Dr. Georges Benjamin is the CEO of the American Public Health Association, with 25 years at the helm of one of the most respected public health institutions in the U.S. And he’s Ken’s guest today.
At the beginning of 2025, Benjamin made an appearance on Ken’s livestream during Robert F. Kennedy Jr. 's Senate confirmation hearing to be health secretary. At the time, Benjamin warned what could happen with RFK Jr. as the national head of public health.
Fast forward to today, America faces its worst measles outbreak in 35 years, with over 2,300 cases and counting. Taylor Farms, already potentially linked to a deadly E. coli outbreak, is at the center of a massive Cyclospora outbreak tied to contaminated lettuce sickening thousands.
Benjamin unpacks how we got here, what RFK Jr. gets wrong, why Make America Health Again was never going to get the support it needed from Republicans and why gutting public health infrastructure has consequences.
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Ken Cook: Hi there, it's Ken Cook, and I'm having another episode. Today, I'm thrilled to have the opportunity to talk to one of the preeminent public health authorities in the world, definitely in the United States, Dr. George Benjamin, MD. Dr. Benjamin is the executive director of the American Public Health Association Last time he joined me on the podcast, uh, we were live streaming confirmation hearings for HHS secretary, with Dr. Benjamin helping us decode in real time exactly what was at stake. Well, we warned you back then, and in this episode, we'll find out just how right we were to be so worried. Because right now, the United States is in the middle of its worst measles outbreak in 35 years. Measles. The CDC has logged more than 2,300 cases so far this year, already surpassing, at halfway, last year's total. It's also the most cases reported in a single year since the disease was declared eliminated in this country back in 2000. The overwhelming majority of those infected are, of course, unvaccinated, and outbreaks are actively growing in states from Pennsylvania to Utah to Virginia. It's a devastating, tragic, and entirely preventable case study in what happens when public health infrastructure gets undermined by budget cuts and reorganizations and scientific nonsense. There's more. Taylor Farms, one of the country's biggest produce suppliers, is at the center of a massive cyclospora outbreak tied to iceberg lettuce grown in Mexico, with nearly 2,000 illnesses reported across nine states, close to 100 hospitalizations, and cases traced back to fast food chains like Taco Bell. This comes on the heels of an E. coli outbreak linked to Taylor Farms' romaine lettuce that sickened dozens and killed one person last year. It's hard not to notice the pattern. The systems meant to make sure that food is actually safe to eat are the ones being undercut by this administration. Dr. Benjamin doesn't hesitate to call the Trump administration destructive, a Project 2025 playbook aimed at gutting the administrative state, the deep state, and a Make America Healthy Again movement that he believes had some of the right instincts, but was always going to be sabotaged by its fellow travelers in the far-right MAGA. But first, say a little bit, Dr. Benjamin, about what got you into medicine. Uh, where did that bug bite you? And say a little bit about your career trajectory. I was very interested, for example, to learn that you had a deep background working in the military with respect to the medical profession. So tell us a little bit about how you got to be Dr. Benjamin.
Dr. Benjamin: Well, I'm both an accidental doctor and an accidental public health guy. I knew I wanted to be a scientist, whatever in the heck that meant as a kid. I was a nerd. You know, glasses-wearing- ... looked at botany, looked at biology, looked at chemistry, had a chemistry set. All the stuff you have as a kid knowing you wanted to go into the sciences, but not knowing what science I wanted to go into. Except physics I thought was really tough. I never really understood physics. A little too theoretical for me.
Ken Cook: I'm with you.
Dr. Benjamin: I was in college working in a lab, ended up becoming a research assistant doing sickle cell research.
Ken Cook: Uh-huh.
Dr. Benjamin: Dr. Soo Sang Kang. He was an MD-PhD, and we were looking for a molecule that would interrupt the sickling process for people with sickle cell anemia.
Ken Cook: Okay.
