Shafaat Choyon.

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Essays · Public Health

Essays on public health and health communication.

I hold an MPH and the CHES credential, and I founded HSREP, a platform arguing that health-system resilience is economic protection. These essays are about prevention, health communication and who pays when health systems fail, in the US and in Bangladesh.

In this topic: Health communication and trust Prevention and behavior Outbreaks, climate and environment Health systems, money and policy

Health communication and trust 10

The people closest to health care believe more health myths

The people closest to health care believe more health myths

A 2026 Edelman and Yale analysis found that frequent users of the health system were over 1.5 times as likely to hold three or more divisive health beliefs. The doctor is still the most trusted voice. The clinic just is not built to be a messaging channel yet.

Bird flu reached Washington's dairies. Warn the task, not the town

Bird flu reached Washington's dairies. Warn the task, not the town

H5N1 was confirmed on two Yakima County dairies on 8 October and in an exposed dairy worker a week later. The public risk is low and the worker risk is real, so one loud message fails both audiences.

Mixed messages, real costs: America now has two vaccine schedules

Mixed messages, real costs: America now has two vaccine schedules

Ten months after CDC advisers ended the universal hepatitis B birth dose, parents get one answer from Washington and another from their pediatrician. The bill for a split schedule arrives as confusion first and infections later, and the clinic is now the message.

Losing measles elimination is a trust bill coming due

Losing measles elimination is a trust bill coming due

The US could lose its measles-free status in November, and Bangladesh just fought a far deadlier outbreak. One ran out of trust, the other ran out of vaccine. Only one is fast to fix.

Clarity is an intervention, not polish

Clarity is an intervention, not polish

We treat clarity as polish. It isn't. Confusing health guidance has a body count and a price tag: clarity is itself a health intervention.

The DRC's Ebola Outbreak Is a Trust Problem, Not a Virology One

The DRC's Ebola Outbreak Is a Trust Problem, Not a Virology One

1,406 Ebola cases in the DRC, and WHO cites community mistrust and violence as the active blocker, not the virus. Outbreak response is a trust problem first.

Shame is a design flaw: not a personal failing

Shame is a design flaw: not a personal failing

Shame feels like clarity but works like a wall. In health comms, stigma is a barrier you design around: channel, framing, segmentation: not lecture away.

A hotline on a bar of soap: the object is the channel

A hotline on a bar of soap: the object is the channel

Praava's doctor hotline on Lifebuoy soap took about 3,000 calls a day. The lesson: borrow an object people already hold, then staff the line behind it.

Measles is back: a trust problem, not a supply problem

Measles is back: a trust problem, not a supply problem

The US passed 2,200 measles cases in 2026: a trust problem, not supply. Why messengers beat facts, from a soap-packet hotline in Dhaka to a US campus campaign.

Health communication that changes behavior

Health communication that changes behavior

Field notes on segmentation, friction, framing and measurement: the principles behind campaigns that move behavior, not just awareness.

Prevention and behavior 9

Pre-eclampsia kills 42,000 mothers a year, and we know how to stop it

Pre-eclampsia kills 42,000 mothers a year, and we know how to stop it

WHO's new roadmap says high blood pressure in pregnancy causes about 16% of maternal deaths. The tools are cheap and proven. Mothers die in the gaps between visits, wards and hospitals, so the handoff is the intervention.

Loneliness Is Worse in Poor Countries, Not Rich Ones

Loneliness Is Worse in Poor Countries, Not Rich Ones

WHO's Commission on Social Connection found loneliness hits low-income countries hardest, 24% versus 11%. The fix isn't a clinic. It's an accessible channel.

The nutrition transition: the environment is the disease

The nutrition transition: the environment is the disease

Bangladesh now carries undernutrition and diabetes at once; the US drowns in the same processed calories. The food environment, not willpower, is the disease.

507 Million Children by 2040: A Capacity Problem, Not a Willpower One

507 Million Children by 2040: A Capacity Problem, Not a Willpower One

World Obesity Atlas 2026: 507 million children overweight or obese by 2040. China, India, and South Asia lead the scale. Health systems need a 15-year plan now.

The quiet epidemic: tobacco and the new nicotine

The quiet epidemic: tobacco and the new nicotine

Tobacco kills ~158,000 a year in Bangladesh: one in five deaths; the US fight moved to youth vaping. Same economy, opposite framing: shaming never wins it.

Clean hands, still: the cheapest health tech we underuse

Clean hands, still: the cheapest health tech we underuse

Bangladesh hit 98% water access, yet arsenic poisons ~50M; the US is still pulling 9M lead pipes. Water and hygiene: the highest-return health tech, underused.

