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Good evening and welcome to our community Conversation.

PA Health and Politics, presented by PBS 39 radio 91.3 FM and Lehigh Valley News.com.

Tonight, we will take an in-depth look at the latest insights into public health across the Commonwealth.

We're diving into the findings of the 2025 Pennsylvania Health Survey, conducted by the Muhlenberg College Public Health Program and the Muhlenberg College Institute of Public Opinion.

This spring, researchers collected opinions from Pennsylvanians on everything from health care, access to immunizations, mental health, and the political landscape.

We're joined by leading voices in medicine, public policy and research to explore what the data tells us and what it means for you.

We begin by taking a look at how the survey was conducted and what made this year's results so different from years past.

For that, we sat down with Christopher Borick, a professor of political science and the director of the Muhlenberg College Institute of Public Opinion.

Chris, thank you so much for joining us.

Oh, it's my pleasure, Brittany.

It's always great to talk to you.

So the 2025 Pennsylvania Health Survey is out for this year.

It came out this spring, and some of the findings in this survey are unlike some of the findings we've seen in years past.

But let's start with how did you get these findings?

How does this survey, how is it conducted and how does it work?

That's great.

We've been doing the survey now since 2013.

It's part of our ongoing outreach in Pennsylvania to study issues.

We do it with our public health program at Muhlenberg.

And every year we go out and interview Pennsylvanians across the Commonwealth.

Regarding these issues.

It's largely by cell phone.

So we have conversations, interviews with these, Pennsylvanians.

And we asked them an array of questions.

Some of the questions we ask every single year.

We repeat them to see how things might be changing among Pennsylvania residents.

Other questions are timely that we add based on what's going on in the world, what kind of health issues are playing out, what kind of topics are key.

And so this year, we once again, without this spring, talk to over 500 pencil Virginians, and got some really interesting findings on, on issues that we think are salient for, for the state.

Sure.

What are some of the key findings that really stuck out to you as different than years past?

Well, we asked questions on broad health topics.

For example, how are people feeling about health care in the state?

How are they feeling about their own personal health, their mental well-being?

And we did see this year a little bit of a downward trend in how people evaluate both the overall health care that they receive, and their overall health.

And that's an interesting shift.

You know, it's not dramatic.

I think most Pennsylvanians still think they get good health care.

Most Pennsylvanians still rate their overall health and mental health pretty positively.

But compared to last year, in the last few years, we've seen a bit of a step back in terms of those overall evaluations of individual health and health care.

Sure.

And one of the key findings in that that point was the cost of health care.

Yeah.

So one of my favorite questions that we ask every year is an open ended question.

What do Pennsylvanians think are the biggest issues facing health and health care in the Commonwealth?

And this year, when people, in their own words, told interviewers, the most common things are cost, and access.

These, in the area of health policy have always been challenges.

Can you get access to health care?

How much and how affordable is that care?

And when individuals in the state were telling interviewers what they thought was the biggest challenge, those words came over time and time again.

Access, affordability.

Let's talk health care quality some more as we welcome to read the vice president of community health for Saint Luke's University Health Network.

Thank you so much for joining our conversation.

Sure.

It's great to have you here.

So the report found that 51% of Pennsylvanians say that the quality of health care in the state is either excellent or good.

At first glance, sounds good about half, but that's down from 70% the previous year.

So thoughts on why that went down over the past year?

Sure.

So at Saint Luke's we have high quality metrics and we hit, those high marks that every hospital we have.

However, I think, I wonder if the perception is based on the social determinants of health.

The social determinants of health are really those issues, those external issues that have a tremendous impact on health care or health overall.

Additionally, the cost of living has increased, and there's a lot of talk in media about, provider shortages and such in, and rural communities and rural communities are having a difficult time with health care.

An example I can give you is Saint Luke's minor's campus.

That hospital would have had to shut its doors had we not merged.

Had Saint Luke's not merged, with Minor's Hospital.

And that hospital serves a large rural population with acute health needs and chronic diseases and such.

Sure.

We hear time and time again in the health care realm, access and cost are huge, drivers for people's opinions on the health care that they're receiving.

So as a whole, when you look at Pennsylvania, are Pennsylvanians getting the care that they need right now?

Would you say so?

I do think access to care is an issue that we struggle with in Pennsylvania.

And it's not just about having facilities, but it's also ensuring that people feel comfortable walking through the doors of those facilities and receiving the care.

We have, community health navigators or community health workers who work as navigators to ensure that they can build the trust with our community and our partners, and connect them to care and resources.

And we find that that makes a large, impact and a big difference in folks being able to reach that care.

Additionally, I do think it's important to have health care where you live.

And, Saint Luke's has done a really, intentional job of placing hospitals in communities, full service hospitals, so people aren't transported to other campuses and have the support of their family and their support network wherever they're receiving their care.

Sure.

So what are some of the biggest concerns right now among your patients and people you hear from?

So we conduct community health needs assessments every three years.

In this round we had over 15,000 survey responses.

And we saw that access to care, improving chronic disease and, mental and behavioral health, access to mental and behavioral health services, with a three priorities that came through in our survey as well.

Sure.

We're going to talk more about mental health and our overall health later in the program.

But I do want to ask you, you know, this this survey looked at Pennsylvania as a whole, but are there regional differences in access and quality?

Is there regional differences in health care that people are receiving?

So I think there are regional differences in health care.

And it has to do with health systems too.

At Saint Luke's, we prioritize our community, and have folks embedded in places like schools and, pantries, soup kitchens, shelters to ensure that, folks are, aware of the resources and services that we can provide.

And then, you know, help bridge that gap and bring people into the system.

We have over 250 partners in our community.

And so, by working so closely with the folks that serve our community, we're able to, again, ensure that people are receiving the care they need and the support they need.