Dr. Benjamin: By the way, we found one, but it physiologically it doesn't do anything. But nonetheless, that was my first publication. Uh-huh. But I found it challenging. Even though I was a, a, a nerd, I just didn't know enough. So I went to medical school with the idea of getting a good basic science background to do molecular genetic research with no interest in clinical medicine, no desire to be a doctor really, except I was gonna go to medical school to get this background. Fell in love with clinical medicine Happened to go to medical school as emergency medicine was just being developed as a specialty
Ken Cook: Ah, okay ...
Dr. Benjamin: fell in love with emergency medicine. Army paid my way to medical school, so I went into the Army and did my residency in the Army, but the Army was not accepting residents in emergency medicine because they were just starting their residencies. In fact, I was an intern in the ER the day the Army opened up its first emergency medicine residency as an internal medicine resident.
Ken Cook: Okay
Dr. Benjamin: And then as the forces would have it, my advisor, everyone had a faculty advisor, was a guy who actually built all the emergency medicine programs for the military.
Ken Cook: Now, when I think of military medicine, to me it seems like isn't it always a goddamn emergency? Just what, what-
Dr. Benjamin: Well- ...
Ken Cook: what's left?
Dr. Benjamin: No, you know, military me- medical training programs are no different than the civilian. Okay You see military members and their families, and-
Ken Cook: Yeah ...
Dr. Benjamin: they have heart attacks and asthma- Sure and they need to have blood pressure taken care of. So no, my training was no different than anybody else, except the fact that when the military regionalizes stuff, that means that you take care of everybody who needs specialty care in that region. So just to give you an example, if you're a specialist in gastroenterology-
Ken Cook: Mm-hmm
Dr. Benjamin: one of the things that you learn to do is a procedure called endoscopy, where you take a tube- Yeah ... and you go through the mouth into the stomach to, to look at the stomach- Mm-hmm ... if you have a bleed or any kind of tumor or anything like that. That's usually reserved for people who are specialists in gastroenterology. Yeah. Now, as a resident, you do get to do a few of those procedures 'cause they want you to learn to do the procedure as a internal medicine resident. But in the military, because we did so many, everybody who needed to have an endoscopy in the southwest region that went to San Antonio, is where I trained-
Ken Cook: Yeah
Dr. Benjamin: got it done there.
Ken Cook: Okay.
Dr. Benjamin: So there were so many, and they passed them off to us fellows. So as a resident, I got to do as many endoscopies as any specialist-
Ken Cook: Wow ...
Dr. Benjamin: in gastroenterology.
Ken Cook: Wow.
Dr. Benjamin: It's like going to, you know, in Chicago, Cook County Hospitals and the city hospitals. Yeah.
Ken Cook: Sure.
Dr. Benjamin: They get so many procedures that their interns did procedures that some specialists-
Ken Cook: Yeah
Dr. Benjamin: only had limited procedures just because of the volume. Yeah. So anyway, my military experience was amazing. And then when I finished my training- Because I had done some extra time in emergency medicine, they said, "Look, we can send you out as an internist, but we need a specialist of internal medicine in our training program in emergency medicine. So how would you like to be a, a internist in our training program in emergency medicine?" So I went to Washington State, to Madigan Army Medical Center, and I served as their pet internist, and did so much emergency medicine that I ultimately was able to grandfather into the specialty and became board certified in both internal medicine and emergency medicine. And then eventually I ended up at Walter Reed running the ER at Walter Reed as one of the Army's emergency medicine specialists. So I identify both as an internist and as an emergency physician.
Ken Cook: Yeah. So how did you go from the practice of that form of medicine to the practice of the medicine broadly described as public health? 'Cause that's a, that's a leap for a lot of MDs. Yeah. It's a different cat, right?
Dr. Benjamin: Well, it's medical management. And one of the things that you can see, right out of my residency I was a section chief and a service chief, and I, I got into medical management very early on. So when I left the Army, I went to the city hospital as chief of community medicine and ambulatory care at the city hospital at DC General.
Ken Cook: Yeah.
Dr. Benjamin: I was there about two and a half years. My phone rings, and the mayor's on the other end of the phone and says, "Have I got a job for you." And so on Friday I'm the chief of community medicine at the city hospital, and on Monday I'm the city health commissioner. Wow. Now, I saw the job as being the chief of medicine for the city.
