Public Health and civil society: Challenges for the future

Post date: Apr 12, 2024 

Public Health is the art and science of promoting health, preventing disease and injury, and prolonging life through the organized efforts of society. We have made great strides in Public Health to achieve these aims through a set of core values:

• Primacy of prevention: preventing disease and injury is better for people, business and society than trying to treat and cure disease or injury after they have occurred;

• Health for all: all of us regardless of age, gender, income, religion, or ethnic status deserve to be as healthy as possible;

• Determinants of health: while individual choices and genetics make a difference to health, evidence shows that our physical and social environments are actually more important determinants;

• Evidence-based: when we act on promoting health for all, we must collect and use the best evidence possible.

These values are especially needed in Alberta to sustain the organized efforts of society over the years and decades ahead. There are key elements that will be fundamental to the success of Public Health for Alberta and beyond.

Trust: COVID and other population health threats have demonstrated the importance of trust. With trust in Public Health, the efforts of society reduced smoking rates, deaths from cancer and communicable disease, and workplace and traffic fatalities. That trust is based on being open and truthful: meaning what we say, and saying what we mean. It is built on a culture of transparency, honesty and accountability for what we do as Public Health professionals. We also need to make certain the province in which we work values that honesty. 

Disarming anti-science: When the lives of people, families and communities are at stake, we cannot make decisions or take actions based on myths, rumors, anecdotes, lies, or who shouts the loudest or has the most clicks. Public Health leaders, our governments and civil society organizations need to continually demonstrate their commitment to evidence-based Public Health program development, implementation and evaluation. We cannot allow Public Health to be silenced by those who reject what the very best science, derived by diverse ways of knowing, reveals.

A strong Public Health system: We need sufficient investment in a Public Health system with adequate workforce, infrastructure and resources to meet its important aims. Like all prevention activities in our lives, such as changing the oil in your car or buying insurance for your house, failing to invest the necessary time and money creates a huge long-term risk. Making the investment in our health and the health of our communities returns important gains through risk reduction.

Surge capacity: A strong Public Health system relies on the ability to generate additional capacity (people, resources, funding) to respond to major emergencies and epidemics. Inevitable major adverse events lie ahead. Strong and resilient communities are best able to respond to extreme weather, fire and flood emergencies, extended droughts, climate refugees, changing infectious disease patterns, and the economic disruption that will accompany these consequences of climate change. We need to re-invest in our communities and agencies to increase their readiness.

Ultimately Public Health consists of all the things we do with and for one another. Investing in clean air and water, a safe and healthy food supply, and immunization programs that are universally accessible and free of charge, and ensuring that where we live, work, play, and study are healthy and safe spaces have resulted in the long-lived, vital and active Albertans and communities we have today. We need to make similar investments in our future to ensure that our children enjoy the same benefits.

Finally, a warning for the future. One of the greatest strengths of Public Health is that it works with everyone, and that diversity allows us to ensure our work is intended to achieve health for all. Consequently, one of the greatest threats to success is anything that divides us, that is dishonest or untrue, or manipulates us as seeing other people as less deserving or worthy of society’s organized efforts. These destructive lies are spread and amplified by people, organizations and governments that are acting out of ignorance, maliciousness or as deliberate attempts to undermine our pluralistic, democratic and open society. We are all aware of social media and its algorithms. There are even harmful computer programs (bots) that can further inflame these divisions. Even worse, there are governments that support their development and use.

Make no mistake about it—in Public Health we identify these actors and behaviours as hazards, "a source or situation capable of causing harm". One of the most important strategies for our continued health is to find ways to reduce and eliminate these hazards and make ourselves and our communities more resistant to them. All of our lives depend on other people. The COVID pandemic's enduring lesson should be how much we depend on one another. Our future health depends on how well we have learned that lesson.