Twenty years ago I fell into a career in public health. I was in my early twenties, had just gotten engaged, and was looking to put my master’s degree in French Studies from New York University to work in international je ne sais quoi, in Washington, DC, or Baltimore, where my fiancé was in medical school. I ended up joining an international maternal and child health training organization, developing training programs in Francophone Africa, and earning a Master of Public Health degree along the way. After moving to Chicago in the mid-1990s, I worked in local and national public health advocacy, evaluation and education, with a focus on women’s health.
I have also spent the last 20 years trying to explain to others outside of the field, just what public health is.
The tag line on my public health alma mater, the Johns Hopkins Bloomberg School of Public Health, Web site reads, “Protecting Health, Saving Lives—Millions at a Time.
A friend of mine asked me, so it’s health care for the poor, right?
No, it’s not. Or, rather, it’s not just that. To borrow the tag line of the department of Health and Human Services, it’s Health for All…by the year 2000, by the year 2010…like Zeno’s paradox, we just never seem to get there.
Sometimes it is harder to explain something that is, in essence, quite straightforward.
As Dr. Al Sommer, my last dean at Hopkins School of Public Health, liked to say, people might understand our field better if we called it the public’s health.
Public health is about all of us-- whether you are a Wall Street bachelor earning a six-figure income or a five-person family living below the poverty line. It requires our government’s commitment to our safety and well-being through enacting laws that are based on policy decisions that (ideally) are derived from research. Some laws are enacted at the state level, others at the federal. Sometimes those distinctions don’t make sense. For example, why should helmets for motorcyclists be mandated in Missouri, but not in Illinois?
Public health focuses on prevention and interventions aimed at populations versus individuals. Some see this as paternalistic. But individuals are not passive in this concept. Individuals must be active players in their own health and in respecting the laws established to protect the public’s health. I prefer to see public health as an interactive contract.
So, I’ll make an effort to brush after every meal, if my government promises to provide me with clean water when I turn on my tap. While we’re at it, let’s make it clean, fluoridated water.
I’ll watch my diet, but please provide me with healthy options for grocery shopping, not just package stores, in my neighborhood.
I’ll try my best not to smoke, but don’t force me to inhale the second-hand smoke of others when I’m in public places.
I’ll work to support myself and contribute to society, but make my workplace safe.
I will stay home when I’m sick and not expose others to my contagions (and vice versa, I hope), but give us all the level playing field of universal vaccinations.
I’ll pick up after my dog, but please make sure the streetlight is working so I can see it!
Medical care is for individuals, but is also a part of the public’s health. A basic package of preventive medical care is necessary to ensure the health of the public. Now, do you consider that a privilege or a right?
I ask that, because this is the fundamental question facing us in these times. Public health folks, by definition, believe that a basic package of health care is necessary, important and, yes, I’ll say it, a basic right to be guaranteed to every person. Note I didn’t write “citizen,” because again, the public health lens doesn’t distinguish between a passport-carrying U.S. citizen and an illegal immigrant. I can catch diseases from either one. It’s their right to have coverage; it’s also my right to have my health safeguarded.
In some countries, all they’ve got is public health. And the way this country is going, we’re going to need a lot more of it. Our high tech, highly specialized, super trained medical system will not make a dent in our infant mortality rate (the second worst among industrialized countries) or our rising maternal mortality (the risk of dying from complications of pregnancy or childbirth), if we don't fix our public health system first.
Public health is an optic through which so many issues—ok, all issues--can be viewed more clearly.
War? Not a good idea for the public’s health. Best to prevent it.
Family planning? A great public health idea. It prevents maternal mortality, reduces abortions, gives mothers, babies, and families a better chance for healthy lives.
If the beginning of my career was a dovetailing of my French skills and my public health education, this chapter represents my desire to weave in my skills and identity as a mother with my training and experience in public health. The essence of motherhood is also about protection, about making wise decisions on behalf of one’s children, in the hopes of developing wise, healthy and, ultimately autonomous people who are good members of society. It is through the combined optics of public health and motherhood that I propose an occasional series of articles to be published under the title, “Public Health Mom.”
Public health is just an esoteric notion if not translated into policy and enacted as law. So I’ll also be looking closely at what our legislators and the presidential candidates have to say about the public’s health.
If we all put on public health glasses, we might find we’re on the same page about even the most divisive of issues. Perhaps we will come to view public health as maternal—and that will be a positive thing.
Upcoming Posts:
Helmet safety
Birth Centers: Now Legal in the State of Illinois
History of Public Health in the United States
Eye on the Presidential Candidates, through the lens of public health
Vaccines and early childhood education: US vs. The French
War is Not Healthy for Children and other living things: a public health view of war
The right to bear arms versus the right to stay alive
Depression: a public health issue
Obesity: the Bloated States of America
Workplace Safety, or Why I’m too old to work at Abercrombie & Fitch
The American Medical Association: It's not your father's AMA anymore.
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