Ken Cook: Right.
Dr. Benjamin: Because we had- couple nursing homes. We provided care for the developmentally disabled, kids in the juvenile justice system. We had this medical examiner's office, and this pesky little thing called public health. Which public health lab, the epidemiology programs, et cetera.
Ken Cook: Yeah.
Dr. Benjamin: Of course, that became 90% of my job, of course. I had people who ran the clinics. I had people who ran the nursing home who were experts in health administration. I was there for almost two years. New mayor wanted her own health commissioner, so I left. Went out and practiced emergency medicine for about two and a half years. I was just doing the ER medicine and some other stuff when Governor Glenn Denning was elected as governor.
Ken Cook: Mm-hmm. Yeah.
Dr. Benjamin: And he needed new deputies, uh, both for Medicaid, for public health, and for his operations. And so I was asked to interview for the public health job, which was a big $1 billion operation- Yeah ... with lots of stuff in it, including, again, this pesky traditional public health stuff. And then when he left to go to Johns Hopkins to run their tobacco programs, I became Secretary of Health for the state of Maryland. The person who, who was running for governor, who I would've stayed with working with, Kathleen Kennedy Townsend, did not win the governorship.
Ken Cook: Right.
Dr. Benjamin: So she did not win, and we changed parties.
Ken Cook: Yep.
Dr. Benjamin: So I was gonna have to look for a job anyway. Anyway, APHA was open, one of several jobs I looked at, so I ended up taking a job at APHA for what I thought would be a two-year stint. And I start my 25th year in December.
Ken Cook: Yeah. What an amazing run it's been, and EWG has interacted with APHA. They've all been under your tenure, and the level of professionalism and the, and the commitment and the, the willingness to step into the public square and speak truth to power, no matter who's in power, has always impressed me. That, that's a hallmark of the APHA. Not always the case with some other associations, but it's, it's been a hallmark with you. Well,
Dr. Benjamin: you know, I've, I've always been of the belief of the need to say what's on your mind. You have to be thoughtful. Sometimes it's not wise to say what's on your mind.
Ken Cook: I have a whole annotated list of those in my portfolio, but go on. Yeah.
Dr. Benjamin: I'm married with two daughters, so I've had to learn that through my whole life. But, you know, I try to say what's right. I try to be right about what I'm saying. I try to be as timely as I can. I try to say what I'm gonna say for impact. Meaning, there are times when people would like you to say something, but if it's not gonna make a difference- And I don't feel I need to be on the record, then sometimes- Yeah it's better to hold your powder until you can make a difference.
Ken Cook: Yeah.
Dr. Benjamin: Because there are times when people won't hear you. And so all of those things are in my thought process, and I've gotten my staff to think about things that way.
Ken Cook: Yeah.
Dr. Benjamin: Sometimes it will hurt your pocketbook. Sometimes it will turn your image. But, you know, at the end of the day when I've done the look back, almost all the times we've been right.
Ken Cook: Yeah.
Dr. Benjamin: When we've been impactful, we've tried to recognize that.
Ken Cook: Yeah. Well, it's my experience, my observation has been errors on your part don't come to mind. I'll just say that, Dr. Benjamin. That brings me to a sort of the start of the discussion about the current times that we're in. Walk me back from the ledge here. In some ways, the very idea of public health, but certainly how public health is practiced by institutions like yours, like the CDC, like NIH, has been under a stress unlike we've ever seen before, in my estimation. And it almost sometimes feels like mortal danger with the efforts to fire scientists, change regulation around vaccines, upend practically every corner of HHS in ways that I find v- very menacing.
Dr. Benjamin: Yeah.
Ken Cook: Are we making public health stronger by these challenges? Tell me that's the case, 'cause I really wanna believe it.
Dr. Benjamin: No, we're not. We're not. And understand that while we're taking it personally, we should be careful with that.
Ken Cook: Yeah.
Dr. Benjamin: This is an administration that is undermining civil society in ways we've never seen before.
Ken Cook: Yeah.