Sure.

When it comes to health care quality, what's driving public perception?

I think media and politics play a large role in, public perception.

I think we saw that in the survey as well.

And I don't think it's a data driven approach as much that, makes people, think about how they view health care.

Sure.

Does cost fall into that?

Absolutely.

And again, at Saint Luke's cost is one of those things that's really important to ensure that, people are able to access those resources.

Sure.

Access and cost going hand in hand.

And so what are some of the provider challenges?

You know, we talk about Saint Luke's.

What are some of the challenges that health care systems are facing in 2025?

So I think one of the largest challenges we see from a public and community health perspective is, reimbursement, for mental and behavioral health services and care.

You know, that's, something that I know, systems are working on and I think would assist our community in accessing those care services much better.

Sure.

Final thoughts on what you thought about the health care, survey is this does this align with what you're hearing from the community that Saint Luke's serves?

Yeah.

It wasn't surprising news just because we're running, data and and services a lot.

And, it's unfortunate sometimes when you hear some of those pieces.

But it also helps guide us and to understand what and how we need to approach issues and provide those services.

Wonderful.

Rodricka Reed, the vice president of community health for Saint Luke's University Health Network.

Thank you so much for your insights.

Thank you for having me.

Back again with Christopher Borg from Muhlenberg College.

And so we heard about health care quality.

But this all comes out to some of the things we've learned in this survey when it comes to politics and the way people feel about health.

Specifically, the Secretary of Health and Human Services.

Yeah.

So Robert F Kennedy Jr, the secretary of Health and Human Services, of course, has an iconic name as part of the Kennedy family, the Democratic legacy.

But he's also been a controversial figure in American politics, particularly, with some of his stances on health related issues.

Vaccine in particular.

And so it was probably no surprise, when he was picked by President Trump to serve in this key role, that there would be mixed reactions to his, leadership and his, job.

In the secretary position in the cabinet.

And that's exactly what we found in the survey.

Pretty mixed reviews and more Pennsylvanians had a negative view of his work in the capacity as Secretary of Health and Human Services than a positive view.

Sure.

The survey says that less than four out of every ten Pennsylvanians expressed the lack of trust.

They expressed a lack of trust in this.

In this role that is so high up and a standard for our health.

Why do you think that is?

Yeah, that's right.

Pretty.

And that's the key role with health.

Often trust is paramount right.

That you trust somebody to be able to take care of you or to lead.

And so when it comes to health policy, I think it's particularly important to think about the trust.

Has positions, as I mentioned before, historically, positions on immunizations, the effects, the safety of immunizations often clash with public health officials and public health experts across the country and across the world.

And that's become a lightning rod, if you will, and public's interpretation and evaluation of RFK Jr. And I think when we asked and we did this this spring, during the first 100 days of the Trump administration and lots of movement, lots of changes, the public seemed to be a little uneasy.

Pennsylvanians seem to be a little easy with his style, his leadership, and his decisions.

And again, in an area like health, trust of the public, with public health officials.

And he is a public health official by his appointment, I think is crucial because there's often, as we've seen and experienced during health crisis, the leadership and the trust in those officials becomes really important for implementation of policy.

Sure.

And I want to talk about policy as it pertains to health and how people perceive their health.

We've seen a big change in policy since this new administration has taken over.

Do you think that they directly impact, this the results of this latest?

Yeah, certainly.

When any time you're in the field with the poll and you're measuring where the public is, it's it's the proverbial snapshot in time.

So we did this during the first 100 days of the Trump administration.

And of course, during the president's, new administration, there's been lots of changes, lots and uncertainty in economic policy, environmental policy, transportation policy, you name it.

And and among those fields is health policy.

And so the public, as they try to get their arms around, these changes may have considerable discomfort.

It might be just with the change that is happening, it might be with the particulars of the change and who's making the changes and what kind of changes are being made.

And in the Secretary of Health's case, you know, RFK Jr.

I think it's, it's a little bit of both.

Some of, it is in his policy positions that the public is maybe uncomfortable with, and some might be in his leadership style and his association of course, with the administration.

And that's how they're appraising, the individual performance of the secretary.

Yes.

Let's take a look at some of the changes that RFK junior has made in the first hundred days of this administration since taking office as secretary of Health and Human Services, Robert F Kennedy Jr has shaken up the US healthcare landscape with sweeping reforms that have stirred both applause and controversy.

Here is a breakdown of the key changes RFK Jr has introduced, and what they could mean for the future of health care in America.

First, RFK Jr has launched a massive restructuring of the HHS, consolidating multiple agencies into a new organization in the administration for a Healthy America.

Or, never in American history has the federal government taken a position on public health like this.

Alongside this move came the layoff of nearly 10,000 federal employees and the cancellation of billions in public health.

The university grants legal challenges to these cuts are already in motion, though he had this to say during a recent hearing.

I don't think people should be taking advice, medical advice.

Write me.

The Secretary of Health and Human Services is pushing for stricter approval standards, including mandatory placebo controlled trials for all new vaccines.

I think what we're going to try to do is to lay out the pros and cons, the risks and benefits accurately as we understand them, okay, with reputable studies, critics say this could slow down vaccine development and reduce access, especially during health emergencies, but supporters argue it's a step towards increased safety and accountability.

In a controversial move, RFK Jr rolled back a decades old transparency policy, ending public comment periods on many HHS decisions.

People.

This rollback has raised alarms among advocates who fear the public's voice is being shut out of major health care decisions.

Disruptions will not be tolerated.

But it's not all cuts and controversy.

RFK Jr has emphasized chronic disease prevention, calling out what he labels unhealthy fat within the HHS.

He's also directing the CDC to refocus on outbreak response and pandemic preparedness.

