REYNOLDS: Why We Need Public Health

All semester, I have been sharing my opinions on various public health problems and why they are so important. For my last column of the semester, I am going to tackle a bigger question: why do we need public health?

Good public health programs focus on prevention. When something is prevented, though, nothing changes and bad things don’t happen. This means that a lot of times, it can be difficult to see and understand what public health does and why it’s important.

For example, vaccines are a method of public health that have been around for years. They have decreased a lot of death by disease and even eradicated some diseases such as smallpox. However, now people are questioning vaccines because they think, “Well, these diseases barely exist anymore. Why should I get vaccinated?” Well, guess what? The reason why they don’t exist is because of vaccines.

This can be hard to deal with in the public health field, because if we’re doing our jobs successfully, you should hardly notice that we are here. Fortunately (or maybe unfortunately) for us, there are always new challenges to work on and problems that evolve.

Today, we realize that public health is about more than just vaccinations. Public health is built environment. That’s when your environment is built strategically to create a positive health outcome. Think about how Boston Universty’s 2-mile campus adds exercise to your day.

Public health is clean needle exchanges. Public health is gun violence prevention. Public health is adding sanitizer dispensers in hospitals. Public health is safe sex. Public health is solving childhood obesity. Public health is economics. Public health is politics. Basically, public health is almost everywhere we look.

Not only are we using public funds to make sometimes controversial changes, but we are also often fighting against huge corporations. We are pitted against powerful and influential organizations, organizations that buy you over with sneaky marketing techniques and false promises. Think the fight against big tobacco. Or how public health is fighting junk food companies that perfectly engineer cheap and unhealthy food to taste delicious so they can make money. And then there’s public health that is trying to think long term and wants you to put down those instant satisfactions.

People, on an individual level, enjoy their cigarettes and unhealthy food and aren’t in a position to give them up, yet having healthier lifestyles saves money and lives in the long run. Public health is about the big picture, the grand scheme of things.

Public health is about behavior change, which is difficult to understand, as human beings are complex and sometimes irrational. It can be frustrating, especially when you can see the obvious answers in theory, but they don’t work in practice.

A lot of public health gets lost in the data. A big problem with public health is skillful communication and positioning people so they are ready, willing and able to make the change. Sometimes, you have to meet people where they are, even if it’s not where you want or need them to be. Change takes time and can be a slow process.

Sometimes (read: most of the time), we have to make hard decisions in public health. We always have to decide where the best place to put our money is. Sometimes, we have to choose whether a program will have more impact or impact more people. Sometimes, we have to choose whether to work on prevention or treatment, even if treatment won’t solve the problem. Sometimes, we have to do things that aren’t effective, just to keep the general public and funders happy.

Just because you are not directly affected by an initiative does not mean it won’t impact your life. A healthier society is better for all of us. A healthier society means a happier and safer place for everyone involved.

My public health professor, Sophie Godley (bless her, she’s an incredible human being), said in class the other day that, “Poverty is the root of all public health problems.” If we could solve poverty, we could solve public health problems. While this is mostly true, I wonder if it would work the other way. If we work on solving public health problems, could we begin to eliminate poverty?

Obviously, solving poverty and solving all public health problems are lofty goals that will take lots of time, money and dedicated people if they ever get solved. But it’s important to remember why you are here and the differences you can make.

After spending this semester learning about public health and working with various public health organizations, I’m sure this is what I want to do with my life. Public health work is extremely challenging and rewarding. I want to work to make people’s lives better, starting on a fundamental and necessary level.