Every time someone asks me “what is public health,” I cringe a little. The question seems so obvious, and yet when I try to answer, I often stumble. One major accomplishment from my placement this summer is that I am now able to quickly and clearly communicate what my chosen field is all about.
I went to South America with the intent to study women’s reproductive health, a topic of major significance in public health. I hoped to interact with representatives of the Ministry of Public Health and learn about complex interactions among the nation’s healthcare system and community advocacy organizations, and how these interactions are influenced by the historical, social, economic, and cultural context of the country I was in. Instead, I was assigned to shadow a general practitioner, a gynecologist, and a social worker. While I was game at first, I soon became frustrated.
I discussed the mismatch between my professional development goals for the summer and what I was actually doing with the program director. I explained that while this is an incredible opportunity for someone interested in clinical work or case management, the shadowing experience was not the best fit for a public health student. She explained that my experiences were public health oriented because they were occurring within free clinics and hospitals that provide medical services to the public. I pushed back (politely, of course). Then, it happened. She asked me that infernal question: “So, what is public health then?”
I fought off the coming cringe with all my might; after all, her question was a fair one, no? I did my best to define public health using my limited Spanish vocabulary, which was challenging but also forced me to speak in simple declarative sentences. It’s hard to say “on the one hand…, but on the other…” in a second language! While this conversation was helpful both for moving my thinking forward and for improving my placement (my supervisor was very responsive), mostly I talked about what public health was not. Ok, at this point I was “on a mission” to be able to explain it.
I started with an official source, the American Public Health Association (APHA) website. According to APHA, “public health promotes and protects the health of people and the communities where they live, learn, work, and play.”
Yawn.
Well, that is certainly true, but this definition is not very descriptive of the essence of public health, and it’s not very helpful for distinguishing public health from, say, medical care or social work. Public health goes far, far beyond individual care or case management. In public health, we’re interested in the health of everybody and in the interaction of complex systems that affect the health of everybody. Our goal is often to disrupt these systems so that they lead to improvements for all and to a more equitable distribution of health and healthcare resources. And so, like Dorothy in the Wizard of Oz, I had my answer all along. I only had to figure out how to channel it.
What is public health? Public health is a calling. It’s a calling for people with a big picture perspective and a diverse skill set who are intent on leading transformative work to improve health for all under the most challenging circumstances imaginable.
Whew!
Marina Hernandez, CHES
MPH Student in International Health and Development