The first 1,000 days: the highest-ROI window in health

The first 1,000 days: the highest-ROI window in health

Bangladesh cut maternal deaths 79%; the US is the only developed country where they rise. Conception to age two is where a health dollar does the most work.

How mental health became the premium category

How mental health became the premium category

Investors once treated mental health as charity. In 2026 a mental-health app sold for $835M. The demand was always there: someone designed around the barrier.

GLP-1s: the drug was never the hard part

GLP-1s: the drug was never the hard part

Only ~12% of Americans take a GLP-1, and most who start quit. Pharma solved the biology; behavior and adherence decide the outcome: the layer I've built on.

Outbreaks, climate and environment 7

Dhaka topped the world's dirty-air list, and winter hasn't started

Dhaka topped the world's dirty-air list, and winter hasn't started

On 6 October, Dhaka's air was the worst of any major city in the world, before the winter smog season. A new study puts the toll at 242 deaths a day across six cities and about $23 billion a year. The biggest single cause is heart disease, which tells us who should own the problem.

Dengue 2026: 114,000 admissions, and the peak arrived on schedule

Dengue 2026: 114,000 admissions, and the peak arrived on schedule

Bangladesh has admitted 114,251 dengue patients and lost 352 lives this year, most of them since August. The surge is seasonal and predictable. Florida, with its biggest outbreak in a decade, is learning the same lesson.

The slow pandemic: antimicrobial resistance

The slow pandemic: antimicrobial resistance

Antimicrobial resistance may kill 39 million by 2050: three a minute, South Asia hardest hit. A behavior and communication problem, and so it's neglected.

Heat Kills on Moderate Days, Not Extreme Ones

Heat Kills on Moderate Days, Not Extreme Ones

NYC data: 80% of heat deaths happen on moderately hot days, not extreme ones. The highest-impact public health message is rarely the dramatic headline.

The mosquito economy: dengue is a climate problem now

The mosquito economy: dengue is a climate problem now

Bangladesh logged 102,000+ dengue cases last year; 2026 is climbing. It's no longer only ours: local dengue is turning up in the US. Climate rewrote the map.

Roads are a health crisis we refuse to own

Roads are a health crisis we refuse to own

Bangladesh had its deadliest road year in 2025: 9,000+ lives: while the US cut its toll. Same machine, opposite paths: one treats road death as designable.

Air quality is a health emergency nobody owns

Air quality is a health emergency nobody owns

Dhaka's air ranks among the world's worst: PM2.5 ~13x the WHO limit: and US wildfire smoke made the threat American. High-leverage, and no one owns it.

Health systems, money and policy 7

Bangladesh's health budget crossed 1% of GDP. Spend it below the hospital

Bangladesh's health budget crossed 1% of GDP. Spend it below the hospital

Bangladesh's FY2026-27 budget puts Tk 69,409 crore into health, 1.01% of GDP and the first time above 1%. Families still pay 79.3% of health costs themselves. The money will do the most good in community clinics, medicines and follow-up, not in new buildings.

Overdose deaths fell 12%. The safety net under that drop is being cut

Overdose deaths fell 12%. The safety net under that drop is being cut

US overdose deaths are down to about 67,800 a year, the third straight year of decline. The drop rests on Medicaid-funded treatment and harm reduction, and both are shrinking just as the drug supply shifts toward stimulants. Bangladesh shows what that next wave looks like.

Medicaid work rules are a paperwork test, not a work test

Medicaid work rules are a paperwork test, not a work test

From 1 January 2027, adults on Medicaid expansion in 43 states must prove 80 hours a month of work or study. Most already qualify. The ones who lose coverage will mostly lose it to paperwork, and outreach is the intervention.

Three more years as an LDC: what Bangladesh should buy with the time

Three more years as an LDC: what Bangladesh should buy with the time

On 29 October the UN General Assembly gave Bangladesh three more years before it leaves the least developed country group, to 24 November 2029. That keeps its trade benefits and cheaper medicines until then. The condition is reform, not rest, and the medicine clock is the one that matters most for health.

Medical Debt's Racial Gap Is a Margin Question in Disguise

Medical Debt's Racial Gap Is a Margin Question in Disguise

56% of Black adults carry medical debt versus 37% of White adults. Bangladesh's out-of-pocket burden resolves the same question differently, who absorbs the cost.

The $200M question: where to spend it on health

The $200M question: where to spend it on health

The World Bank put $200M into Bangladesh's primary care. Given real money, where does a health dollar actually change an outcome? My answer isn't a shiny app.

The workforce crisis and the community-health-worker answer

The workforce crisis and the community-health-worker answer

America's health system is short of people, not technology. The answer is a model Bangladesh has run for decades: move tasks to those closest to the community.

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