“The Art of Public Health”
In doing this week’s readings, I was most interested by the recurring theme of the role that culture and values play in the way that people receive messages, specifically in the articles by Gawande, Dembicki, and Hanlon et. al. This highlighted an issue that has been repeatedly coming up for me as I learn more about and gain some practical experience in public health: knowing how to be effective as a public health specialist has a lot to do with knowing how to interpret (and change) human behaviour.
The concept of social marketing was foreign to me until very recently. My focus entering the program was on health literacy. Having worked in communications for a few years, I believed that presenting information in a clear and well-written way was all that was needed to get information across. I was stuck in the trap of assuming that evidence was enough to convince people that something I “knew” or “science showed” was good for them.
However, reality has begun to sink in and my naïveté has slowly begun to fade as I realize that with many public health issues, people are not just sitting around waiting to be informed, they are not necessarily captive and interested listeners, but rather they must be convinced and persuaded of what Gawande points out might be an “invisible problem” or might involve an intervention that goes against their exisiting value system.
As Dembicki outlines in his article on the trouble in getting conversation on climate change out of the “left-wing ghetto”, the messages that people hear are largely based on deep-seeded values and the emotions they provoke. That is, much of the knowledge-to-action gap on climate change, and a whole range of other public health issues, probably has something to do with the way the information is being communicated.
As many of the other posters touched on, in some of this week’s readings the action cycle steps of adapting knowledge to the local context and implementing interventions are dealt with very briefly, disguising in a way the often labourious processes that these are in practice. In my view, (which undoubtedly reflects my own moral biases), much of the work of knowledge translation should lie in discovering better ways to translate knowledge so that it is compatible with pre-existing views and values.
That’s not to say this is easy. It involves processes of framing, tailoring, and perhaps most difficult of all, what Dembicki points out, our own moral biases and irrationality as communicators. On this point, Hanlon et. al. bring up what I found to be a very intriguing perspective, that there is not only a science to public health, but also an art. In incorporating creativity into public health work and drawing on ideas of identity and belonging as important motivators for human behaviour, we are sure to generate more meaningful knowledge exchanges.
Dembicki, Geoff. How to talk to a conservative about climate change. The Tyee, July 29, 2013.
Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N. (2006). Lost in knowledge translation: time for a map? The Journal of Continuing Education in the Health Professions, 26(1), 13-24.
Gwande, Atul. Slow ideas: why innvations don’t always catch on. New Yorker. July 29, 2013.
Hanlon, P., et al. (2011). Learning our way into the future public health: a proposition. Journal of Public Health, 33(3), 335-342.