A Call for Bold, Brave Public Health Practice.

We are living in contentious times for public health. In the absence of national and global leadership to guide us through the most challenging of moments, public health is being called to fill the void. Navigating uncharted territory with insufficient data and ever-changing circumstances, it is reasonable that good, smart, well-intended people would shine light in different directions. By way of just one example, recently prominent public health experts endorsed two different, competing paths forward to manage the world’s COVID infection.

I have my own perspectives about what may be the right approach for the world, but in the midst of so much uncertainty, it seems to me reasonable and important to address COVID-19 with humility and the understanding that different approaches may be valid in different contexts, as part of a set of approaches deployed for difficult challenges of the moment. This moment, I believe, calls for public health practice that is informed by humility and acceptance of diversity in all its expressions.

As practitioners, we are called to engage the urgencies of the world boldly and bravely. This means using our scientific training and moral compass to guide the way. Our decisions must balance moral and data-informed arguments – listening to head and heart – and recognizing that there is, in both areas, plenty of room for uncertainty and, often, disagreement.

Our challenge is to resist falling prey to the pitfalls of urgency, uncertainty, and disagreement. It is not uncommon for individuals, teams, and organizations to devolve under the pressures of urgency, uncertainty, and/or disagreement. We only need look at the rancor in the United States’ political divide to understand the consequences. To say the least, little gets done.

For public health, uncertainty and disagreement make our work more important than ever. We need to work harder to understand and to embrace the complexities of a rapidly changing world by challenging injustice, expanding health equity, and improving overall health. Sometimes the path to doing what is right is not so clear – this is one of those times.

What is clear is that it will take all of us in public health to recognize, with an open mind and heart, there may be a plurality of voices and approaches that lead us forward through these difficult times. It is people who practice bold public health who make the difficult decisions when the challenges are most hard. And the same bold, brave practice allows us to course-correct when the data change and our compass points a new way.

So, this is a call for us all to embrace a ‘big tent’ bold public health practice. One that is comfortable with gray and lines that bend and twist. One that actively respects the plurality of thought. It starts with an open mind, an open heart, a stretching out of our comfort zone, listening actively, and a willingness to try on other perspectives. Now is the time.

I look forward to walking this new path together with you all.

Craig S. Andrade is associate dean for practice and director of the Activist Lab.