Why are EHPs anonymous and invisible? …some further thoughts following Pete Hill’s blog

Many thanks to Pete Hill for such a thought provoking recent blog exploring the anonymity and invisibility of EHPs (see: http://jigsawpsph.wordpress.com/2013/05/16/im-looking-through-you/).

Instead of speculating further how EHPs became anonymous and invisible (I only have 30 minutes) I would take a step back and question whether public health, including the work of EHPs and others, was ever particularly well known or visible and I enlist the help of Rayner and Lang’s highly recommended Ecological Public Health (http://www.routledge.com/books/details/9781844078325/) to briefly explore this question.

They argue that invisibility has long characterised public health and can take ‘cultural’ (e.g. lacking a ‘good’ story, burdening economic growth) and paradoxical forms whereby successful societies that embraced collectivist public health principles (e.g. improved environmental health) soon forget why they did so and increasingly view such interventions as attacks on the individual (e.g. the ‘nanny state’). In response, Rayner and Lang propose a vision for good public health that embraces the challenges of complexity we face today (e.g. climate change, urbanisation, inequalities) but seeks to construct a more appealing narrative and recasts public health as both interdisciplinary collaboration and societal progress. Further, good public health must be built around continuous change and reassert itself as a democratic project built on a firm ecological foundation.

Returning to my original question, how could this grand vision of ecological public health help EHPs become more relevant to society (and therefore known and visible)? I offer no easy answers, but by engaging with Rayner and Lang’s work perhaps we can become more confident by better understanding who we are as public health professionals, why we do what we do and how we can contribute to a better public health for all in the future. I agree with Pete that we EHPs need to wake up and get out more, but without a better understanding of the complexity of our invisibility and ‘why we are where we are’ I fear we could remain in the public health doldrums. However, Rayner and Lang describe the CIEH as the “most overtly pro-Ecological Public Health of all UK [professional] bodies” (2012:343). Further, I can’t recall ever working on a case that didn’t involve interdisciplinary collaboration within a framework of democratic accountability and the recognition that street level environmental health changes each and every day!

With best wishes, Rob


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