The Language of Public Health.

Before I start today’s Dean’s Note, a reflection that the federal election will be determined this week. I have commented recently on politics and health, and on some issues relevant to this election. It has been, among much else, an election where language has mattered perhaps more than ever, negatively and positively. It is then perhaps apposite that we had scheduled to run today this Dean’s Note on language.

For the past two years, we have been making an effort to communicate our work much more clearly, both internally and externally. Through our Strategic Thinking Initiative, we articulated our mission and values. We have embraced new outlets for expressing our unique perspective as a School through our redesigned website and publications, our continued contributions to both the academic and journalistic press, and our use of social media. As we advance our outward-facing engagement, it seems worthwhile to reflect on the language of public health and how we might broaden our vocabulary in pursuit of healthier populations.

Why do we communicate? Internally, our communications represent an attempt to create spaces here at SPH where ideas can be heard and engaged with. Even if this engagement results in disagreement or debate, the process of coming together to share thoughts and opinions is, I think, a perennially enriching exercise. To this end, we have established fora for shared language and experiences, and vehicles—like Viewpoints—for our scholars to express their take on both contemporary issues and the overarching themes of our field. Externally, we aim to influence the broader conversation as part of our responsibility as a leading school of public health, to arrive at the confluence of knowledge and values needed to promote population health. Through our media engagement, our advocacy, and our embrace of digital platforms, we seek to export our on-campus discourse to the wider world and effect positive change, using the power of language to bring this about.

For our words to have resonance, they must above all be clear. This begins with knowing our audience. We must be clear about who we are speaking to, and choose what we say accordingly. More than two thousand years ago, Cicero summarized the importance of being able to speak to multiple groups, saying, “He, therefore, is the man of genuine Eloquence, who can adapt his language to what is most suitable to each. By doing this, he will be sure to say every thing as it ought to be said.”

Who, then, are our audiences?

First, there is our academic audience, our peers. As scholars, our engagement with the academic world is the backbone of our work. When we conduct our research and give voice to our findings, we do so to advance knowledge and establish a scientific basis for our arguments. While the audience for academic writing may be comparatively small, this makes for robust transmission of ideas and feedback. When we address our peers, our thought process is laid bare for their review. The scientific method, itself a kind of common language, gives us a shared framework through which we can evaluate one another as we lay the foundations of our field. From this interplay of empiricism and argument arose much of what we currently take as a given in public health. The utility of hand washing, for example, was once hotly debated in the academy. As strange as it may be to think something so seemingly self-evident used to be an academic question, many now “obvious” truths about health developed the same way—from the uselessness of bloodletting, to the germ theory of disease, to the declassification of same-sex love as a mental illness. The fates of what we now accept as truisms were once dependent on the clear and consistent expression of an argument, often over the course of years. In these cases, understanding progressed through a combination of methodological rigor and disciplined communication, with language contributing to change in the broader world.

Our second audience represents a slightly larger sampling of people: influencers working across many sectors who are in a position to change the policies that affect health. Our engagement with this group allows us access to the kind of real-world leverage that gives public health solutions the broadest possible reach. By learning to “speak the language” of those who are in a position to make change happen, we are better able to find areas of confluence and opportunities for collaboration. Consider economics. Economics is a field that, like public health, concerns itself with the distribution of well-being within and across populations. Yet, between disciplines, the words used to describe this common mission can be quite different. Where we say “health,” the economist might say “utility”; where we say “minimizing disparities,” she might refer to a “Rawlsian function.” To collaborate with an economist, then, we must familiarize ourselves with how an economist talks. This has the added benefit of familiarizing us with how an economist thinks. By opening ourselves to the vocabulary of others, we open ourselves to different habits of mind, improving our ability to make connections and see areas of overlap between the work of public health and the many less obviously health-related fields that nevertheless shape the wellbeing of populations.

Finally, there is our outreach to the general public, to change the culture around matters of health. With the exception of certain watershed moments, like last year’s marriage equality victory, it can be difficult to measure the progress of change in real time. One key benchmark can be language—the public conversation about issues related to health. Consider our efforts to curb the gun violence epidemic. That the word “epidemic” is now used prominently in reference to this ongoing tragedy is itself a sign of progress. It suggests our success in nudging the conversation forward, in framing gun violence as a public health crisis, rather than simply a matter of law and order. This shift demonstrates the power of words to both define a problem and create a context in which it might be solved. From education to income inequality, there are many other areas where the language of public health may be brought to bear. Just as our own speech must draw from the language of other disciplines, we must not be shy about applying the words and phrases of our field to sectors where they might make a difference. As we work to shift perception and culture, we must likewise work to influence the way people talk about health, changing—literally—the terms of the debate, as we move towards the ultimate goal of changing minds and societies.

How, then, can we as a school continue to use language in an effective way, towards improving the health of populations? Four pragmatic directions to highlight.

First, through a new initiative, launching this week, called Public Health Post (PHP). PHP is an online presence, edited by Professor David Jones, that aspires to elevate the conversation around public health through an idea-centered dialogue that focuses on the drivers of population health. It will include content that is both internally generated and externally aggregated, drawn from journalists, policymakers, academics, and other influencers who create change on the local, national, and international level. The platform will unfold the narrative of population health through data visualization of public health statistics, traditional longform journalism, video, and more. Our hope is that PHP will help catalyze the evolution of the language of public health—a language that is flexible, alive to new ideas and expressions, and unstintingly concerned with the foundational drivers of health.

Second, excited as we are to provide platforms like PHP, such efforts mean little if—as Professor Jennifer Beard argues in her Viewpoint—we do not also work to enable the next generation of public health professionals to participate in the conversation. Our writing program is designed to do just that, strengthening our students’ skills through peer coaching and feedback at any stage of the writing process. Because so much of this process consists of often frustrating revision, a finished piece of writing can belie the amount of sheer work that led to its production. Acknowledging that the writer’s task is not as easy as it sometimes looks, we aim to provide as much assistance as we can to those engaged in this painstaking but ultimately worthwhile endeavor.

Third, we are investing in efforts to better train our students in the language of public health and in communicating for the health of the public. To that end, one of our new certificates for the incoming MPH class focuses on Health Communication and Promotion. This certificate, led by Professor William DeJong, aims to provide students with practical skills for developing and implementing communications-based strategies to improve population health.

Fourth, but perhaps most fundamentally, our communications efforts are ably led by our Communications team. The message from Kara Peterson, our director of communications, accompanying this Dean’s Note in this week’s SPH TW elaborates on the work of this group.

I hope everyone has a terrific week. Until next week.

Warm regards,

Sandro

Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Twitter: @sandrogalea

Acknowledgement: I am grateful to Eric DelGizzo, Kara Peterson, and Professors Jennifer Beard, William DeJong, and David Jones for their contributions to this Dean’s Note.

Previous Dean’s Notes are archived at: https://www.bu.edu/sph/tag/deans-note/