One thing's clear RFK Jr's tenure as HHS secretary marks a dramatic shift in how the US approaches public health.

Supporters call it a necessary reset.

Okay, critics warn it could undermine decades of progress.

This in this health survey, we saw a drastic increase in people who believe that immunizations are directly impact ING the rate of autism in folks, and we haven't seen that before.

No, no.

So we've asked this question, Brittany, all the way back to 2013.

Every year we've asked Pennsylvanians, do they see that a link between MMR shots, childhood vaccinations, and the likelihood of a child getting autism?

And interestingly, for many years we saw a decline in that, that Pennsylvanians were increasingly saying there is no link, for this.

And we've even heard studies that say there's no link.

Oh, there is overwhelming.

And this is really an important point.

There's overwhelming evidence from research that there is no link.

There was a debunked study 30 years ago, that that said there was a link, but there's been hundreds, literally hundreds of peer reviewed studies that have said there is no link.

So from the science perspective, it's settled.

There is not a link.

However, public perception doesn't always align with what science may say, so public may not have the same views as empirical sciences.

And this is important in this case.

In this case, what we've seen is for years, through public health efforts, through communication efforts, through outreach efforts.

It was doing its job.

It was reaching the public.

And the public was saying, yeah, there is no link.

If fewer or fewer Pennsylvanians saw that link.

And even during the pandemic, we saw that number reach a record low.

Percentage of Pennsylvanians say there is the link.

But over the last few years that starts to creep up, more Pennsylvanians were saying that, yeah, I think, you know, there could be a link here.

I agree that there is a link.

This year is the year that we saw the biggest change in terms of upward movement of Pennsylvanians saying that they believe there is a link between immunizations and autism.

It's about a third of Pennsylvanians right now, which is, you know, double that what it was a few years ago.

And I don't think necessarily it's shocking to think why now?

I think it's connected to things.

We've talked about messaging from government officials, messaging from the Secretary of Health and Human Services.

That's certainly in the past has raised some questions, or concerns about that possible link.

So our politics are having a direct impact on how we think about our health as a whole.

And immunizations.

I think most certainly that's the case in this particular area.

Brittany, leadership, we talk about it, political scientists, we talk about the impact of communication.

We call it elite cuz what the elites are saying, how does that affect mass opinion?

And in this case, the shift that we saw on Pennsylvanians perceptions of the relationship between MMR and autism doesn't come out of the blue.

And while we can't pinpoint per se the exact impact of the communication and the messaging coming from someone like Secretary of Health and Human Services Kennedy, it certainly makes sense that the shift comes at the same time as we're seeing changing messages.

Vaccines remain a hot topic.

The survey explored how Pennsylvanians feel about immunizations in a post-Covid world, and now we discuss that with some of our doctors and what doctors are seeing on the front lines.

Joining us now is Saint Luke's senior vice president of medical and academic affairs, Doctor Jeffrey Gerry, along with Doctor Thomas Whalen, a retired chief medical officer for Lehigh Valley Health Network.

Gentlemen, thank you so much for joining us for this conversation.

Thank you for having a pleasure.

So we hear a lot about vaccines this these days, but it's nothing new, especially in this post-Covid world.

So where do we stand on vaccine hesitancy?

What are we hearing from patients and people in the community?

Doctor Jerry, if you'd like to start, there's basically three different categories.

There are the total vaccine deniers, and there's no way that you're going to get them to change their mind.

There are people who are vaccine fatigued, and they just don't want to hear anything else because they feel that there's been too much information.

Those people can be swayed.

And then there's the vaccine hesitant who have some information, and they make some decisions, but they're willing to change their mind if they can be given additional information.

And that's those are the last two groups that we have to work on.

The group that's absolutely in denial.

We find that that's not a very, group.

That's a group that's receptive.

Sure.

Doctor Whalen, what are you seeing in support or not?

Support or hesitancy in vaccines?

No, I agree with Doctor Jerry's the classification.

That's certainly the three main tiers.

The study, of course, you know, focused on autism and its relationship to vaccines and, and here it's it's really incredible.

It's hard to prove the negative, but the negative has been proven in terms of autism.

The hesitancy began in the late 1990s with a study by a gentleman named Wakefield, who studied 12 children, non-randomized and concluded that there was a linkage.

He also had been linked to some legal support for some of his studies in the early aughts, a study of over 500,000 children in Denmark.

A population based cohort study, a valid methodology, clearly demonstrated there's no relationship.

So to see that a third of our population believes that linkage is highly distressing.

If there's anything that's been proven, it's that autism has no relationship to vaccines.

There's also, unfortunately, we we think that it may be multifactorial, and the unknown is what leads people to kind of make these linkages when it doesn't belong.

I do believe that it is worthwhile for the current administration to do this again, because people are likely then to listen to it and where they didn't listen to the evidence that Doctor Whalen brought out.

Sure.

Is that why we're seeing people change their, you know, their opinions on immunization and their link to autism?

Is it is it the current administration?

Do you see in your day to day, you know, research and interactions with patients?

Do you see that people are changing their opinions because of politics?

Politics should never have gotten in the way of public health.

And, I can say that that is been a problem with both parties.

It isn't just the current administration.

We didn't do what Australia did, which was to decide that they were going to put politics aside and try and come out with the best evidence and support that.

So because it's been a political football that has created all kinds of issues and those issues continue, I will also add that much of what we're seeing right now has to do with what happened during Covid.

During Covid, there were people in, the administration and public health, other people who were vaunted who came out with statements that were absolute when they never should have been and when they were proven incorrect, they didn't come out and correct it.

We always started all of our advice to our community by saying that what we're telling you is based on the scientific evidence that we have, that evidence is going to change.

And if it's wrong and sometimes it is, we will change it.