Dr. Benjamin: This goes back to a view that government should not invest as much money of our tax dollars as they're giving. They've been invested in any part of our society. They're taking apart our educational system. They're taking apart our health system. They're taking apart our national security issues. So we need to understand that this is a very destructive administration that's destroying lots of reasons for our civil society. Yeah. I've got my own views and personal views as to why that is. I can tell you that Putin is laughing all the way to the bank.
Ken Cook: Yeah.
Dr. Benjamin: Mm-hmm. Right? And we have a president, man in the office living in public housing- ... who is, um, got some real challenges both personally, medically, and ethically, right? But they're going after health, and yes, they are destroying every aspect of health. And public health, because it's been undervalued and under-resourced, was an easy target.
Ken Cook: Yeah.
Dr. Benjamin: But don't be confused by the fact that they've gone after the regular healthcare system as well.
Ken Cook: Yeah.
Dr. Benjamin: They've gone after the AMA, they've gone after American Academy of Pediatrics, they've gone after Food and Drug Administration in ways that are very destructive in terms of our whole regulatory structure, the way we fund healthcare. And they've only been in office a year and a half.
Ken Cook: Yeah.
Dr. Benjamin: And so we're going to have to reinvigorate and rebuild our systems. We have been in a, an effort to stop what they're doing, slow down what they're doing. The resistance has been all about trying to keep them from doing the greatest damage that we can.
Ken Cook: Yeah.
Dr. Benjamin: While at the same time, by the way, reimagining the future. So the bad news is they're tearing things apart.
Ken Cook: Yeah.
Dr. Benjamin: The good news is they've torn it a- apart so much, it'll be easier for us to reinvigorate and reimagine the future We just have to decide what we wanna prioritize when we get back the control and the, the reins of power. And having been in DC long enough, I know that power is cyclic-
Ken Cook: Yep ...
Dr. Benjamin: and that they have upset so much of the public-
Ken Cook: Yeah ...
Dr. Benjamin: that getting consensus will be difficult, but not impossible.
Ken Cook: Yeah. There's no question, I think you, you get a sense of, of unity around the need to resist and push back at what's coming out of this administration. And I think you're right, sort of at a deeper level, there are all these political philosophers who come to power under this administration who, who fundamentally think that their main job, the main obstacle to the society that they th- think they want is the, um, the administrative state, the ability of government to do its job, that that has- Yep to be torn down first. The strength of public health and many other professions is that if you go back to basics and say, "Well, are infectious diseases a problem or not?" And if you just ask regular people that, mostly they'll say, "Yeah, that could be bad," or pollution in my drinking water, air pollution, whatever the case may be. And if they don't have a response to that that acknowledges it's a problem, then we need for people to know that. Mm-hmm. And then the follow-up question, if they do think it's a problem, is, "So tell me, what's the solution? Is it destroying the federal government, the ability to practice public health, the ability to monitor for pollutants, the ability to enforce laws?" And that's when the unpopularity comes through in a way that makes sense around the kitchen table.
Dr. Benjamin: Yeah. Well, you know, this is a, a government that came in under the Project 2025 framework, which has been a, you know, every conservative- idea that has ever been on the table. They put it in a book.
Ken Cook: Yeah.
Dr. Benjamin: And then they said, "Once, next time we get into power, we're gonna try to implement some of this stuff." Now, they wanna reduce the amount of money that government has to spend. Because they think- Yeah ... if they reduce the spending and the amount of government, they'll force people into a box so that government will get downsized.
Ken Cook: Yeah.
Dr. Benjamin: And that's fine until they realize, and they're beginning to realize, what government does. I often tell people that you never know what somebody does until they leave and nobody picks up that job.
Ken Cook: Yeah, that's right.
Dr. Benjamin: And all of a sudden you find about all the things that they did that nobody knew they did.
Ken Cook: Maybe it wasn't all waste after all.
Dr. Benjamin: That's right. That's right. But this particular administration has done things in a haphazard manner. DOGE was the most ill-conceived, idiotic idea. Bringing in people that had no concept of government without any understanding. Is there things that can be trimmed in government, things that can be improved? You bet.
