Opinion: Public health and civil society: Challenges for the future

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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;

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

• Determinants of health: while individual choices and genetics make a difference, 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 health threats have demonstrated the importance of trust. With trust in public health, society reduced smoking rates, deaths from cancer and communicable disease, and workplace and traffic fatalities. That trust is built on a culture of transparency, honesty and accountability for what we do as public health professionals.

• Disarming anti-science: When the lives of people are at stake, we cannot make decisions or take actions based on myths, rumours, anecdotes, lies, or who shouts the loudest or has the most clicks. Public health leaders, our governments and 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 reveals.

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• A strong system: We need sufficient investment in a public health system with adequate workforce, infrastructure and resources. Failing to invest the necessary time and money creates a huge long-term risk.

• Surge capacity: A strong public health system relies on being able 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.

Ultimately, public health consists of all the things we do for one another — investing in clean air and water, a safe and healthy food supply and immunization programs that are universally accessible and free. Ensuring that where we live, work and play are healthy spaces has resulted in the vital and active communities we have today. We need to make similar investments in our future to ensure that our children enjoy the same benefits.

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Finally, a warning for the future. One of the greatest strengths of public health is that it works with everyone, and that diversity ensures 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 into seeing other people as less deserving of society’s organized efforts. These destructive lies are spread and amplified by people, organizations and governments acting out of ignorance or as deliberate attempts to undermine our pluralistic, democratic and open society.

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.

Dr. James Talbot and Dr. Lynn McIntyre are writing in collaboration with the Alberta Public Health Association, which promotes public health through advocacy, partnerships and education.

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