Former U.S. Surgeon General Jerome Adams’ youth and career path, lessons learned from the COVID-19 pandemic, and advice for journalists were all on the table during his fireside chat on Friday, March 10, at Health Journalism 2023 in St. Louis.
Adams served as the 20th Surgeon General of the United States from 2017-2021 under former President Donald Trump. He is now a presidential fellow and executive director of health equity initiatives, and a distinguished professor of practice in the Departments of Pharmacy Practice and Public Health, at Purdue University in Indiana.
In a wide-ranging conversation with AHCJ Executive Director Kelsey Ryan, Adams addressed everything including his childhood, growing up with severe asthma in a modest family in rural Maryland and the surgeon general’s responsibility for overseeing the U.S. Public Health Service Commissioned Corps and its 6,500 health officers stationed around the world and helping recognize and respond to health threats.
“I never dreamed I would be Surgeon General of the United States — I never thought I could be a doctor,” Adams said. Although he said he had the aptitude, good grades and a family that prioritized education, he never met a Black doctor, despite his health issues, until he got to college. That inspired Adams to pursue a career in medicine.
After finishing his medical training, Adams worked in Indiana as an anesthesiologist and became involved in organized medicine and advocacy through the American Medical Association and Indiana-based medical associations. That’s when he met then-Congressman Mike Pence.
Later as governor, Pence appointed Adams as state health commissioner in 2014, and in that capacity, Adams was thrust into the midst of an HIV epidemic. When Pence became vice president of the country, he recommended Adams serve as surgeon general. Trump nominated Adams for the role in June 2017; he was confirmed by the Senate that August.
During the talk, Adams addressed some criticisms aimed at him during his time in public office. One concerned his work advocating for syringe exchange programs in Indiana to stop the state’s outbreak of HIV caused by needle-sharing.
“It continues to be one of the things I’m most proud of during my public health career,” Adams said, noting that syringe service programs were illegal in the state and most conservative communities at the time. Through outreach to the community visiting jails, churches and local hospitals, he garnered interest to push for such programs to become legal in Indiana.
Bordering states Kentucky and Ohio also grew their programs. “It shows that even in the places you would never expect, you can accomplish great things for the community and the nation if you’re willing to be present and stay at the table,” he said.
Adams said his passion has been bringing attention to noncommunicable diseases as well as the opioid epidemic. As surgeon general, he issued an advisory asking more Americans to carry the medication naloxone, which can reverse the effects of an opioid overdose.
The issue was personal, he said, noting he had a brother who served time in prison due to crimes related to an addiction and two uncles who battled substance use and alcohol disorders. Naloxone dispensing increased 400% during Adams’ time as surgeon general. “We saved tens of thousands, if not hundreds of thousands of lives,” he said.
Some of his additional calls to action focused on e-cigarette use, hypertension, suicide prevention and maternal mortality.
Misinformation and the pandemic
Adams also addressed misinformation surrounding instructions to people in the peak of the COVID-19 pandemic, noting that in his surgeon general role, he helped carry out decisions made by agencies such as the Centers for Disease Control and Prevention.
It’s unlikely that we will learn the true origins of the pandemic as China is not sharing information, Adams said. And there still are no agreements in place for countries to share information if another pandemic emerges. In 2020, scientists largely believed that most respiratory viruses were spread through droplets, he said, and that if people had symptoms they should stay home and isolate.
“Once information got out of China that there was high asymptomatic spread, we had to change that advice,” Adams said. “The scientific community took way too long to acknowledge airborne spread and didn’t have the information about asymptomatic spread to make choices that ultimately would have helped save lives.”
When it comes to trusted sources of health information for people, he said, a recent survey shows people have low trust in local elected officials and medium trust in government agencies like the CDC but maintain high trust in their doctors and nurses.
“We need to do a better job of equipping and arming local doctors and nurses with the information that they need to help people make good choices,” Adams said. Additionally, he said, better communications training is needed for public health officials.
“There’s a saying, ‘Tell them what you know, tell them what you don’t know and tell them how you had to find out.’ It sounds simple but it’s hard to do, and it’s really hard to do in a world of communication by tweets and then headlines.”
Educational programs in both science and math education also are needed in the U.S. so people can understand the importance of public health messages, he said.
Adams noted that health inequities also came to light during the pandemic, with scientists realizing along the way that older adults, people of color, those from marginalized communities, and people who were obese or had chronic illness were at higher risk of getting infected with the virus and developing other illnesses such as diabetes and cancer.
“COVID forced us to reckon with the fact that risk is not equal,” he said, noting that not every family had the room to spread out to isolate or work from home. “Equity is about giving people what they need, and we need to give different people different resources.”
In closing, Adams called on journalists to help make news relevant to readers by showing them data from their own communities that feels more relevant and applicable, to find voices that don’t get amplified “as much as they should,” and to try to be as apolitical as possible in reporting and the way questions are asked.