What Unites Schools of Public Health

 A symphony orchestra is created to make sounds together ("sym"-"phony").  Each musician’s behavior in the organization serves ensemble which serves the listeners. Beauty unfolds from the unity of purpose. 

 I believe that schools of public health are equally beautiful for the same reason.  Dedicated to making humanity’s places healthier, our product is research, teaching, and practice of a scientific craft.   The heart of our craft is a never-ending wheel: Assess Health Threats, Co-Develop Policy and Strategy, Assure Solutions, then repeat.   

 

This wheel can fail when assessment devolves to a one-off observational report, or when health interventions are disconnected from the community’s receptivity.  But masterfully executed, the public health wheel can lead to self-sustaining improvements that create harmony between humans and their habitat.  The chance to contribute to this magnificent and unheralded beauty is what draws faculty and students. 

 

The integrated wheel of assessment/policy development/assurance is the musical score played by a public health school.  The wheel is how they guide the research they do and the courses they teach. The wheel is how graduates conduct public health when they work for health departments, hospitals and NGOs.  Keeping the wheel spinning in harmony requires unifying multiple experts, leaders, and community members.   

 

At a school of public health there can be a wheel in a wheel. The acts of assessing, co-developing policy, and assuring can be applied to elevate the performance of the teaching and research efforts.  Just as community members share a common interest in safe air, water, and streets, faculty share systems of mentorship, recruitment, financing, and procurement.  When school communities gather to self-assess and problem-solve they are practicing the wheel of public health internally. The sublime result is that they become better at integrating solutions for their school and they can better expound the wheel for students and practitioners.  So it should be easy to get harmony.

 

But musicians have an existential commitment to playing in harmony that is stronger than what drives most members of a faculty. Musicians are failures unless they play in sync, but that rule does not hold in public health.   Although public health practitioners and teachers aspire to integrate their work, harmony has become optional.  Each type of public health problem and public health expert typically receives their own piecemeal program or package.  Their success depends only on their ability to play their solo piece.  Health promotion is conducted on disease at a time and not in conjunction to address common root causes.  The efforts to ask the community, “What are our health priorities? What are our capabilities?” are fragmented into across multiple streams.  The core capabilities of building trust and assuring partnerships are pursued only when expedient. 

 

Harmonizing the work of schools of public health requires preserving the excellence of individuals while adding the coordination.  The internal wheel that allows faculty to voice priorities in how to improve a school resembles the external wheel of the entire profession mission--a wheel in a wheel.  What schools profess to teach is something they must also practice on their campus. Departments of chemistry teach chemistry and those of literature teach literature. But schools of public health teach a wheel of mindful assessment and cooperative work to improve habitat for a community. It should be easy to unify public health soloists into an ensemble. The obstacle is separate streams of money, attention, identity and advancement. The way forward is deliberate efforts to point out beauty--how all can work together to create the world we want inside a school and in the people we serve.

 

David Bishai 

Clinical Professor and Director 

School of Public Health 

The University of Hong Kong