Conceptualizations of “public health” and government action among U.S. adults in 2025

Abstract Introduction Understanding how Americans think about public health and the role of government institutions is crucial for informing effective health communication in a polarized political climate. Methods We deployed an open-ended national survey of 1,004 adults in October 2025 to assess public perceptions of these topics. Results Respondents associated the term “public health” with health for everyone (44%) and health of everyone (23%), alongside healthcare (20%) and other themes. The most common perceived government benefit was facilitating access to healthcare (39%)—particularly by addressing cost (16%). Among perceived government harms, more Republicans than Democrats cited overregulation (16% vs. 8%, p<0.01), limiting personal freedoms (16% vs. 6%, p<0.001), and inefficiency (10% vs. 4%, p<0.01); more Democrats than Republicans mentioned dismissing science (7% vs. 2%, p<0.01) and defunding (7% vs. 2%, p=0.02). Weighted analyses yielded minimal substantive differences from unweighted findings. Conclusion Findings reveal both cross-partisan common ground in term associations and divergent concerns regarding government action. Public health messaging should leverage shared priorities and acknowledge partisan concerns about government roles.