Often times when I tell people that I am a public health
professional I am met with “So you are a doctor?” Or when I was in college, my
family repeatedly asked, “Are you going to open your own practice?” No… not
quite. While the clinical aspect of public health remains a vital component to
the success of many programs, we cannot neglect the non-clinical aspect of
public health.
One thing that I have always loved about this field is how broadly interdisciplinary it is. A person’s health is impacted by everything- Our water, our socioeconomic status, our education, exposures and food habits..
As a first year at James Madison University I didn’t know what I wanted to
major in. I liked helping people, I enjoyed health, but I hated bodily fluids
and was scared of hospitals. In fact, as a child I told my first grade teacher that
I wasn’t allowed to watch TV because we were going to watch “Curious George
Goes to the Hospital”. As I searched for answers to the “What do you want to
do” question, I kept coming back to Health Sciences: Public Health Education as
the answer. The course list included community health, child and adolescent
health issues, human sexuality and reproductive health topics, public health
program theory among others. The major was a broad survey of all of the
components of public health and I wouldn’t have to perform any exams!
The world outside of university halls often forgets that public health is not synonymous with clinical health. One focuses on treating and healing patients including preventive care, while the other focuses on health at a population level.
The world outside of university halls often forgets that public health is not synonymous with clinical health. One focuses on treating and healing patients including preventive care, while the other focuses on health at a population level.
Partners, yes, but not synonyms.
I believe that
international development is the best field to get a good look at public health
in practice. Here, we have the Millennium Development Goals and Post-2015
Agenda for Sustainable Development as developed by the United Nations (See
image below). We see a number of topics that all affect health.
MDG 2: Achieve
Universal Primary Education: Increased education has been linked to
improved physical health. Improved education rates leads to economic
development, higher wages, and reduces premature mortality. On the most basic
level, when an individual becomes ill and visits a physician, the instructions
provided by the physician can be critically evaluated and followed. Education
matters to physical health; Non-clinical educators matter to public health.
MDG 4: Reduce Child
Mortality: Here we can link physical health most closely with public
health. When we are addressing a development program, what is the current rate
of child mortality, what is the cause of that mortality, and how do we address
it? Non-clinical public health professionals can be used to conduct the field
interviews, look at the data, and draft a plan of attack against that cause of
death that physicians AND non-clinical professionals can carry out. This
doesn’t have to be done by physicians- in fact it is often a waste of resources
to primarily use physicians to do this data gathering and analysis. In
international development, conservation and best use of resources is vital as
funding is very limited and the work matters very much.
MDG 7: Ensure
Environmental Sustainability: This may be one of the most confusing
elements of public health for many to understand when we assume public health
is only clinical health. Climate, energy, and sanitation affect health? The WHO
reports over three billion people using biomass to cook daily meals and to heat
their homes. That’s nearly half of our world population exposed to soot and
smoke constantly just to survive. That’s families dying due to pneumonia,
stroke, COPD, and lung cancers because they are using outdated technologies. We
need clinicians to address this when these health issues manifest, but we also
need engineers, public health program developers and managers, and advocates on
the community level to address this.
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I’m not saying clinicians are not vital to public health, because they are. But there is a place for non-clinical health professionals in public health, too. We cannot expect every public health professional to have M.D. or R.N. after his or her name in order to be a key asset to our programs or in order to have the knowledge necessary to innovate. We need brains that look at public health and understand how to connect the multidisciplinary dots. We need a team approach. Yes, we need clinicians, but we also need non-clinical professionals, too.
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