Ken Cook: Sure.
Dr. Benjamin: But simply coming in and saying, "We're gonna fire all the probationary employees," not realizing that 20-year employees when they go to a new job become probationary. So that now you're getting rid of all the people that know something.
Ken Cook: Yeah.
Dr. Benjamin: Because they think probationary employees as a definition is the same in the government as it is in the private sector, which it isn't.
Ken Cook: Yeah.
Dr. Benjamin: By coming in and saying, "We're going to get rid of this group that is messing around with the cruise industry," not realizing that the cruise industry actually funds the Vessel Sanitation Program. And one of the reasons that the cruise industry is able to be in business is their ability to control infectious diseases. Now, they've got... I love a cruise. I'm a cruiser, so I love cruising.
Ken Cook: Uh-huh.
Dr. Benjamin: And they have a good infection control program, and I speak up for them from that perspective all the time. I have no qualms about going on a cruise. But it's because they have those systems in place, it's because the CDC inspects them, it's because there are outside accrediting bodies that help them do what they do is why they're so successful as a business. The reason that you and I on an average day can go into any restaurant in this country and eat without getting sick is because of restaurant inspections that the public health community does.
Ken Cook: Yeah. Yeah, for sure.
Dr. Benjamin: Not that those restaurateurs don't care about their business, they do, but having that outside look- Helps their business model, and we don't get credit for that
Ken Cook: Absolutely. Public health is, in a way, like environmental protection. People, uh, take for granted that the air is cleaner, the water's cleaner. We've got a ways to go, no question about that, but if you don't see evidence of these problems right in your face- Yeah ... it's easy to imagine that they're taken care of or maybe that they never even existed, which is much worse, right?
Dr. Benjamin: Well, we often make the assumption that products are safe because they're sold.
Ken Cook: Yeah.
Dr. Benjamin: And there's lots of good studies. Consumer Reports, by the way, does studies, has done some studies looking at cosmetics-
Ken Cook: Yeah ...
Dr. Benjamin: and looking at all the heavy metals and stuff in the cosmetics, and the exposure that people getting from stuff that they put on their bodies. And the FDA is able to regulate some of that stuff, but not all that stuff.
Ken Cook: Yeah, for sure. So how do you think the, the public health profession, what do you feel is the, the mood now in the face of these assaults? It seems to me that I'm seeing connections being made across, uh, medical and scientific fields that weren't made necessarily before, a, a common defensive posture, and a, a resolve to overcome some of the policies that are being improperly foisted on medicine and public health. I've been impressed by that, and I think of all the ways in which the Make America Healthy Again community might be disappointed, ironically enough, in the way Kennedy has gone about trying to diminish the importance of vaccination because he's made so many mistakes. He fired scientists instead of hashing out differences. He rushed ahead with decisions that clearly violated the Administrative Procedure Act, and all of those things are ultimately gonna trip him up. Uh, if you put yourself in his shoes, and I, I know what a bad fit that's gonna be, but let's try it anyway. Let's say that he did wanna make the case that we needed to make major changes in our approach to vaccines, and one of the triumphs of public health, of course, across so many disease and health endpoints. What would he have done differently if he really wanted to substantively challenge public health and the postures taken around vaccines? What would you have advised him if he wanted to do it right, as it were?
Dr. Benjamin: Well, you know, we opposed his confirmation, not just because we thought he was not knowledgeable about health in general, but we didn't think he had the right administrative skills or temperament.
Ken Cook: We agree.
Dr. Benjamin: But what he has shown us is what you can do as a activist secretary An active secretary who was evidence-based, science-based, who followed the rules and brought in some of the world's best experts could have talked about and had a broader conversation about food safety or vaccines or how best to improve the public's health. So what would George Benjamin had done had I been Secretary of Health? I would have grabbed the Healthy People objectives because those are consensus objectives that we've had for several years. I would've had a press conference and talked about the state of health of the America. I would have made sure that the people that got appointed to the jobs in my administration were the best people with the best scientific expertise in all of these areas. I would have gotten people who don't necessarily agree with me on everything, but who credential-wise were impeccable in their, in their scientific and credentials and their thinking processes. I would have had lots of public input. I would have vetted them through the process, and I would have, over time, made sure that I, either by vetting existing bodies or, or bringing in new people, got the team in place that I thought could improve the public's health. And then I would have set about Getting consensus among all the various groups in the country that are concerned about health, including MAHA.
