We live in highly polarized times. It is hard to think of any major health issue today that is not affected somehow by polarized worldviews. From climate change to pandemics, reproductive rights to vaccines, gun control to complex humanitarian crises, domestic health equity to global health—each issue is riven by deep divisions in values and priorities, often at the intersections of economics, identity, religion, culture, and nationalism.
Not only do such partisan politics affect the public discourse on hot topics, but they also affect the training and conduct of public health research, practice, and training. On the one hand, we each hold commitments to our core values and priorities. On the other hand, the broad societal call for diversity and inclusion necessitates that we encounter viewpoints that may clash with ours. How can we effectively, at least without making matters worse, navigate such polarizing issues to ultimately serve the health of the public?
From our reading of the literature, observations, and various engagements and conversations with public health experts, social scientists, and clinicians, we gleaned 10 principles for effectively engaging with people who have diverse viewpoints.
1. Break out of echo chambers: We tend to stay in zones of comfort and largely among people who share similar values and views; as such, our biases only get further reinforced. Such echo chambers exist no less in public health and science than in society at large. We need to intentionally and regularly reach out to people with opposing views and values to understand our own biases and to appreciate multiple perspectives to an issue.
2. Listen first to understand
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: As a general rule, it serves for effective relationship- and trust-building to approach people with the goal of understanding their worldview, reasons, and values before expecting them to understand our own views. Such empathetic listening is harder to practice—but even more valuable—when we are in conversation with people whose views are opposed to our own views.
3. Consider that you might be the one who needs to rethink your position
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: Epistemological humility that the opposition may offer new and relevant information can enhance our ability to make an informed decision on the issue at hand. If we are unwilling to ever consider changing our position or underlying dogma, it is unlikely that any convergence across differing positions can be achieved. While some values may be nonnegotiable, truly data-driven, scientifically grounded decision-making can happen only through a willingness to update our own position in light of new information and consideration of context and complexity. Expecting the other person to change without being open to it yourself is like asking someone to play a rigged game in which you are the only one who has a chance of winning.
4. Never assume or judge the other side’s motivation or intent: Humans tend to infer or assume negative motivation and intent on the part of others with differing viewpoints. Presumed intent taints the conversation with prejudgment and is counterproductive. Staying open to the honorability of even our opposers paves the way to sharing facts and learning from differences in reasoning and interpretations.
5. Do not essentialize a person based on a single expressed viewpoint
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: Each of us is a multidimensional, complex individual capable of holding competing viewpoints and finding intellectual comradery in unexpected places if we allow it. Reducing individuals to their viewpoints on specific issues dehumanizes them and removes the space for reflection that might lead to changing their mind (or yours).
6. Identify common and shared areas: Instead of focusing on differing stances on a polarized issue, use dialog to identify common and shared issues of interest. Leverage common and shared interests to make human connections. Human connection is the beginning of a process that helps build trust, gradually and naturally creates emotional safety, and allows for open discussion of issues that may be contentious or may drive divisions.
7. Be patient and take the long view: Although politicians are beholden to the election cycle, we in public health must look past short-term popularity if we are committed to health for all. Considering the realm of acceptable possibilities, present and future, may give us more scope for negotiation and long-term, sustained action across time and place.
8. Look for solutions that are win-win: Embrace coalition building for complex problems. Think creatively about motivation, positioning, and the currencies that matter to people. Ensure all parties involved in the negotiation receive or at least perceive some gain. Levers for change and slivers of opportunity for solutions often appear unannounced or unplanned. Practice lateral and nonlinear thinking to identify opportunities for negotiated win-win solutions.
9. Facts alone don’t work4: Our most strongly held beliefs are often tied up in our identity, our lived experience, and the groups with which we socialize. Human connection and friendship can be the basis for profound intellectual and social change by creating porous space for dynamically broadening the notion of community and belonging. When it comes to polarizing issues, data alone cannot change minds. The mind follows the heart more often than it follows the numbers. While facts can persuade some people, most people are more easily persuaded by trusted voices and a narrative that resonates with their personal identification with issues and values. Communication channels, such as stories, cartoons, humor, and art, can be powerful mediums for provoking reflection and engendering change.
10. Be proactive: Neither quietly complaining about nor belligerently shaming the opposition has gotten us very far in matters of public health. If anything, self-righteous positions often make matters worse and further polarization. All too often, even in health sciences and practice, we default to human instinct and react to crisis events by sorting ourselves into “them” and “us.” Such a reactive approach seldom allows for constructive and creative solutions. On the other hand, it can be powerful to take whatever opportunity you have to proactively present an idea (even in theoretical ways) and start a conversation to understand multiple dimensions of a polarizing issue that is meaningful to you.
Public health is a profession committed to serving the public regardless of identity or creed. Yet, left unchecked, polarizing societal debates can impinge on our ability to practice public health in a manner that lives up to our mission. As we confront multiple complex interdisciplinary challenges in health in an increasingly interconnected space domestically and globally, the 10 lessons we have articulated may be essential for both effectiveness and equity. Incorporating and embedding these lessons within public health training curricula and into the ethos of broader diversity and inclusion in academic, governmental, and nongovernmental institutional settings can be a major step forward.
