Ungoverning by Nancy L. Rosenblum

Author:Nancy L. Rosenblum
Language: eng
Format: epub
Publisher: Princeton University Press
Published: 2024-07-03T00:00:00+00:00

Deconstructing Public Health Administration in the States

Two areas of state politics bring into focus how partisan federalism meets ungoverning: public health administration, especially during the Covid pandemic, and election administration.

The catastrophe of Covid provided a very public stage for ungoverning in the states. In the initial stages of the pandemic, states responded with different degrees of stay-at-home orders, business restrictions, masking, school closings, and more, but the differences did not correspond to partisan lines. That had changed by summer 2020, as partisan polarization became intense with rising radical anti-government rhetoric and policy (Wallace-Wells 2023). One cause of the shift was the presidential campaign, with Trump claiming that the pandemic was no big deal (Waldman 2020). In all fifty states, Republican legislators went on to file bills to curb public health authorities, banning mask mandates as “a burden on the public peace, health, and safety of the citizens of this state [Arkansas]” (Weber and Barry-Jester 2021). Local governments got into the act in Utah and Iowa, ordering that schools could not require masks. County commissioners with no public health expertise were authorized to veto county-wide public health orders. “It’s time to take the power away from the so-called experts, whose ideas have been woefully inadequate” (Weber and Barry-Jester 2021). Although for the most part state public health officials remained in office and agencies were not eradicated, we saw hatchet-like acts of ungoverning, with expertise sidelined and institutions highjacked. Disdain for knowledgeable and experienced administration in a crisis situation was plain, and plainly inspired by Trump’s repudiation of the recommendations of his own public health task force.

Imitating Trump, some Republican governors substituted their own dictates for a consultative and transparent process. Governor Kristi Noem of South Dakota, for instance, resisted medical experts’ calls to shut down public activity, and early in the pandemic she refused entreaties by the state’s largest medical association to implement stay-at-home orders (Beaumont and Groves 2020). By the end of 2020, South Dakota had the second-highest number of infections (adjusted for population) of any state in the country. One in nine South Dakotans had been infected, and one in six hundred had died of the virus (Bump 2021).

Vaccines were a fault line and a source of popular mobilization by the reactionary movement against public health. When Covid vaccines first became available, Governor DeSantis advocated vaccination of Florida’s elderly population. But seeing an opportunity to indulge those who resented shutdowns and rejected vaccines, he soon reversed his position and opposed efforts by businesses to require vaccination (Caputo 2021). His surgeon general altered scientific data to claim that young men should not be vaccinated. And DeSantis flirted with conspiratorial allegations against vaccine manufacturers, suggesting that vaccine mandates were about profits not public health (Scott 2022). He directed the Florida Supreme Court to impanel a grand jury to hear charges against vaccine manufacturers. Against recommendations by medical experts, he banned mask mandates in schools (Hart 2021). He also formed a “public health integrity committee” to vet—and contradict—public health advice from the federal government.

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