Ken Cook: Yeah.
Dr. Benjamin: Okay?
Ken Cook: Of course.
Dr. Benjamin: And brought them to the table, and in a very transparent way began to prioritize the things that we needed to do. I would have made sure that we got a system for health with everyone in and no one out. I would have done things to strengthen the nation's research enterprise. I would have put together a group to think about how do we improve replicability in our research enterprise. But I would not have unfunded things because- Yeah ... of political ideology. Now, obviously, that may have been difficult with this current leadership in the White House.
Ken Cook: That's right.
Dr. Benjamin: But-
Ken Cook: Yeah ...
Dr. Benjamin: if I had had leadership which would allow me to be a good manager and follow the evidence and follow the science, I would have been able to deliver to the president a healthier society and outcomes, and then every year I would report to the American people what those outcomes were, and I would have said, "You know, we did this well. We didn't do this well." I would have brought together people to help me figure out what I didn't do well and improve upon it. And like everything else in science, it's an iterative process to help to get us to the truth. That's how I would have proceeded. And I would have thought that a secretary with that as a broad health agenda, utilizing the experts that he or she had, would have been able to dramatically begin improving the health and wellbeing of the American people.
Ken Cook: Yeah.
Dr. Benjamin: Mr. Kennedy was not it. The people around him are not it. Hopefully, the next administration in Congress, I should say the next Congress followed by the next administration, I hope we can begin to get the accountability that's necessary to put in place people to craft the requirements of a system That is actually interested in the cost of the American people, bringing down costs, improving outcomes so we're no longer at the bottom of outcomes of the other industrialized nations.
Ken Cook: Yeah.
Dr. Benjamin: And that would've been my benchmark, by the way.
Ken Cook: Yeah.
Dr. Benjamin: How do we compare to the other industrialized nations as at least a major benchmark to move us forward? And if we don't address diversity, equity, and inclusion as a core part of that, we're missing the opportunity to improve the health of the American people.
Ken Cook: No question. I mean, two points, uh, just very quickly. You mentioned Project 2025, which has been sort of the, the playbook for this administration, and also this sort of broad ideological convergence amongst conservative thinkers that the, the real problem is that we need to destroy the administrative state. We need to deal with the deep state, all the expertise, all the bureaucrats, and so forth. It seems to me also that the impulses of MAHA, many of which I agree with, they were destined not to work out under MAGA, right?
Dr. Benjamin: It couldn't work.
Ken Cook: It couldn't work. It couldn't work, right? You can't deregulate EPA, you can't defund FDA, you can't fire the people who Biden brought in to start dealing with food chemicals. You can't do all of that and then do anything much beyond Instagram posts-
Dr. Benjamin: Right ...
Ken Cook: and podium appearances to talk about healthy eating.
Dr. Benjamin: So first of all, I, I, I see MAHA as not outside the public health family-
Ken Cook: Right ...
Dr. Benjamin: but a group within the public health family.
Ken Cook: I agree.
Dr. Benjamin: I bring them into our family.
Ken Cook: Yeah.
Dr. Benjamin: Now, what I also wanna remind them at is that the food program at the FDA was underfunded.
Ken Cook: Totally. Yeah.
Dr. Benjamin: Totally underfunded. And if you wanted to address dyes in food, nobody disagrees with that. If you wanna address sugary beverages, guess who's been trying to push for sugary beverage control for years? The public health community.
Ken Cook: Of course.
