Pub Date : 2026-02-05DOI: 10.2105/AJPH.2025.308350
Safura Abdool Karim, Ruth Faden, Anne Barnhill, Virginia A Brown, Jeff Kahn, Nancy Kass, Anna Mastroianni, Stephanie Morain, Vardit Ravitsky, Reed Tuckson
Public health has long grappled with moral and epistemic disagreement-conflicts over values and facts that shape decisions about how best to protect population health. While these forms of disagreement are not new, recent years have seen a shift toward a more entangled and intractable form, which we term "wicked" disagreement. This wicked disagreement, adapted from the concept of wicked problem, sees political identity as shaping both factual beliefs and moral commitments, rendering traditional tools of public health persuasion-such as appeals to evidence or shared values-ineffective. Wicked disagreement is not defined by what is disputed but by the polarized context in which facts, values, and identity are deeply fused. In this essay, we argue that public health must develop new strategies for navigating this terrain, including sustained engagement with a wide range of communities, transparent communication about uncertainty, and a willingness to revise guidance publicly. Navigating wicked disagreement is not about achieving consensus. It is about finding trustworthy ways to protect life and advance health in a fractured public sphere. (Am J Public Health. Published online ahead of print February 5, 2026:e1-e9. https://doi.org/10.2105/AJPH.2025.308350).
{"title":"Navigating \"Wicked\" Disagreement in Public Health.","authors":"Safura Abdool Karim, Ruth Faden, Anne Barnhill, Virginia A Brown, Jeff Kahn, Nancy Kass, Anna Mastroianni, Stephanie Morain, Vardit Ravitsky, Reed Tuckson","doi":"10.2105/AJPH.2025.308350","DOIUrl":"https://doi.org/10.2105/AJPH.2025.308350","url":null,"abstract":"<p><p>Public health has long grappled with moral and epistemic disagreement-conflicts over values and facts that shape decisions about how best to protect population health. While these forms of disagreement are not new, recent years have seen a shift toward a more entangled and intractable form, which we term \"wicked\" disagreement. This wicked disagreement, adapted from the concept of wicked problem, sees political identity as shaping both factual beliefs and moral commitments, rendering traditional tools of public health persuasion-such as appeals to evidence or shared values-ineffective. Wicked disagreement is not defined by what is disputed but by the polarized context in which facts, values, and identity are deeply fused. In this essay, we argue that public health must develop new strategies for navigating this terrain, including sustained engagement with a wide range of communities, transparent communication about uncertainty, and a willingness to revise guidance publicly. Navigating wicked disagreement is not about achieving consensus. It is about finding trustworthy ways to protect life and advance health in a fractured public sphere. (<i>Am J Public Health</i>. Published online ahead of print February 5, 2026:e1-e9. https://doi.org/10.2105/AJPH.2025.308350).</p>","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":" ","pages":"e1-e8"},"PeriodicalIF":9.6,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-13DOI: 10.2105/AJPH.2025.308284
Auden E Cote-L'Heureux, David L Chin
Objectives. To examine how gerrymandering affects federally qualified health center (FQHC) availability in North Carolina. Methods. We used data from 2004 to 2022 and spatial regression models to correlate gerrymandering metrics with FQHC availability and utilization at the zip code level. Results. Gerrymandering severity is inversely associated with FQHC availability and utilization. For example, individuals in communities split evenly between 2 state senate districts in this 18-year period (from the end of 2004 through 2022) traveled about 30% farther to their nearest FQHC in 2022 than individuals in communities entirely within a district, and they were up to 20% less likely to visit an FQHC. Increased electoral competitiveness also reduced FQHC availability and utilization. Residential segregation was not linked to FQHC availability or gerrymandering severity. Conclusions. Gerrymandering weakens local political representation and may lead to reduced access to vital health care services-a structural issue with far-reaching implications for health equity and national policy reform. (Am J Public Health. 2026;116(2):270-277. https://doi.org/10.2105/AJPH.2025.308284).
