Language and Public Health

By Richard A. Aronson, MD, MPH

A goal of Humane Worlds Center is to help change the language of medicine and public health so that it better reflects the underlying ideals of these noble professions. Our use of words, as I learned so well from my freshman English class at Amherst College, defines how we all approach and actually think about life. Language itself determines how we receive, process, interpret, and provide output for our thoughts and, importantly, actions. Humane Worlds Center seeks to appreciate language as a foundation for creating conditions for the use of language in ways that resonate with people from diverse cultures, across boundaries. It’s important for us to explicitly acknowledge and address the widespread use of bureaucratic jargon, complex technical terms, unintelligible acronyms, and violence related metaphors that permeate the language and culture of society as a whole. It appears everywhere in our discourse, written and verbal. For example, we “target” just about everything and everybody, most of whom don’t take kindly to the idea of being targeted; we design policies, programs, protocols, and services to, say, “combat” violence, which certainly qualifies as an oxymoron; we figure out all kinds of ways to “fight” poverty; we design “interventions” on people and communities for campaigns, for example, to “attack” high rates of asthma and its “triggers”; we describe people as “high risk cases” to be “managed” rather than as human beings to be cared for; we fill grant proposals and electronic mail with “bulleted” talking points and confusing often bizarre acronyms; in medicine, we identify babies who “fail” a hearing screen as having birth “defects”; and in public health we use the epidemiological related meaning of “surveillance” in the post-9/11 era when such a word is widely perceived in a much darker context and linked to a real war; and of course we thrive on building “infrastructure”, whatever that non-specific and vague word means to the public. The uncritical and ubiquitous use of such words and terms, though largely unintentional, contribute to cultural norms that can undermine the purpose and ideals of public health and the quest for a culture in which education and democracy thrive. In the quest for health and healing, people and communities cry out to be honored, respected, and included in the design and implementation of systems to enhance their well-being. Indeed, the genius of public health, at its best, lies in its unique ability to honor and include such cries in whole systems change. But our dominant communication patterns have the opposite effect. Our challenge is to pay greater attention to such communication and, in the long view, to change our language so that it explicitly embraces and supports the quest for a culture that affirms the ideals of education and democracy. Through such a change, we can be in a stronger position to create and sustain humane public health policies and systems that honor the dignity of all people and that reduce unconscionable inequalities. Public health has a wide array of people from around the world who carry out innovative promising practices to do just that. Our calling is to make these practices systemic and enduring.

Public Health Conversation and Mentoring at Amherst Draws 35 Students

By Jodie Simms, Annah Kuriakose, and Richard A. Aronson, MD, MPH

We are delighted to share that the Public Health Event held at the Amherst College Career Center on December 5, 2008, was a huge success. Thirty five students with interest and passion for public health turned out for a 90 minute dynamic conversation with six alums (Dick Aronson '69, Alan Blum '69, Gary Forester '69, Anya Guyer '99, Molly Greene '01, Jesse Bump '94) and one faculty, Prof. Christopher Dole of Anthropology. Individual mentoring sessions of 30 minutes each followed, in which all six alums participated. Jodie and Annah have received lots of positive feedback from students who have said things such as "my eyes were really opened to new possibilities and to things I never thought of before, including ways to contribute to health besides medicine". One woman said it was the best event she had ever been to! Other words used to describe it were: exciting, inspiring, thought-provoking, motivating, helpful, fantastic, and powerful. We are grateful for the sharing of experience, knowledge, and ideals that happened. We hope that the energy that came from this event will spread into the future and awaken a stronger presence of public health at Amherst and beyond.




P.S Please let me know if you have any thoughts or suggestions of how we could make the event even better in the future!

North Dakota Meeting Facilitation December 9 2008

By Richard A. Aronson, MD, MPH

On December 9, 2008, I facilitated an exciting meeting, "Uniting for a Healthy Future: Integrating Systems for North Dakota’s Children, Youth, and Young Adults", sponsored by the North Dakota Center for Persons with Disabilities at Minot State University. The meeting took place in Bismarck and drew 35 diverse stakeholders, including several family members who shared inspiring stories of resilience, advocacy, and activism. The purpose of the gathering, funded in part by a federal grant from the United States Maternal and Child Health (MCH) Bureau, was to develop collaborative partnerships for creating integrated, family-centered, culturally competent systems of care so that children and youth with special health needs in North Dakota have the full equal opportunity to thrive in body, mind, and spirit. I helped the group 1) Identify common work efforts taking place around the state, that focus on advancing the medical home, cultural and linguistic competence, family involvement, and youth in transition to adulthood; 2) Build on current strengths of such efforts; 3) Identify how partnering on a shared vision may help enhance outcomes; and 4) Develop partnerships to sustain systematic efforts to build a healthy and productive child, youth, and young adult population in North Dakota. Broad participation of many stakeholders is essential for promoting medical home systems of care, and for assuring that integrated systems are in place to support youth with special health needs in their transition to work and adulthood. This kind of participation, rooted in core principles of cultural competence and family involvement, challenges us to develop new forms of collaborative leadership. This becomes even more urgent at times of economic crisis. Such leadership seeks to unite stakeholders and serve as a catalyst for essential but previously unlikely partnerships. It enables people to discover common ground for action that they did not realize they shared. Such discovery can bring dignity, hope, and equity to children and youth with special health needs and their families. To facilitate the day, I drew from Future Search, guiding the group through a series of small group activities (Mind Map, Prouds and Sorries, Ideal Future Scenario, Confirm Common Ground), each of which was followed by large group dialogue. Future Search, developed by Marvin Weisbord and Sandra Janoff, is a uniquely interactive planning tool that has been used with notable success during the past 25 years in many of the world’s cultures.