Unfortunately, we didn't hear that, from some of our public health officials and that is what has led really to a total distrust currently of, of what you would say would be organized medicine.

We have a lot of repair work to do, shorten your years of practicing.

And this goes for both of you and your years of practicing.

Have you seen shift in people's opinions as administrations change, doctor.

Well, clearly.

Yeah.

Although is it causal or is it just a temporal relationship?

So I emerged from my fellowship in 1984.

So vaccine hesitancy really didn't exist as such back then, certainly not to the degree that it is now.

And so that shift has occurred.

Is it influenced by administrations, perhaps, our current Secretary of Health and Human Services, I wholeheartedly agree with at least one thing that he said before a congressional panel.

And that is you shouldn't take medical advice from him.

Okay.

Doctor Jerry, how about you?

Have you seen the opinions of your patients changed throughout the years as the administrations change?

Yes, absolutely.

And again, what we need is a concordance, really, of both parties to agree.

We had, you know, in the beginning, we had people like, Nancy Pelosi who said I wouldn't take any vaccine that that Trump has helped to develop.

And then we had Trump literally rip his mask off, you know, during Covid and have a whole bunch of people become infected during, a major public ceremony that should never have occurred.

And unfortunately, again, it has left a wake.

As far as RFK is concerned, there is absolutely no question that he has done a number of things that have been absolutely provocative and harmful.

At the same token, you know, what I would say is that not everything that he has said is wrong.

And, when he has criticized some of the advice that has been given, I mean, people have made every vaccine sound like it's going to be 100% effective.

It's 100% safe.

That is certainly not true.

What you have to be able to do is to really level with the public and tell them what's good about vaccines, what isn't so good about vaccines, and what may change.

The public will accept that what they won't accept is someone saying, I am the science, and this is the way it is.

That never should have been done.

Sure, as we move forward with the, opinions changing on immunizations, are we worrying at all in the medical community?

Are you worried at all about disease resurgence and people not getting immunized?

And then we see these these different you know, we're seeing it in Texas.

Right now, you're not just seeing it in Texas.

You may not realize it, but at this point in time, for instance, when we look at whooping cough, it is Pennsylvania leads the nation in terms of whooping cough, measles.

As you know, there's been over a thousand cases across the country.

There have been more than 31 states that have had measles, including Pennsylvania influenza.

I can tell you from being intimately involved in treating children as well as adults.

It's been a hard year.

Everyone over the age of six months, everyone over the age of six months should have the flu vaccine.

And, that just wasn't the case.

We saw that one third of the people who were eligible to get the flu vaccine actually did.

And that's unacceptable.

So as I said, we have a tremendous amount of repair work to do.

We have to get out into the community, use community leaders that the communities, various communities trust, and then hopefully we'll make some progress, because right now we have areas in our own listening area that are very under ambient, under immunized.

And we know that for many of these things, you need a 95% rate in order to get what's known as herd immunity.

We don't have that in a lot of our communities.

Doctor Whalen, I'd like you to weigh in as your specialty with children.

And so how do you feel on the topic?

And are you concerned as we move forward, if parents start to decide, you know, maybe my child doesn't need that immunization.

So I wholeheartedly agree with everything Doctor Gerry said.

And this reflects really another aspect of the study.

It's the polarity and the anxiety that exists among our populace both here and beyond in the United States.

And and unfortunately, some of the aversion to vaccines is predicated upon political leverage on the topic of vaccines rather than through investigation into the utility and the complication rates and the other things that Doctor Jerry's already mentioned that we need to fully inform our public about.

But if this scaremongering going around, that's even further.

Putting kerosene on the fire of aversion to vaccines.

We only have a couple more minutes here.

But what are you telling patients or people who ask for your medical advice?

What are you telling them right now in this kind of clouded environment, you don't know what the science is pointing to or not.

When it comes to what the administration we are telling people are, there are legitimate sources of information.

There are illegitimate sources of information to pay attention to some of the legitimate sources of information, and to understand that science, by its very nature, there may be some disagreement.

We've seen some disagreement sometimes between the f, the FDA, the ACIp, and some other governmental bodies.

That's acceptable because eventually what happens is that's how you arrive at truth.

But, there are certainly are places where people can go and get the current information.

And that's true, really, of both of our hospital systems.

And we advise people to do that.

And there are also numbers to call in, and you can speak to your family doctor or your primary physician.

That's probably the place to start.

And they will be able to give you the kind of information that is suited to that individual.

Because remember, not every immunization, one of the problems that has been made is to make one size fits all.

So one size doesn't fit all.

And that's been really, I think, one of the one of the big issues.

You have to listen to your family doctor and that person will tell you is this immunization correct for you?

Sure.

Doctor Whalen, fully support the primary care providers are key to provide concise, reliable information and it needs to be tailored to the population as a whole.

So while doctor Jerry is still actively working in my retired life, most of my conversations are now happening at the country club.

But for instance, people my age, I strongly urge them to continue getting Covid vaccinations.

My grandchild, who's five years old.

I really don't care if he gets it.

It's up to his parents and their pediatrician to decide that.

But the utility needs to be tailored to the population that's being targeted.

Exactly.

And that's where some of these things have changed that, you know, at one time when Covid first came out, it was a very different disease than what it is right now.

And so some of the advice that we are giving for certain populations has changed.

So I totally agree with Doctor Whalen.

Gentlemen, I thank you both so much for weighing in on this topic and bringing some clarity to a topic that is kind of doesn't have a lot of clarity at this time.

Doctor Jeffrey Jerry and Doctor Thomas Whalen, thank you so much for joining us.

Thank you.

Thank you.

As we continue to discuss the impact of politics on how people feel about health, we have to look at and think about our overall mental health and stress.