{"title":"Political Boundaries, Health Care Gaps: The Link Between Gerrymandering and Federally Qualified Health Center Availability.","authors":"Auden E Cote-L'Heureux, David L Chin","doi":"10.2105/AJPH.2025.308284","DOIUrl":"10.2105/AJPH.2025.308284","url":null,"abstract":"<p><p><b>Objectives.</b> To examine how gerrymandering affects federally qualified health center (FQHC) availability in North Carolina. <b>Methods.</b> We used data from 2004 to 2022 and spatial regression models to correlate gerrymandering metrics with FQHC availability and utilization at the zip code level. <b>Results.</b> Gerrymandering severity is inversely associated with FQHC availability and utilization. For example, individuals in communities split evenly between 2 state senate districts in this 18-year period (from the end of 2004 through 2022) traveled about 30% farther to their nearest FQHC in 2022 than individuals in communities entirely within a district, and they were up to 20% less likely to visit an FQHC. Increased electoral competitiveness also reduced FQHC availability and utilization. Residential segregation was not linked to FQHC availability or gerrymandering severity. <b>Conclusions.</b> Gerrymandering weakens local political representation and may lead to reduced access to vital health care services-a structural issue with far-reaching implications for health equity and national policy reform. (<i>Am J Public Health</i>. 2026;116(2):270-277. https://doi.org/10.2105/AJPH.2025.308284).</p>","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":" ","pages":"270-277"},"PeriodicalIF":9.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12801726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.2105/ajph.2025.308367
Eun Kyung Lee,Megan B Cole
{"title":"How Political Dynamics May Shape Availability and Utilization of Health Care Services Through Federally Qualified Health Centers.","authors":"Eun Kyung Lee,Megan B Cole","doi":"10.2105/ajph.2025.308367","DOIUrl":"https://doi.org/10.2105/ajph.2025.308367","url":null,"abstract":"","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":"104 1","pages":"168-170"},"PeriodicalIF":12.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.2105/ajph.2025.308307
Bobby P Smyth,Peter McCarron
{"title":"Use of an Inappropriate Control Period When Exploring the Impacts of Cannabis Legalization.","authors":"Bobby P Smyth,Peter McCarron","doi":"10.2105/ajph.2025.308307","DOIUrl":"https://doi.org/10.2105/ajph.2025.308307","url":null,"abstract":"","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":"55 1","pages":"182-183"},"PeriodicalIF":12.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-13DOI: 10.2105/AJPH.2025.308264
Sonja Mackenzie, Neha Mann, October Hertenstein
There are 1000 antitransgender bills across the United States, more than one quarter of which target educational settings. School districts are an increasingly critical policy domain through which transgender and nonbinary youth health is harmed and can be protected. Trans-led resistance, including activism and advocacy, has been found to lead to improved health. This case study describes one California school district's policy advocacy process as a model for building transgender youth health through a participatory process that, in itself, has supported transgender joy. (Am J Public Health. 2026;116(2):210-213. https://doi.org/10.2105/AJPH.2025.308264).
{"title":"Transgender Youth Health and Joy: A Model of Evidence-Based School District Policy Change to Support Transgender and Nonbinary Youth Health.","authors":"Sonja Mackenzie, Neha Mann, October Hertenstein","doi":"10.2105/AJPH.2025.308264","DOIUrl":"10.2105/AJPH.2025.308264","url":null,"abstract":"<p><p>There are 1000 antitransgender bills across the United States, more than one quarter of which target educational settings. School districts are an increasingly critical policy domain through which transgender and nonbinary youth health is harmed and can be protected. Trans-led resistance, including activism and advocacy, has been found to lead to improved health. This case study describes one California school district's policy advocacy process as a model for building transgender youth health through a participatory process that, in itself, has supported transgender joy. (<i>Am J Public Health</i>. 2026;116(2):210-213. https://doi.org/10.2105/AJPH.2025.308264).</p>","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":" ","pages":"210-213"},"PeriodicalIF":9.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12801723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.2105/ajph.2025.308354
Elizabeth Cerceo,Cordelia Stearns,Kathleen Shapley-Quinn,Matthew Salzman
{"title":"Disaster Within a Disaster: Ensuring Access to Opioid Use Disorder Treatment During Natural Crises.","authors":"Elizabeth Cerceo,Cordelia Stearns,Kathleen Shapley-Quinn,Matthew Salzman","doi":"10.2105/ajph.2025.308354","DOIUrl":"https://doi.org/10.2105/ajph.2025.308354","url":null,"abstract":"","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":"29 1","pages":"171-174"},"PeriodicalIF":12.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.2105/ajph.2025.308288
Theodore E Schall,Jacob D Moses,Elizabeth A Dietz,Laura E Stamm,Justin Penny,Ayden I Scheim
{"title":"Dangers of a Politically Motivated Research Agenda on Transgender Health.","authors":"Theodore E Schall,Jacob D Moses,Elizabeth A Dietz,Laura E Stamm,Justin Penny,Ayden I Scheim","doi":"10.2105/ajph.2025.308288","DOIUrl":"https://doi.org/10.2105/ajph.2025.308288","url":null,"abstract":"","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":"39 1","pages":"192-196"},"PeriodicalIF":12.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.2105/ajph.2025.308364
B Ethan Coston,Stewart Landers
{"title":"The Need to Focus on Flourishing LGBTQ+ Futures.","authors":"B Ethan Coston,Stewart Landers","doi":"10.2105/ajph.2025.308364","DOIUrl":"https://doi.org/10.2105/ajph.2025.308364","url":null,"abstract":"","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":"18 1","pages":"188-191"},"PeriodicalIF":12.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.2105/AJPH.2026.116.2.153-154
{"title":"Mastheads.","authors":"","doi":"10.2105/AJPH.2026.116.2.153-154","DOIUrl":"10.2105/AJPH.2026.116.2.153-154","url":null,"abstract":"","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":"116 2","pages":"153-154"},"PeriodicalIF":9.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12801738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.2105/ajph.2025.308368
Perry N Halkitis,Kristen D Krause
{"title":"LGBTQ Public Health Is Public Health: Advancing Equity When Institutions Falter.","authors":"Perry N Halkitis,Kristen D Krause","doi":"10.2105/ajph.2025.308368","DOIUrl":"https://doi.org/10.2105/ajph.2025.308368","url":null,"abstract":"","PeriodicalId":7647,"journal":{"name":"American journal of public health","volume":"234 1","pages":"159-161"},"PeriodicalIF":12.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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