Before the COVID-19 pandemic, when I told people I studied public health, people would often ask me, what is public health? Since 2020, things have changed. Now, people assume I study vaccines and diseases. Public health, however, is more than that. I often tell people that it can be anything that impacts your health from medical care to policies surrounding transportation.
In my experience, public health has been a tool for learning how to reduce violence at a population level. I grew up in a violent environment and a home with constant conflict. It wasn’t until I was in high school that I realized that violence can be passed down through behavior generationally and that our environment can either promote or prevent violence from blossoming.
How does public health play a role? It allows us to look at populations, identify patterns, and prevent violence perpetration. Public health exists at all levels, from the policies that enable broad access to highly lethal weapons to the way medical practitioners interact with a victim of gun violence.
Like all fields, public health has its limitations. For instance, because public health works at the population level, there is a distance between public health and the people it serves. When quantifying the impact of gun violence, I sometimes refer to life lost as the Year of Population Life Lost (YPLL) and its cost to the healthcare system. While this speaks to policymakers, it feels disconnected from the people behind the numbers.
Public health also experiences barriers to establishing trust with communities due to unethical experiments like the Tuskegee Syphilis study conducted by the Public Health Service in 1932. This study enlisted 600 Black men, with 399 diagnosed with syphilis and 201 without (Centers for Disease Control and Prevention [CDC], n.d.). Conducted under the guise of observing the natural course of the disease, the study withheld treatment despite the availability of penicillin from the mid-1940s onwards. In 1972, heightened public scrutiny prompted its termination by an advisory panel, which cited significant ethical breaches (CDC, n.d.).
To improve the field, public health is attempting to become more interdisciplinary. Community-based participatory research which involves a collaborative approach between researchers and community members has become more common. The field has also taken influence from the liberal arts considering the role of ethics in guiding practice.
Public health is not perfect. It is essential to acknowledge the atrocities committed by public health practitioners. People have good reason not to trust us, and it is our responsibility to win back that trust if we hope to have a positive impact. Through collaboration and ethical reflection, public health aims to better serve and build trust within communities, addressing historical challenges and evolving towards a more inclusive and effective approach.
Reference
Centers for Disease Control and Prevention. (n.d.). Tuskegee timeline. Retrieved from https://www.cdc.gov/tuskegee/timeline.htm
Tower to Town 