And this survey kind of showed that certain groups of people are feeling the stress a lot more than other groups.

So what were some of the findings when it comes to mental health and the kind of impact of the political field on people's mental health?

It's a great it's a great question.

It's very important.

We live in Pennsylvania.

Pennsylvania is a place that is highly competitive politically.

We just came off a year where the world was paying attention to Pennsylvania as its key swing state, in the presidential race.

Lots of campaigning here, lots of ads.

So over the last few years, we've really looked at how that might be affecting Pennsylvanians mental health.

What kind of stress is that?

We see, and we saw last year, for example, that that of all issues, Pennsylvanians, even compared to economics and others were pointing to, politics and current events as a major source of stress.

So we wanted to revisit it this year.

Interestingly, there's a little bit less overall stress among Pennsylvanians compared to last year in terms of politics, and that might be because we're not bombarded as much with ads.

Just going to say is that because it's not the election year, this is a little bit it's post election.

So I what it is kind of thing.

I think that's exactly right.

I think it's a little bit less.

And you were not seeing it in your face as much as we did in 2024.

Nevertheless.

And you raised this really good point.

We do see differences across groups and two big groups that help define who's stressed and who's not is one's gender and one's Partizan affiliation.

And in our survey this year, the 2025 survey, we found, women are more likely than men to report that politics is a major stress in their lives.

Almost twice as many Pennsylvanian women compared to Pennsylvania men.

And the other big divide is, is political affiliation.

Democrats are much, much more likely than their Republican counterparts, to say that politics is a stress in their life.

And that's probably not that surprising in the sense that there's a new administration and it's a Republican administration.

It's a Republican administration that has made many changes, historic levels of action during the first 100 days of the administration and Democrats are reporting that they're very stressed by by what's going on.

Independents are also significantly stressed, more so than Republicans, less than Democrats.

Sure.

On the same topic in years past, does it kind of flip flop if it was a Democratic administration holding office versus a Republican?

Yeah.

Unfortunately, we didn't ask this question.

His in the in the public health survey over time.

We kind of brought it in last year because of the historic level of attention that going on in the stress that we saw, in Pennsylvania, I would imagine we do see in other areas for, for example, on perceptions of the economy or perception of the direction of the country when there's a new administration, you usually see a shift in how people refer.

So if it's a Democratic administration, Republicans are more negative about the direction of the economy, direction of the overall health of the country, and when there's a switch.

So it's probably not surprising on a whole that you'd see a shift in this.

But the differences compared to last year are really extreme.

Sure, we'll have to wait another four years to see what we can compare the two, but we're going to keep asking this question now because we think it's really valuable.

And again, it's Pennsylvania because politics is so central and so competitive in the state that we want to really track this over time.

The survey also looked at how politics are affecting mental health across the Commonwealth in an increasingly polarized landscape.

What's the toll on Pennsylvanians?

To answer that question and more is Doctor James James, the chair of the Department of Psychiatry and Behavioral Health at Saint Luke's University Health Network, along with Doctor Beth Peters, an assistant professor of psychology at the university.

Thank you both so much for joining us.

Thank you.

Wonderful.

So we are talking about stress as it relates to the current political climate, and so does stress and anxiety.

Have a link from what you're both seeing to causing mental health problems when it comes to patients that you're seeing.

Beth, we'll start with you.

Absolutely.

I am currently working a part time with Pinebrook Family Answers, which is a community mental health agency, and the majority of our clients are all on Medicaid.

So that is a huge stressor for our clients that we're seeing right now.

And they're bringing that into session.

And we're talking about it absolutely.

Because of everything that's happening in the first hundred days of this, political climate.

And so, Doctor James, I'll bring you into this conversation as well.

What are you seeing firsthand?

What are you hearing from your patients?

Yeah, I have seen it escalating for the last several years, but particularly recently, I've had a lot of patients come in with a lot more despair, distress, hopelessness, you know, sleeplessness, anxiety.

Consumed by a lot of what's been going on in the country, actually, to where most of our sessions are spent around that.

And, and I'll see people that don't have that degree, but a smaller degree.

And most every person that I have coming through has some sentiment, or they'll leak out little statements throughout our interviews and our conversations during the appointment to suggest there's some level of distress.

Some people are favorable towards what's going on, others aren't, and I see it flip whenever there's changes in the political climate.

Sure, the survey had suggested that, folks who were Republicans, they reported feeling less stressed during this time.

Right now, while Democrats report feeling significantly more stressed.

And is that a surprise to you?

Not one bit, not one bit.

And I think that it comes from a lot of different places.

We talked about polarization.

I'd like to talk a little bit more about that, but there's the reality of it too.

As you mentioned, there's there's the social and economic impact.

There's a health care impact.

So there's a lot of real world impacts on people's lives.

People of immigration status or minority populations, people that, might have risk of discrimination, and also people who just have always felt a little bit marginalized.

Sometimes people don't feel like they have a voice.

And so I have people from all different spectrums coming in, who who I let my ear to, and I see a lot of pain and fear and suffering.

And that's not to place judgment on anybody that's outside of that room, but to recognize that the environment we live in is quite polarized.

Sure.

Now, is that different from now when the new administration has taken office versus an election year?

Are you seeing it kind of calmed down now that things are, you know, set into place versus we don't know what's going on.

It's mixed.

I've actually seen some people who it's been the real world impact is starting to sink in.

And then I have other people who were basing their concerns out of fears, and it was just that they had come to expect a certain outcome.

It didn't go that way.

And so there was that shock to their system.

Some of those people have adapted and come better, and other people again, because things have become more and more real for them.

It's become harder and harder for Beth.

What would you say?

Absolutely.

I, I completely agree with all of that.

I also work with Ellie Mental Health in Bethlehem.

So we're not seeing the Medicaid patients.