Dr. Benjamin: Where was MAHA when we were trying to do that? So we're happy to work with them on that. You know, beverage taxes was a tool that we were trying to use, but okay. But remind you also that industry does play a role. You have to find a helpful relationship with industry. Despite whether you believe it or not, whether you like it or not, industry paying for- Some of the look at the ability to rapidly engage in drug development is how we got good drug development, how we got better regulatory activity over drugs to speed up- Yeah the regulatory process of drugs. Now, there are two ways to do it. We can pay more in taxes and devote more dollars there, or we can have industry play a stronger role with appropriate guardrails. I would argue that you can do that for foods.
Ken Cook: Yeah.
Dr. Benjamin: But simply complaining about the process doesn't get you there.
Ken Cook: Yeah, and there's no fee system for funding food regulation as there is for medical devices and drugs.
Dr. Benjamin: They could do one if they wanted to, but there was a decision not to do that, and okay. But you get what you get.
Ken Cook: Yeah.
Dr. Benjamin: You get what you pay for.
Ken Cook: Yeah, no question about it. You know, one of the things that I learned, uh, first from the great public health doctor, Dr. Phil Landrigan, I know he's someone you know well.
Dr. Benjamin: Yeah.
Ken Cook: This is when we were discussing what should be in a new pesticide law to make sure we're fully protective of children and the, the general population, and he reminded me of the old observation from statistics, but at... I hadn't thought of it in the context of public health, which was the truth is in the tail. That you have to look at the tail end of the distribution of any kind of particular health problem, and there's going to be, at the far extreme of it, a fairly small group of people, a small percentage of the population, and public health is really dedicated to flattening that curve so that we take care of the average person, but we're also reaching out-
Dr. Benjamin: As much as we can, yeah
Ken Cook: because we all end up in one tail or another, don't we, doc? That's right. That's right. I mean, I don't- That's right ... I, I'm gonna be in the tail of a traffic accident, a heart attack. We all end up in a tail, but we wanna make sure for public health purposes that that tail has fewer and fewer and fewer people in it. And to me, the war on diversity, equity, and inclusion is most egregious, it's egregious in many ways, but most egregious when it ignores the data that have been collected by the public health profession and associated professions over the past 30, 40 years or more that shows that we absolutely do have, in that tail, a group of people who tend to be low income, oftentimes people of color in communities that lack representation in civil society, lack representation in Congress and so forth, don't have the economic advantages. That's what is most upsetting to me that has been tossed out is that evidence-based Case for making sure that public health and medicine stops ignoring or now- Yeah, yeah ... focuses on that end of the, of the continuum. Does that ring true to you? That's how I think of it.
Dr. Benjamin: This group isn't interested in the health and wellbeing of, of anybody, right? This is a white supremacist agenda.
Ken Cook: Yeah.
Dr. Benjamin: They're cutting anything they think are related to minorities.
Ken Cook: Yeah.
Dr. Benjamin: The biggest benefit of DEI programs was white women.
Ken Cook: Yeah.
Dr. Benjamin: There are many programs that benefit everybody, and yes, there are populations that need more help, more assistance. But it turns out when you start focusing on populations of need, you find all kinds of other populations.
Ken Cook: Yeah.
Dr. Benjamin: Let me tell you a quick story. So when I was in Maryland, every health department looks at infant mortality. Every year, infant mortality gets looked at, and we track infant mortality because it's something we wanna address because it's a good public health issue to address. And we had one year where infant mortality went up, and it went up in African American women with health insurance, not the traditional lower income-
Ken Cook: Mm-hmm
Dr. Benjamin: communities or adolescents. It was middle-income women with health insurance.
Ken Cook: That's a puzzle.
Dr. Benjamin: Yep. And so big spike, longer period of time. We were perplexed. So why it didn't impact everybody? We did the look back, and it turned out we had missed it in white women, and the only reason we would've picked it up was because we saw it in Black women. That's because the spike was lower-
Ken Cook: Uh-huh ...
Dr. Benjamin: and didn't last as long.
Ken Cook: Okay.
Dr. Benjamin: So what was the etiology? Which was an issue of structure. It was the fact that fertility treatments were now becoming more ubiquitous and easier to get. And so when you did that, we had more women who were getting pregnant being cared for by providers who weren't necessarily treating them as high-risk pregnancies and being delivered in high-risk pregnancy places.
