Strategies to Address the Impacts of American Individualism and Individualization on Public Health Practice: Lessons from COVID-19 in the United States

This study sought to uncover strategies that enable public health leaders to better understand the public that they serve, communicate with them, and frame policy initiatives in ways that consider the influence of American individualism and the individualization of American society.This research utilized a qualitative, case study design, with an emphasis on key informant interviews. Through the case example of the COVID-19 pandemic, this methodology explored how public health leaders can (1) better engage a public that believes in individualism and is constrained by the structures of individualization, (2) communicate effectively to blend individual values and public health values, and (3) frame policy initiatives in ways that take individualism and individualization into account so that policies will be understood and accepted within a context that may run counter to the policy appeal. Interviews included two primary groups of key informants—influential public health leaders, and experts and community leaders from other disciplines and industries that rely heavily on public health and serve or study specific communities.Key informants detailed how individualism and individualization manifest, resulting in 18 foundational insights, which were subdivided into five thematic categories: deep empathy, ethics and theories of justice, public health echo chamber, political polarization and ideology, and relationship building. Combating and addressing the COVID-19 pandemic in the US proved to be more than functional, operational, or political challenges. The foundational insights paint a robust picture of the massive challenges that cultural narratives and social structures played during this time. This research also generated 47 strategies public health leaders can utilize to better engage, communicate, and frame public health policy. Strategies range from short-term practices to long-term systemic changes.With the context of the foundational insights and the strategies to act, public health leaders can begin to move forward from the COVID-19 pandemic with a new vision on how to better serve communities and the public. The work ahead is the responsibility of current and future public health leaders. The context will always be messy and complex; however, instead of ignoring these realities, actions can be taken within the discipline of public health to respond to this difficult landscape and can improve practice and ultimately the public’s health.