We're seeing patients with private insurance, but we're also seeing patients that are dealing with discrimination fears.

And they're dealing with fears of simply losing their jobs or losing their insurance because of they lose their jobs.

So we're seeing it across the board.

It knows no socioeconomic guidelines or backgrounds.

Sure.

You're mentioning different age groups, of course, the age group that has Medicare, Medicaid, and then, you know, that that kind of middle age group, what about children?

Are you seeing this trickle down to our youth?

I know that mental health crisis has grown among our youth.

Are you seeing that as the political climate changes, as well?

I'm seeing it in teenagers that I work with.

Specifically, I don't go much below 13 or 14, but I am seeing it in teenagers because they're hearing it in their schools.

You know, they're learning about it.

They're hearing it from their friends.

And depending on how their parents are reacting to them, they're hearing it from them, too.

So I am seeing it trickle down into the younger ages.

Doctor James, you as well.

Yeah, absolutely.

And I think that even the younger and I agree, I don't work with the youngest populations, but when parents bring their stress home and their worries, kids feel that.

And so it's not just the kids.

They're hear that from school or the people that are getting more tuned in because of their age, and they're getting to the voting age.

It's interesting.

Even people that aren't voting age are very passionate.

They're very concerned about what's going on in the world.

They're very tuned in through whatever social media platforms they tend to rely on for their news.

Sure.

Speaking of social media, is that a big, you know, stressor on not just the younger population, but the everybody's on social media these days?

Are people feeling that?

I would say yes.

I even my own daughter's 16 and she'll send me political things that she sees on social media.

And she's like, is this real?

Is this really happening?

How is this how is somebody not stopping, you know, what's happening?

So they're they're seeing it in so many different areas in so many different ways.

And it is absolutely impacting them and seeing it in those different ways.

We often see misinformation on Facebook, Facebook and other social media platforms as well.

Doctor James, does that contribute to an overall decrease in mental health?

Most certainly does.

I think one of the most concerning pattern is going back to the polarization we talked about is that particularly when it comes to social media apps, Instagram, TikTok, Facebook, others, that that it kind of has algorithms and things start trending a certain direction.

And then you start hearing things or seeing things that reinforce or things that you've spent more time on, or things that you've liked or your friends like, and then all of a sudden you start having a very biased presentation of what's going on in the world.

And I think that, you know, reading literature is a great way to step away from that, finding unbiased sources.

But all too often we go to places that are comfortable or we enjoy or we get feelings about.

And unfortunately, what happens then is, is we start seeing the world in a very skewed way, which then creates either euphoria and excitement because we feel good about the direction of things, or the opposite fear and anxiety and despair.

So on the other hand, what about news watching opposed to social media browsing?

Is one better than the other, or can they both cause stress?

I think it's a matter of of degree.

I think that if you're doomscrolling, it's probably not going to do good for your mental health.

But there's also a lot of news and media outlets that have a certain perspective, or they have certain topics that they focus on.

And I think if we are really doing our due diligence about being balanced citizens and trying to be well-informed, I think it's good to find those, more, neutral sources of information.

And certainly, like I said, reading.

I think it's a great way to step away from some of those images and sounds and sound bites.

They can sometimes be sensationalized where reading can be, if you find the right source a little more pure.

Sure about that?

You're shaking your head.

Do you see the same thing?

Absolutely.

I can't tell you how many times I am encouraging my clients to just turn it off, walk away, go do something else, go outside and get some fresh air.

Just you need you need to know when you're cut off and you need to know when to stop yourself short.

I think that leads me to resources, as you just said, walking away or taking a break.

What are some other ways we can disconnect and kind of lower that stress level when it comes to just mental health in general, but mental health and politics as well.

My favorite one that I encourage all my clients to do is to get outside.

Not only are you getting fresh air, you're also getting exercise and you're getting out of your house.

And it's a change of scenery and it's a change of pace.

If you have a dog, take your dog for a walk.

Connecting with friends, connecting with family.

As long as it's not toxic, obviously.

But whatever you can do to just stop that doomscrolling stop that constant feed of negativity.

Sure, doctor James, what would you say?

I love that I'm all about the nature too.

I think there's something rejuvenating.

It separates you from the noise.

But I also think that people have lots of hobbies.

So maybe if nature is not your thing, you know, I like if you like to quilt, if you like to do crosswords, if you like to dance, if you like to sing, if you like to play chess, whatever it is, remember to connect with those things that used to bring you joy that maybe you have not, focused on lately.

And then, of course, there's yoga, meditation, and many other great coping skills, breathing exercises.

There's a lot of great resources out there if you just want to seek them out and find one that speaks to you.

Some really great tips.

What about resources for people who may be struggling with their mental health?

Where can they go?

Where can they turn?

What's the best thing you can offer them?

Well, certainly I think if you're looking for a medical provider or support, talking to your primary care provider is a great place to start.

If you don't have anybody to turn to.

There are a lot of great resources out there when it comes to therapists.

There's a lots of wonderful clinicians in the area you can look to, certainly, you know, being somebody from Saint Luke's, I will say that we have a great resource there for whether it be therapy or a psychiatric services or many other kind of resources.

But we have partners and community, resources beyond us as well.

We all know there's a lot of great, groups and networks out there.

They can provide those resources.

You know, 998988 is a great, hotline if you're having some suicidal thoughts or you're feeling like, really insecure about your mental health in the moment so they can help walk you through some very dark times as well?

Sure.

Beth, what would you add?

Absolutely.

One thing that people can do if they're looking for a therapist is they can always go to Psychology Today.

Just Psychology TODAY.com.

You could even put in what insurance you have, and it'll bring up therapists in your area that take that insurance and that are accepting new clients.

I hear that a lot.

