Washington, DC, February 12, 2024 — A new qualitative study from the National Association of County and City Health Officials (NACCHO) describes the pervasive harassment local health department leaders experienced during the COVID-19 pandemic and its negative effects on their professional and personal lives.

The data were collected in 2022, through focus groups of local health department leaders. NACCHO researchers identified four key domains surrounding harassment experiences. These include factors influencing perpetrators of harassment, the content of threats, the effects of harassment on individuals and the wider local public health workforce, and factors mitigating the effects. The effects of harassment can lead to serious negative health issues. In fact, a recent study found that many public health workers experienced post-traumatic stress disorder (36.8%) and depression (32%). Of note, focus group participants shared that they had been verbally and physically attacked, mailed packages with harmful contents including feces, and had their health departments threatened with defunding and legal action. Personally, they feared for their own and their families’ safety. Professionally, they experienced fatigue and burnout.

Focus group participants attributed most harassment instances to community members’ perceptions of COVID-19 response measures as violations of individual freedoms (face mask and vaccination mandates), as well as a change in social norms that appeared to sanction harassment. These findings add to growing literature about the experiences of public health workers during the pandemic. One study found that the percentage of Americans that felt harassing public health leaders was justified increased between 2020 and 2021, while another found 5% of local health departments experienced leadership turnover due to political conflict during the first year of the pandemic.

Preventing and responding to harassment against local health departments involves several policy and practice solutions at the federal, state, and local levels. NACCHO recommends that local governmental agencies should investigate threats or incidents and prosecute when warranted. State and federal agencies should coordinate with local health departments to implement timely and direct communication during public health emergencies, and increase timely and flexible funding for local jurisdictions to better respond to community needs. All elected officials should prioritize protections against threats and violence aimed at public health officials.

“Local health departments across the country are in need of a coordinated effort to address the ongoing harassment across their workforce,” said Lori Tremmel Freeman, NACCHO CEO. “As local health leaders were responding to the pandemic, more than half reported harassment towards the local public health workforce in their jurisdiction, which had a widespread impact on their mental health and wellbeing. This is unacceptable. We need to raise awareness of the issue, enforce laws on the books, and develop key policy solutions to protect the well-being of all local health leaders and staff.”

Read the full article, Local public health under threat: Harassment faced by local health department leaders during the COVID-19 pandemic, here.

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About NACCHO
The National Association of County and City Health Officials (NACCHO) represents the country’s over 3,300 local health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit www.naccho.org.