Trump 2.0 as a Case Study for Public Health Liberation Theory

Introduction

By Grok

Public Health Liberation (PHL), as articulated by Williams et al. (2022), emerges as a transdisciplinary framework aimed at accelerating health equity by addressing the systemic contradictions within the "public health economy." This economy encompasses the economic, political, and social drivers that perpetuate health inequities, characterized by anarchy, competition, and hegemonic influences. PHL posits that health equity requires a radical reconceptualization of public health practice, rooted in liberation philosophy, community-driven praxis, and novel theoretical constructs such as the Theory of Health Inequity Reproduction, public health realism, and hegemony. The second term of Donald Trump’s presidency, referred to here as "Trump 2.0," provides a compelling case study to evaluate PHL’s explanatory power and practical utility. This essay argues that Trump 2.0 exemplifies the anarchy and illiberation within the public health economy, while also highlighting opportunities for PHL-inspired interventions to foster health equity through community mobilization, liberation safe spaces, and strategic praxis.

(Prompt used for essay, "write long essay that Trump 2.0 is a case study for Public Health Liberation theory")

The Public Health Economy Under Trump 2.0

PHL defines the public health economy as the totality of interactions among agents—governments, industries, communities, and institutions—that shape health outcomes through competition for resources and power. This economy operates in a state of anarchy, lacking centralized principles or moral coherence, which reproduces health inequities. Trump 2.0, beginning in January 2025, amplifies this anarchy through policies and rhetoric that prioritize economic and political self-interest over public health, often at the expense of marginalized communities.

During Trump’s first term (2017–2021), public health was marked by deregulation, skepticism of scientific expertise, and policies that exacerbated inequities. For instance, the rollback of environmental protections, such as the Clean Power Plan, increased exposure to pollutants in low-income and minority communities, a form of environmental racism PHL explicitly critiques. The handling of the COVID-19 pandemic further exposed these dynamics, with denialism, anti-mask rhetoric, and vaccine hesitancy fueled by political factions undermining public health efforts. Trump 2.0, building on this legacy, is poised to deepen these trends through proposed policies like further deregulation, reduced healthcare access via Affordable Care Act (ACA) rollbacks, and immigration restrictions that limit healthcare access for undocumented populations.

These actions align with PHL’s concept of public health realism, which posits that agents in the public health economy act out of self-interest, often engaging in misleading speech or actions to maintain power. The Trump administration’s framing of public health measures as infringements on personal freedom exemplifies this, prioritizing political capital over community well-being. Moreover, the administration’s alignment with industrial polluters and pharmaceutical interests reflects hegemonic control, where powerful agents maintain dominance by directing resources to their advantage, as outlined in PHL’s 16 Principles of Public Health Realism.

Illiberation and Historical Trauma

A central PHL construct, illiberation, describes the internalized oppression and fear that immobilize communities, preventing them from challenging systemic inequities. Trump 2.0’s rhetoric and policies exacerbate illiberation, particularly among marginalized groups. For example, anti-immigrant policies, such as mass deportation plans, instill fear in Latino and other immigrant communities, discouraging them from seeking healthcare or engaging in public health advocacy. Similarly, the administration’s support for policies restricting reproductive rights retraumatizes women, especially Black women, who face disproportionate barriers to healthcare access. These actions resonate with PHL’s emphasis on historical trauma, where contemporary policies echo past injustices like forced migrations or discriminatory urban renewal, reinforcing cycles of marginalization.

The case of Washington, DC, highlighted in the PHL paper, illustrates this dynamic. The city’s lead-contaminated water crisis, which disproportionately harmed Black communities, was exacerbated by institutional failures and falsified reports by the CDC. Trump 2.0’s potential to weaken federal oversight of environmental regulations could replicate such crises, further entrenching illiberation by normalizing suffering and silencing dissent. PHL’s Morality Principle, which demands immediate intervention in the face of known harms, is directly applicable here. The administration’s inaction or complicity in environmental racism would trigger this principle, necessitating community-led responses to interrupt harm.

Liberation and Community Mobilization

PHL’s liberation philosophy offers a counterpoint to illiberation, advocating for a mindset and practice that empower communities to overcome systemic barriers. Trump 2.0 presents both a challenge and an opportunity for liberation. The administration’s policies, which often marginalize vulnerable populations, can catalyze the creation of liberation safe spaces—social environments where communities affirm shared experiences and strategize for change. These spaces, as PHL describes, can be spontaneous or planned, dialogic or radical, and are critical for fostering collective action.

For instance, during Trump’s first term, grassroots movements like Black Lives Matter gained momentum in response to systemic racism and police violence. Trump 2.0’s policies, such as potential expansions of policing or reductions in social safety nets, could similarly galvanize communities. PHL’s horizontal integration, which emphasizes amplifying marginalized voices in public health discourse, is particularly relevant. Community advocacy groups, such as those led by Black women in Washington, DC, as described in the PHL paper, can leverage their experiential knowledge to challenge policies that reproduce health inequities. The success of the Near Buzzard Point Resilient Action Committee (NeRAC) in influencing Washington, DC’s Comprehensive Plan demonstrates how liberation safe spaces can translate into policy wins.