Oh, there's a waitlist I can't get in for six months.

And your filter search for who's accepting new clients?

It's some great information.

Thank you both so much for sharing that information.

Sometimes I think I hear a lot from people that it's hard to get started, so hopefully those resources are out there for them to take the first step.

Absolutely.

Doctor Beth Peters, doctor James James, thank you so much for weighing in on the mental health aspect of this conversation.

Thank you.

Thank you.

Another interesting topic from the survey was the legalization of marijuana in this state.

I know that we're seeing dispensaries for medical marijuana, but now it's legalizing marijuana across the board.

And so the findings in this were really interesting.

For the first time, they were up lower.

People were not opposing it as much.

1 in 5.

Only 1 in 5 Pennsylvanians oppose the legalization of marijuana.

So talk to me a little bit about these results.

It's they're fascinating results this this year Brittany.

So again, we've asked this question now dating back to 2013.

Every single year in this part of the health survey to see how Pennsylvanians and this is one of the areas, as a researcher where you see significant change compared, it's basically flipped, from where we were 12, 13 years ago, where a majority of Pennsylvanians oppose legalization.

A minority, supported it.

Right now, we see majority support for legalization of marijuana, recreational use, in the state.

And as you pointed out, and this is one of the big findings in this particular survey, we've reached a historic low in the percentage of Pennsylvanians that say they oppose.

Only about 1 in 5, 21% of Pennsylvanians said this year that they oppose.

And that's the lowest we've seen since we started this survey.

There's still a significant portion of Pennsylvanians that are not sure where they stand on the issue, but only 1 in 5, opposing might give us a sense why the Pennsylvania legislature or the governor are in a different place on this issue than we've historically seen with action happening in Harrisburg, bills, legislation being proposed, to, to, to perhaps change the state's policies, to align with states around Pennsylvania right now, new Jersey, New York, Maryland, we seem to be a, like a bubble, if you will, in terms of not coming up with a recreational, policy in the state.

Is there any speculation as to why this opinion has kind of shifted over the years?

Yeah, there's there's some factors.

Of course, there's more experience nationally.

Other states have have shifted policy.

So it might be diffusing into to Pennsylvania.

But I think the biggest single factor is demographic shifts within the Commonwealth.

Generational divides are big on lots of issues.

In this particular issue.

It's enormous.

So if you give me one factor that would explain someone's views on legalization, it wouldn't be Partizanship Partizanship still matters.

Democrats more likely than Republicans, it would be somebodys age that really determines.

And what we've seen since we started asking this question, are demographic shifts.

Some older Pennsylvanians, older generations have moved on.

Younger generations have come in in the state, and those younger generations are much more likely to support.

And so we've seen that shift dramatically over the last 12, 13 years in the state.

The legalization of marijuana has been one of the more divisive topics in the state legislature in years past.

But the gap seems to be closing as you just heard here, to talk about how the fight in the Capitol is changing is State Representative Michael Schlossberg, a Democrat who serves part of Lehigh County.

It's great to have you.

Thank you so much for being here.

Glad to be here.

All right.

So as we just heard, that gap is closing in the amount of people who oppose legalizing marijuana, where do we stand right now in that fight in Harrisburg?

So a couple of weeks ago, Harrisburg or the House of Representatives passed House Bill 1200, which was the Cannabis Adult Use and Safety Act.

It was voted it was approved 102 101.

Every Democrat voting in favor, every Republican voting against that would set up a hybrid system whereby marijuana could be purchased in Plcb stores.

So basically state run stores.

It would then be allowed to be smoked in highly permitted and regulated cafes.

Individuals would also have the ability to grow limited amounts of marijuana at home.

Advertisements, THC levels, packaging, and more would be regulated.

This was done in a way to maximize public safety and also, frankly, give adults the ability to smoke marijuana if they choose to do so.

Okay.

And so that passed the house.

What's the next steps to making that a reality?

Well, this is where Pennsylvania's politics get a little bit fun.

The House of Representatives is controlled 102 101 by Democrats.

That's why we were able to pass this legislation.

The state Senate is controlled by Republicans, and they immediately voted the bill down in committee, which candidly, is frustrating because you have a lot of Republicans over there who said we do need to legalize marijuana.

They just don't want to negotiate or engage on this topic right now.

So at the moment, marijuana is not going to be legalized until the state Senate decides that they want to have a conversation about the specifics of our marijuana legalization bill.

Sure.

And we did invite Representative Gary Day on the show.

He was unable to make it, but he did release a statement recently that said, basically, what's the rush?

And so can you answer that question, why now?

What's the big push?

I would respectfully to my colleague note that there really is no rush on this.

In fact, this was an incredibly long process.

It started last term where we were the health committee had 6 or 7 hearings.

We had a variety of internal caucuses as well.

This legislation was developed after a lot of thought and expertise and based on the experience of the state surrounding us, that of legalized marijuana.

And again, it was done in a way not to rush this out the door, but to make sure adults have the ability to use marijuana if they choose to do so, while at the same time creating jobs and protecting public safety.

Sure, when we talk about legalizing marijuana, this is recreational use.

Medical marijuana is already legalized in the state.

So what's really the difference?

What will it change?

So if you want to use marijuana on a medical basis, you have to go to a doctor.

You have to get your card.

You have to go through a series of hoops that are necessary that was designed to comply as closely as possible with federal law.

This will allow anybody who wants to go in, well, anybody who wants who is 21 or older, I should say, to go into a store and buy and use marijuana.

I mean, this is just making it basically is available.

Is alcohol.

Sure.

Some say, you know, it's a gateway drug or there's some health risks here.

And what's the what's the reply to that?

Here's the honest truth.

There's a lot of us, myself included, who aren't looking at the legalization of marijuana as this is the greatest thing in the world, and I can't wait.

