By Kim Krisberg
I've had this conversation more times than I can count.
You're a reporter? What do you write about?
(Blank stare.) Oh. What's public health? Is that like universal health care or something?
How do you describe public health? It's a tricky question. The Merriam-Webster Dictionary defines public health as the "art and science dealing with the protection and improvement of community health by organized community effort and including preventive medicine and sanitary and social science." Others describe it as a profession dedicated to the prevention of disease and the promotion of healthy behaviors. I've always been partial to more social justice-inspired descriptions that mention the social determinants of health - the living conditions that affect our health, and account for many of the health disparities between different groups. (Of course, talking about the social determinants of health usually elicits more blank stares and prompts my friends to politely change the subject and remind me that this is happy hour, not a policy briefing.)
Public health's invisibility may be a testament to its success, but public health needs more than positive statistics to stay strong and, more importantly, to stay relevant to the political and social dialogue. Even as more and more of the global disease burden can be attributed to the social and environmental conditions that public health professionals are uniquely trained to confront, public health programs still end up on the budgetary chopping block, facing severe cuts and possible program eliminations.
Beyond the borders of Washington, D.C., there is no real public outcry when this happens. Not like when legislators suggest cutting education funds; the outrage from voters is loud and clear. Cutting funds from public safety efforts like police and fire? No way! No money for fixing our dilapidated roadways? You won't get my vote! Slash federal public health and local health department funding? Barely a peep.
It's baffling because strong public health systems and infrastructures are just as vital as education and public safety to our high quality of collective life. In fact, I'd argue that the history of public health accomplishments in preventing disease, improving sanitation, and creating safe workplaces helped build the very foundations from which we prosper. Not to mention that public health interventions are amazingly cost-effective when compared to treating people in clinical settings after they get sick.
So, why is there such a vacuum of public support for public health? One big reason is that public health doesn't tell its story very well. It doesn't tell its story in a way that people can relate to in personalized, identifiable ways. I would bet that the only time many people even hear about public health is in the wake of some sort of disaster or problem, like a massive food recall or a disease outbreak. And being aligned with the "disaster cycle" of news reporting is not necessarily a good thing.
Public health is a very technical field involving complex and intricate work. But at the end of the day, this work affects individual people. That's the kind of story people can relate to. These are always the stories I'm looking for as a public health reporter when I troll local health department websites, but instead I usually find long lists concerning various recalls, vaccine clinics, and advisory meetings. Don't get me wrong -- these are important. But too often, it leads people wondering: What have you done for me lately?
That's where storytelling comes in. Underneath the scientific jargon and statistics, there's almost always a story about public health improving someone's life. When you drill down to the community level -- to the neighborhood level -- there's always a story to tell; a story that resonates and that illustrates public health in action in a way that people can say "hey, that's me." Storytelling can help people better understand the role that public health plays in their lives and can help them envision the negative consequences of living without robust public health systems. Public health needs a face that doesn't wear a suit and speak at a news conference.
Putting a face on public health
For example, while I may be fascinated with an issue like environmental public health tracking, I have a feeling that most people aren't. And in a time when all government programs are looked at with suspicion, a lot of other people are probably wondering why it's worth our collective time and money. So, dig for the story. Find the story of the little girl whose asthma-related emergency room visits were cut in half because tracking air-pollution data helped her doctor create a more precise asthma management plan. Put a face to the program. Show me the value in human terms, outside the tragic setting of disaster and catastrophe.
Or how about one of public health's most prized accomplishments -- the decline in tobacco use? Now, it's true that this is one of those blurry areas -- I mean, how do you tell the personal story of the teenager who didn't start smoking? But you can tell the story of a grandfather who, after serious heart complications, reached out to his local health department and asked for help to quit smoking. Or the story of the college student who signed up for the health department's new cessation program that offers daily quitting tips via text messaging. Or the mom who decided to stop smoking after her children came home from school with educational materials on the dangers of cigarettes.
Beyond just the personal story, there are community stories. Injury prevention is a vital component of public health work, from seat belt campaigns to those that target youth dating violence. Chronicle the story of a neighborhood that mobilizes for more stop signs at a dangerous corner or a pedestrian crossing light at a busy intersection after public health statistics showed a jump in preventable injuries. Talk to the children at the local health fair that's giving out free bike helmets and ask them what they've learned about staying safe. Tell the story of the young high school student who knew where to go for help about her abusive relationship because her local health department recently held a dating violence workshop at her school.
What about the family who put together their very first emergency preparedness stockpile? Or the rural family who -- thanks to public health surveillance -- finds out their well water is being contaminated and promptly takes action to fortify their well against pollutants? Or the young mother-to-be who receives home visits from a public health nurse who teaches her about the importance of breastfeeding?
These are the faces of public health. They may be difficult to find, but it's worth the effort.
These storytelling skills are important because public health is exactly that -- public. If voters and constituents don't know what public health is or how it fits into their lives, how can we expect their elected representatives to support public health?
Collect the stories -- they'll speak for themselves.
Kim Krisberg is a freelance reporter living in Austin, Texas, and has been writing about public health for almost a decade. While her education is in journalism, her heart is in public health.
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Welcome to The Pump Handle! With a heart in public health, you've found a great blogging home!
Just stumbled on this post and call about 16 months late, but I have a new blog that focuses on public health storytelling: www.isthispublichealth.blogspot.com.