Vertical integration, another PHL tenet, calls for expanding the scope of public health interventions across the public health economy. Under Trump 2.0, this could involve coalitions of community advocates, researchers, and subject-matter experts targeting multiple levels—local zoning boards, state legislatures, and federal agencies—to counteract harmful policies. For example, PHL-inspired praxis could include legal challenges to deregulation, public campaigns highlighting environmental injustices, or citizen research documenting health impacts in affected communities. The Rodham Institute’s mass vaccination efforts during the COVID-19 pandemic, as cited in the PHL paper, exemplify vertical integration by addressing structural barriers like online registration through community-based solutions.

The Theory of Health Inequity Reproduction

PHL’s Theory of Health Inequity Reproduction (THIR) provides a framework to analyze how Trump 2.0 perpetuates health disparities. THIR identifies four components: social mobilization, constraints on harmful conduct, economic incentives or punishments, and a constant representing entrenched structural inequities. Trump 2.0’s policies often undermine the first three components, reinforcing the constant of structural inequity.

1. Social Mobilization: Trump 2.0’s polarizing rhetoric stifles social mobilization by fostering illiberation. For example, policies targeting transgender healthcare or reproductive rights may deter affected communities from public advocacy due to fear of retaliation. PHL counters this by promoting liberation safe spaces where communities can build collective power, as seen in the PHL authors’ community webinars that influenced Washington, DC’s planning policies.
   
   

2. Constraints: The administration’s deregulation agenda, such as weakening EPA standards, removes positive constraints that mitigate health inequities. PHL advocates for introducing new constraints, such as health impact assessments for legislation or community-led regulatory appeals, to counteract these rollbacks.
   
   

3. Economic Incentives/Punishments: Trump 2.0’s economic policies, like tax cuts for corporations or reduced Medicaid funding, prioritize profit over health equity. PHL’s THIR suggests leveraging fiscal tools, such as fines for polluters or incentives for equitable healthcare models, to realign economic priorities with public health goals.
   
   

4. Structural Constant: The entrenched nature of racial and economic disparities, as acknowledged by PHL’s reference to Derrick Bell’s racial realism, is perpetuated by Trump 2.0’s policies. While PHL recognizes that not all inequities can be eliminated immediately, it emphasizes the need for seismic shifts akin to the Civil Rights Movement. Trump 2.0’s resistance to such shifts underscores the urgency of PHL’s liberation-focused approach.
   
   

Praxis and Resistance

PHL’s praxis component—applied liberation—offers practical strategies for communities to resist Trump 2.0’s harmful policies. Praxis is adaptive, embracing diverse methods like editorials, protests, and citizen research. The PHL authors’ success in influencing Washington, DC’s Comprehensive Plan through community webinars and coalitions illustrates praxis in action. Under Trump 2.0, similar strategies could target federal policies, such as ACA rollbacks, by mobilizing coalitions to lobby for healthcare protections or by conducting research to document policy impacts on marginalized groups.

Moreover, PHL’s emphasis on training equips communities with skills in policy analysis, community organizing, and media engagement. The internship opportunities provided by PHL founder Christopher Williams, as described in the paper, demonstrate how training can empower students and residents to engage in praxis. Under Trump 2.0, expanding such training programs could build a cadre of advocates capable of navigating the complex public health economy.

Hegemony and Public Health Realism

Trump 2.0’s alignment with powerful factions—corporations, political allies, and media influencers—exemplifies PHL’s concept of hegemony, where dominant agents maintain control by framing issues to their advantage. For instance, the administration’s promotion of “personal freedom” over public health mandates during the COVID-19 pandemic obscured the disproportionate harm to low-income and minority communities. PHL’s public health realism cautions communities to scrutinize such narratives, recognizing that agents’ self-interests may conflict with health equity.

To counter hegemony, PHL advocates for communities to build their own power through horizontal integration, forming coalitions based on shared interests. The PHL paper’s example of public housing residents collaborating with environmentalists to address air pollution highlights this approach. Under Trump 2.0, communities could form similar coalitions to challenge policies like immigration restrictions or environmental deregulation, ensuring that their voices shape the public health agenda.

Conclusion

Trump 2.0 serves as a vivid case study for Public Health Liberation theory, illustrating the anarchy, illiberation, and hegemonic influences within the public health economy that perpetuate health inequities. The administration’s policies, from deregulation to healthcare restrictions, exacerbate structural violence and historical trauma, particularly for marginalized communities. However, PHL’s framework—rooted in liberation philosophy, the Theory of Health Inequity Reproduction, and adaptive praxis—offers a roadmap for resistance and transformation. By fostering liberation safe spaces, mobilizing communities, and leveraging vertical and horizontal integration, PHL empowers communities to challenge Trump 2.0’s harmful policies and accelerate health equity. As PHL asserts, the public health economy’s contradictions can only be reconciled through a radical, community-driven approach that prioritizes liberation over acquiescence to systemic harm.