Ken Cook: Yeah.
Dr. Benjamin: And so more babies, smaller babies.
Ken Cook: Yeah. '
Dr. Benjamin: Cause fertility treatment gets you, you know, twins and quadruplets, et cetera.
Ken Cook: Yeah.
Dr. Benjamin: And so it was a benefit of a technological change that benefited everybody, but for a variety of reasons, the African American women were disproportionately impacted by it, but white women were too. But because we were able to see it across the demographics, we were able to go back and put in systems about who should provide this care, how should the hospitals be labeled, how should these patients be identified, and address it in a systematic way that benefited all populations. But the reason we picked it up was because we were looking for demographics of infant mortality based on race.
Ken Cook: Yeah. Yeah.
Dr. Benjamin: Everybody benefits when you do diversity, equity, and inclusion studies.
Ken Cook: Yeah. That was the upshot of Dr. Landrigan's sermon to me, which is if we can protect to the 99.9th percentile of children from pesticides, we're all gonna be healthier. We're all gonna be protected. Doc, you've been very generous. I just wanna ask you one, one open-ended question. What, what do you think is directly ahead of us in terms of the, the public health profession? Yeah. What do we need to pay attention to? And what would you tell someone who maybe isn't as tuned into policy fights like you and I are to be paying attention to that might give them an insight into what's at risk here if we continue down this path?
Dr. Benjamin: Yeah. I, I, I think that you always have to ask yourself, when you see something that doesn't make any sense, who benefits? So when we see the administration coming out and saying, "We're gonna change X because we wanna go after fraud and abuse or et cetera, et cetera," and then you hear from the alternative view that this is not really a fraud and abuse story. Yeah. I would encourage people to do their homework. The good news is we're having more debates about health. That's a good thing to have a public debate about.
Ken Cook: I agree.
Dr. Benjamin: But I encourage people to become scientifically literate- Look at the source, ask yourself the question, "Who's giving it to me? How do they benefit?" When somebody goes out of their way to disparage somebody else, why are they disparaging somebody else? They don't need to do that. Do your own homework. Do your own research. The benefit of the internet is that the information is out there. Don't simply rely on the artificial intelligence engines to tell you the answers, because those are biased, too.
Ken Cook: Yeah.
Dr. Benjamin: And recognize, even when I tell you something, do your homework.
Ken Cook: Yeah.
Dr. Benjamin: I, I wanna be trusted, but even trusted voices, do your homework.
Ken Cook: Yeah.
Dr. Benjamin: I trust the American people because I've been around... I'm old now, and I've been around long enough to know that the American people are smart, they don't tolerate nonsense, and as they say, Americans will try anything, and eventually always get to the right answer.
Ken Cook: Yeah. That's exactly right. Well, Dr. Benjamin, thank you so much. I s- I so appreciate your time, and I have an affection and respect for the public health community. It's been in- invaluable to me and Environmental Working Group in our work. So many generous scientists and physicians spending time with us to help us understand the landscape of, of health and disease and prevention. So, thank you so much, and thanks for being the stand-up guy that you are, Doc. I gotta say, every t- every time I see you make a statement, it makes me feel like someone's standing up for me.
Dr. Benjamin: Well, I try. I got a group of people behind me. I couldn't do this work if I didn't have the men and women who stand behind me that do this work, so.
Ken Cook: I hear you. Well, I think they're all proud to be standing behind you, and thank you again. Thank you, Ken. Thank you so much for listening. If you'd like to learn more, be sure to check out our show notes for additional links to take a deeper dive into today's discussion. Make sure to follow our show on Instagram at kencookspodcast, and if you're interested in learning more about EWG, head on over to ewg.org or check out the EWG Instagram account at environmentalworkinggroup. Now, if this episode resonated with you or you think someone you know would benefit from it, please send it along. The best way to make positive change is to start as a community with your community. Today's episode was produced by the extraordinary Beth Rowe and Mary Kelly. Our show's theme music is by Moby. Thank you, Moby, and thanks again to all of you for listening.