context is especially important when officials communicate about a rare but potentially serious threat.
That means doing more than delivering information. Public health has to meet people where they are — with empathy, trusted messengers and some willingness to loosen control, said Amelia Burke-Garcia, PhD, director of the Center for Health Communication Science at NORC.
People may be weighing advice from clinicians, relatives, friends and social media as they decide what to believe about a vaccine, disease or treatment, she said. Messages focused mainly on securing compliance can feel dismissive to people who need more information or time to work through concerns.
Artificial intelligence may help public health communicators break down complex information, tailor messages for different communities and add empathy and support to their wording, Burke-Garcia said. AI tools could be useful as agencies try to provide more nuanced communication with fewer resources.
The messenger matters, too, she said. Health agencies may need to partner with community leaders, podcasters, YouTubers, content creators, celebrities and influencers who already have the attention of the audiences public health often struggles to reach.
No matter the voices or platforms used, effective communication still begins with understanding the audience, according to Gary Kreps, PhD, founding director emeritus of George Mason University's Center for Health and Risk Communication. Before deciding what to say or how to say it, public health agencies should know what people are concerned about, what they already know or believe, what they want to learn and where they turn for information.
“Messages fail because they don't resonate with specific audiences, both in terms of message strategies and communication channels used,” Kreps told The Nation's Health. “The best health promotion messages present relevant information as simply and clearly as possible for specific audiences, building upon what they already know and what they want to learn.”
Long-term improvement will require treating communication as a core public health discipline, said Scott Ratzan, MD, MPA, MA, editor-in-chief of the Journal of Health Communication and co-chair of the Nature Medicine Quality Health Information for All Commission.
“The way we view communication is too narrow when we just talk about messaging,” Ratzan told The Nation's Health.
Effective health communication involves more than issuing information. It may also require advocacy, policy changes, regulations and creative ways to reach people when direct messages face political or cultural barriers. Tobacco prevention campaigns, for example, did not succeed because of a single clever slogan, Ratzan said. Progress came slowly through education, warning labels, smoke-free laws, taxes, advocacy and changing social norms.
Doing that work well requires more than assigning communication duties to whoever is available, he said. Public health agencies need trained professionals who understand risk, audience needs and how to communicate across changing media platforms.
“Health communication is a distinct discipline,” Ratzan said. “We need to pay attention to it. We need to invest in it — from schools that are training public health all the way through in-service training.”
That investment is especially important as public health competes with an expanding mix of online voices that may reach people more effectively than government agencies do.
“As information grows and more influencers are out there, we need to become influencers,” Ratzan said. “And we need to influence the influencers with appropriate and scientifically sound quality health information.”
For more information on public health messaging, visit www.nphic.org, https://ibi.gmu.edu/chrc and www.norc.org.
- Copyright The Nation’s Health, American Public Health Association
