What Is Public Health? Telling Our Own Story

There is an old African proverb that states, “Until the story of the hunt is told by the lion, the tale of hunt will always glorify the hunter.” In this issue of AJPH, which is being issued in alignment with National Public Health Week, Former Governor John Kasich (R-OH) makes a compelling case for the need for a more lucid and effective effort to enhance the public’s understanding of what public health is and how we all benefit. He expresses these views in the context of how we build support for rebuilding the nation’s public health system after the greatest infectious threat to the public’s health in more than 100 years—SARS-CoV-2, the virus that causes COVID-19. The COVID-19 pandemic has exposed not only the weaknesses in the organization, infrastructure, and core resources of our public health system but, more importantly, the loss of basic trust and public support for proven public health measures and the practitioners that use them. It has become clear during this pandemic that the general public, including many policymakers, are unclear what public health is, who does it, what is the legal basis for it and the role of its legal authority, how it is resourced, and, most importantly, what is its value.

The governor correctly points out that far too often, public health springs into action and mitigates the threat, but fails to take credit for the success. It is not a kitchen table issue and until recently had not generated controversies for having failed on health policy issues. This is because we remain invisible when our work is done successfully. When nothing bad happens, people accept the benefit but are usually unaware of the effort it took to protect them. They appreciate and value the positive outcome but don’t credit the public health system for its benefit.

Governor Kasich makes a clear case that we have to communicate more clearly and directly, communicating our value in common terms that people value and understand. Such values include things such as, everyone wants the air to be safe to breath, their water safe to drink, and their food safe to eat. They absolutely want to live in safe environments where they live, work, play, and pray. People want to be as free of chronic diseases and injury, as well as infectious diseases, as possible. Although the general public values these outcomes, they don’t often know who is responsible for ensuring they occur. In fact, it is quite common for people to take these protections for granted, and although they all want someone to protect them, they don’t know that when they are protected it is because of public health’s efforts.

The heroic work by the public health community during the pandemic resulted in the saving of an enormous number of lives. By using a science-based approach, the public health community pushed for policies and practices that put in place a range of nonpharmacological interventions like masks, and physical and societal closures to reduce the individual and societal impact of this disease. Using vaccine research conducted over the last 20 years and carefully constructed clinical studies, public health researchers found vaccines against SARS-CoV-2 to be safe and effective. To date, more than 210 million people have been fully vaccinated and are now much less likely to get severe disease or die from COVID-19. Millions of lives have been saved through these efforts, and yet somehow, we are struggling to tell our story. Disinformation and misinformation driven by political or corrupt motives have both undermined the effectiveness of sound public health advice and put at risk millions of people who have come to ignore the facts and ignore the truth. In addition, the motives of the health and public health community have been twisted in ways that have spurred hatred, and promoted anger and, in some situations, violence against the very professionals whose only motive is to keep people safe and healthy.

This year’s theme for National Public Health Week is “Public Health Is Where You Are.” During the year’s celebration, we have the opportunity to tell our own story. We can use the time to tell this story loudly, clearly, and in terms people will understand. We can remind people that we share their core values of safe water, food, and air. We can assure them that we are here to support both their individual and their collective health. We need to let them know we are superheroes and that the science we study and use, the policies we put in place, and the legal authorities we utilize are our “super-powers” that we use only for good. That we believe in individual freedom, as they do, but also in the collective good. We have to be clearer that wearing a mask and getting vaccinated serve both individual and collective protection. That the safety they feel each and every day 24 hours a day when nothing happens is because we are at work 24/7 making sure health threats stay away. But when something bad happens we have their back. When we say “Public Health Is Where You Are,” we mean it!