I don't think there's a ton of people who are really ecstatic about it.

What I will say is that the legalization of marijuana is better than the prohibition of marijuana.

I think if we legalize it, you can regulate it.

You can ensure that the marijuana use by people is safe.

You can take a lot of money out of the hands of drug dealers.

And frankly, you can redirect police resources better if you ask me what I'd rather have a police officer doing patrolling the streets preemptively looking for violence, or busting somebody who's using a drug that, frankly, is less dangerous than alcohol.

I know which one I'm going to choose.

Sure.

And so when we talk about the criminal justice reform implications, did that bill have any pardons for people who may be in the system currently for.

Yes it did.

It allowed for an expungement for people who were arrested for possession only, so that small levels of possession only, which again, frankly, it's categorically ridiculous to me that we are putting people in jail or giving people a criminal record for using a drug that is no less dangerous or addictive than alcohol, or, frankly, than some of the painkillers that our doctors prescribe to us when we're injured.

This does create a pathway to allow people to get their records expunged as long as it's for low level possession only if somebody has a dealing related offense or violence related offense in addition to marijuana.

No pardons.

Sure.

And I know the Democrats have, argued also that there's huge economic impact here.

So what are some of those economic impacts?

Well, if we legalize marijuana and according to the plan we passed, we generate $600 million in revenue.

That's money that we can reinvest in communities, in schools and in public safety.

More importantly, though, you create an opportunity for entrepreneurship.

There are a lot of businesses that have been built around alcohol.

You talk about bars, distributors and more.

We want to give people the same opportunity to do that with marijuana.

Sure.

So again, what's the next steps to legalizing marijuana in the state, considering, you know, only 1 in 5 Pennsylvanians are opposing that right now?

I think, candidly, the next steps are our friends in the state Senate catch up with the rest of the Commonwealth, the fact that approval records are so low, or that disapproval is so low for marijuana, says to me that you've got the rest of the Commonwealth and the rest of the citizens in Pennsylvania really far ahead of a lot of other elected officials.

I know that the bill we passed is not what ultimately is going to become law, but we need the Senate to say, here's our plan and let's negotiate, because we have proven in the past that a Democratic House and a Republican Senate can do good things together, and we need them to engage.

So say that happens.

It's legalized.

What are some of the barriers to people who maybe want to get into this business?

Is there a stigma to this business right now?

You know, what's the path for?

So one of the real challenges remains that marijuana is still very foolishly, but it's still a schedule one drug at the federal level, which really limits the ability of people to get loans, to get financing, or even to do basic banking.

Now, other states have found ways around it.

We would need to explore what those ways are.

At the same time, there's a balancing act.

You don't want to.

You want to make sure that only qualified, reputable people can start marijuana related businesses.

But you also want to make it easy for those people to get into the business.

So trying to balance speed and safety is a very, very difficult task.

And it's one that would absolutely take some time to roll out.

Sure.

And we did talk about the economic impacts.

We hear our neighbors in new Jersey are making tons of money off this right now.

Do we see the same kind of future here in Pennsylvania?

Absolutely.

If we're brave enough to actually engage in it.

And that's frankly one of the biggest arguments for legalizing marijuana.

New Jersey, New York, Maryland, Delaware, even Ohio via referendum have legalized marijuana.

The only state that borders US that hasn't is West Virginia.

So people who live in those border and communities are all going to those states buying marijuana, spending, taxpayer spending their money in those states, generating tax revenue, generating jobs.

With all due respect to my friends in new Jersey, I want that money here.

And that's one of the reasons we need to do this.

And what's the main lobby against this is a big pharma.

No, it it really runs the gamut.

There's a lot of marijuana related corporations who weren't a big fan of the fact that we did it in a state run model.

We did that in a way to try to make sure that we do it right, rather than we concentrate on the money.

I think that we need to have more conversations with the marijuana industry.

Beyond that, I'm not going to say that there's really an industry or a lobby.

I think there's just a lot of a lot of inertia and stigma built around the idea that marijuana is bad.

Just say no kids, that sort of thing, and we need to overcome that in order to get to a place where we do legalize marijuana in Pennsylvania.

Sure.

Some great insights here.

Representative Mike Schlossberg, thank you so much for weighing in.

Absolutely.

Before we go, a final word from Christopher Borick, director of the Muhlenberg College Institute of Public Opinion, on what the survey reveals about Pennsylvanians and where we go from here.

Some really interesting results to come out of this 2025 Pennsylvania Health Survey, especially this year from Muhlenberg College.

So, Chris, I have to ask, what do we do next with these results?

What is this best used for?

Oh, it's one of my favorite questions.

When we do research like this, we want to share it.

We want to, have Pennsylvanians think about it, look at it.

We want to share it through through wonderful media sources.

Like, PBS.

But what's important to us is that it, it fuels, discussions in terms of policy circles, I would hope the legislature that's discussing policy would think about these results.

And use those and their decisions.

They reflect public opinion of Pennsylvanians, public health official officials as they make their policy decisions, where they target their resources, where they target their communication, having information about where the public is and where Pennsylvanians are at allows us to come up with policies and policy approaches that I think recognize where Commonwealth residents are at on really key issues.

And that's our goal every year, is that it gets into those discussions and can help, educate and inform policy making.

Great.

Well, we thank you for doing this work, and thank you for joining us with your input today.

Thank you for having me in.

That's all for this community conversation.

PA Health and Politics.

Thanks to our guests and you for watching.

For more details on the 2025 Pennsylvania Health Survey, visit Lehigh Valley news.com.

For all of us here at PBS, 39 over 91.3 FM and Lehigh Valley News.com.

I'm Brittany Sweeney.

Stay informed, stay healthy, and we'll see you next time.