"I think, unfortunately, we are probably worse off at the moment," he says. "We've retreated from our participation with the World Health Organization. We've stopped participating in and supporting immunizations for poor countries internationally where we often have our best chance of saving lots of lives, but also protecting Americans so those diseases don't reach our shores. And now in the United States, we're creating confusion about the safety and about the value of vaccines."
That confusion, he says, is the product of policymakers putting politics and beliefs above the science.
"It is a real tragedy to me that there are people in positions of serious leadership giving information that is knowingly false or misleading," he says.
Stack's advice, seek medical information from physicians and credible health care sources and stick to the vaccinations that have proved effective in nearly eliminating diseases such as measles.
See the full conversation below.
JJ: What are your top priorities coming into this top spot at the cabinet?
SS: Well, sure. So it's been a great privilege to serve Kentucky for the last five-and-a-half years as the commissioner for public health, and I really look forward to now serving through the end of the Beshear administration as the Secretary for the Cabinet. I'm committed to supporting the governor's goals and initiatives to ensure that every Kentuckian has the opportunity to live rich and fulfilling lives, supported with the opportunities they need to be healthy and well.
And we're going to do our very best to navigate the challenges that we're going to have with the federal policy changes... and make sure that we use the resources we have to the best of our ability to make sure Kentuckians are supported.
JJ: You've said you worry that Kentucky is on the "cusp of having a significant backslide" if the federal government cuts to programs like Medicaid and SNAP kick in. Elaborate on that. What areas are most concerning to you?
SS: Well, 50% of all the children in Kentucky are covered by Medicaid. [Almost] 1.5 million Kentuckians are on the Medicaid program. That's one third of our entire population. Some counties have more than half of all of the residents in their communities on Medicaid. The SNAP program supports 600,000 or more people across the state of Kentucky.
These are big numbers. These are our neighbors. They're our friends. They're often our family members. When some of them lose these benefits in the upcoming years because of the cost shifting or the support elimination the federal government is doing, it's going to hurt our communities. It's going to set them back.
If kids go to school hungry, they can't learn. They can't focus. If families have hunger, we see things like domestic violence and abuse increase. When people are not well-fed and or when they don't have access to health care like Medicaid provides, they have worse problems, worse medical outcomes, and, sadly, they live sicker and they die younger.
So I'm really concerned about that this could hurt the people in Kentucky.
JJ: We learned a lot of lessons from COVID. Do you see us as better prepared now, or with federal government supports backing away as you mentioned and so many aspects of life becoming politicized, are we in danger of finding ourselves even more unprepared for that next health emergency?
SS: I think, unfortunately, we are probably worse off at the moment.
We've retreated from our participation with the World Health Organization. We don't engage meaningfully in anywhere near the same way with the international community. Diseases don't respect borders. COVID came from far, far away—the opposite end of the world—and it was here within weeks and it devastated people across the planet. So, without participating with foreign nations, we have problems.
We are undermining the very integrity of the immunization and vaccination program in The United States Of America. We've stopped participating in and supporting immunizations for poor countries internationally where we often have our best chance of saving lots of lives, but also protecting Americans so those diseases don't reach our shores.
And now in the United States, we're creating confusion about the safety and about the value of vaccines and we're endangering, possibly, the vaccine approval process and the way that these vaccines are paid for. All of these things lead to a sicker and less healthy America and that means a less healthy Kentucky.
As a physician, that just breaks my heart. We know better. We know we can do better. And, yes, I think we're worse off now than we were, in 2019, at the cusp of the COVID pandemic.
JJ: I know that there are some efforts to create regional groups made up of states and health experts to perhaps fill in some gaps when they feel that CDC advice is is not trustworthy. Is there any talk about Kentucky starting anything like that, joining something like that, in order to make sure that good information is out there?
SS: Well, the Kentucky Department for Public Health, this Cabinet, the administration, we partner with states all the time to do things that make good sense to support the people in Kentucky. So we've been doing things like that. We will continue to.
I think the changing federal landscape will challenge us to consider [if] are there other things we need to do or can do. It's challenging. Let's just be honest about it.
The governor has commented about FEMA. And if we eliminate FEMA, how that would be disastrous for the United States. Because in any given year, the United States will have disasters, natural disasters somewhere in the country. We know that for a fact. Every year there are natural disasters, but not every state has natural disasters every year. So to have one national infrastructure that makes it possible to respond is sustainable and necessary, but to have every individual state create the same infrastructure is cost inefficient and quite simply not possible.
The same thing happens with these health and human services aspects. If the Food and Drug Administration is the only agency in the United States with the authority to approve a new pharmaceutical for marketing and human use in the country, there is no way for the states individually or even collectively to replace that.
The Centers for Disease Control had been the preeminent public health agency in the world and now it has been so undermined and crippled that it is really taking away the United States' leadership in public health and population health.
And so, Josh, it's just not simply possible to replicate through a combination of states what the federal government once did, at least not in the world as we understand it now.
JJ: Going into the summer, I'm wondering what you have your eye on when it comes to health threats. We had measles in the headlines here, obviously, in Fayette County, but could we be seeing a COVID variant as well? What are you looking at?
SS: Well, there are always risks that there could be new pathogens that arise or that COVID could change.
I think right now, my biggest concern, and it is still solidly within our ability to fix it, is that folks need to make sure their children are fully immunized against the routine childhood illnesses.
Use measles for example. We had declared [that we] eliminated measles in the United States 25 years ago. We've now had more than 1,200 cases in the United States this year alone. It's going to get hard real soon to be able to claim anymore that it's eliminated in the United States. And if it starts spreading more freely, more people will get sick. And for people under five years of age or the littlest kids, when we've had major outbreaks, as many as one in five of them end up in the hospital. That's how sick they get.
So right now... I'm concerned that we are backsliding on our general immunizations, things we know work, that don't require invention or innovation. They simply require doing what we already know works and having all of us in society maintain our confidence in the safety and value of doing that.
So I would say for this summer, the single biggest thing I could encourage everyone to do, that is accessible to them now, is please go out and make sure your children are fully immunized. And if you are an adult who is not fully immunized, it is never too late. You can always begin that journey to protection today and set yourself on a better path.
JJ: Before I let you go, are there any messages you want to get out there that we didn't touch on?
SS: I'd encourage all of our Kentuckians to please, if you have questions about your health care, seek real professional advice from doctors and nurses and physician assistants who are properly trained and educated to provide that advice so you can make fully-informed good decisions for you and your family's health and well-being.
I also would implore that people listen to credible policymakers who are taking seriously the very serious responsibility of giving scientifically sound and evidence-based guidance to populations, so that people can make well-founded and informed decisions. It is a real tragedy to me that there are people in positions of serious leadership giving information that is knowingly false or misleading and setting people down a path of uncertainty.
As a parent myself, I know there's nothing I wouldn't have done to ensure the health and safety of my child. And I think that's what all Kentucky parents are trying to do — look out for their kids — and they're receiving conflicting and confusing information, much of it knowingly false. Which is causing them to doubt scientifically sound and valid guidance, such as immunizing their children like we have done for a very long time.
So, I would really, really encourage your listeners to listen to their doctors, get professional medical advice, and please listen to credible policymakers who are putting science above politics and beliefs to make sure that people are protected. It's just a real sadness to see people get hurt when they didn't need to get hurt.