As Congress debates President Joe Biden’s COVID-19 plan, it’s worth noting that America is actually suffering from two social illnesses that seem unrelated but may have the same cure.
While there has been great attention to the problems in delivering vaccinations, public health professionals still see a huge problem with “vaccine hesitancy” — too many people deciding not to get vaccinated.
At the same time, local news is collapsing. Even before COVID-19, the number of reporters had declined 60% since 2000. Some 1,800 communities now have no local news outlet, and thousands more provide little to no local news coverage. Since COVID-19, the situation has worsened: Because local businesses have shut, they have stopped advertising in local news outlets. Fewer communities got sound public information from local news, and the vacuum was sometimes filled by disinformation.
The common cure for both problems: a massive government public health advertising effort to encourage vaccinations and other public health steps, with a big chunk run through local news media.
Dr. Anthony Fauci and other public health leaders have stated that to get to “herd immunity” we need 75-80% percent of the population vaccinated. If one out of four (or five) people are not vaccinated then the virus can easily continue its march from one to the next susceptible person.
The signs are discouraging. A December poll suggests that between 47% and 71% of Americans said they would get vaccinated when their turn came — far from the goal of nearly 100% coverage we need with this new vaccine. The Black and Hispanic communities have been hit hardest by COVID-19, and yet are especially skeptical — in part because of the horrifying history of medical racism, like the U.S. government using African Americans as guinea pigs for experiments. In a survey from AP-NORC only 24% of Black Americans and 34% of Hispanics said they would get vaccinated. Another group that remains hesitant, per a Kaiser Health News poll, is rural Americans.
Obviously proper public health messages need to get out through trusted sources. Americans say they trust local news more than national. In one Knight Foundation survey, 79% said they trusted local news to “give information you can use in your daily life” compared to 19% who listed national news.
Unfortunately, local news is shriveling up. Meanwhile, corporations and government have often used computer algorithms to place advertising, much of which unintentionally subsidizes websites that promote disinformation on COVID and other topics, according to a study by NewsGuard.
President Biden has proposed an ambitious plan to boost vaccination. Our two pieces of advice: include substantial public health advertising, and have at least half run as paid ads in local news.
Such an approach could be a lifesaver for local news and help improve coverage of COVID-19. In 2013, New York City was spending $18 million on advertising, but only 18% went to community media. So the Center for Community Media at the CUNY’s Craig Newmark School of Journalism led an effort to change that. In 2019 the mayor signed an executive order requiring that half of digital and print ads go through local media. In 2020 nearly $10 million, or 84%, went to local media — most small newspapers and websites whose revenue had sharply declined because businesses could no longer afford to advertise, according to a study by the center.
The ads not only helped keep the lights on at local news organizations, it triggered better reporting about the pandemic. For instance, the Haitian Times, which covers Brooklyn communities devastated by COVID, went from receiving barely $200 in city advertising to getting more than $73,000 in 2020. It used the funds in part to add reporters to cover public health and other issues.
Public health campaigns can be effective — if the messaging is ubiquitous, consistent and credible. It is especially likely to succeed if such a campaign has consistent national messages plus customized information for specific communities. Most famously, public health campaigns saved hundreds of thousands of lives by changing attitudes about smoking and seat belt wearing.
Obviously, paid advertising is not the only tool public health departments will need to use. We also need to rebuild the civic mindedness that inspires us to choose the uncomfortable (masks), unpleasant (Zoom calls), and difficult (restricted social interactions) actions necessary to achieve near-universal vaccination.
But this is a basic ingredient of any sensible public health approach. And in this one case at least, the same cure can help two different ailments.
Steven Waldman is president of Report for America and coordinator of the Rebuild Local News coalition. Susan Coffin, MD, MPH, is a professor of pediatric infectious diseases at the Perelman School of Medicine at the University of Pennsylvania.