They matter to adcoms at many top colleges. Yes, when they’re missing, it’s noticed, especially when a kid otherwise looks good. So the question is how to overcome.
This is a case where, if everything else is lined up for a top college, you really know the school and what it values (not just speculation,) how you match, not just rep or the usual array of flaky reasons kids want HYSP, then you need to turn your lemons into lemonade.
Sometimes the GC is willing to go to bat, paint the right picture of your intellect, drive, etc, and explain the scores don’t reflect your proven abilities, the teacher feedback. (You decide whether to report, despite, or omit. The GC can back that up.) Some teachers will do the same, put the effort into a solid LoR that highlights your intellectual curiosity and performance.
You can make sure you have the relevant outside experiences, challenges, and comm service that shore up this interest in public health. That’s not shadowing, it’s rolling up your sleeves. And more. All that is pretty much needed for HYSP, anyway.
We can’t guarantee anything, but the more you can hit the mark they look for, other than those scores, the better you overcome this.