The 139th Annual Meeting of the APHA

This past week I had the pleasure of attending the annual meeting of the American Public Health Association in Washington DC. Anyone working in the field of public or community health should try to attend this meeting at least once in his or her life. Admittedly, it is not cheap. The registration fee is generally north of $400, and rooms in the downtown DC area run more than $200 a night. However, if you can afford it, it’s worth the money.

This year’s meeting, titled “Healthy Communities Promote Healthy Minds and Bodies," drew over 13,000 registrants and featured hundreds of sessions on a wide variety of topics. I happened to attend some very interesting sessions on hepatitis B programs, innovative research methods, social justice/health equity, and the CDC initiative “Communities Putting Prevention to Work." I also had a chance to spend some time with my new colleagues in the Asian Pacific Islander Caucus (APIC).

While I enjoyed a number of the many speakers, I wanted to provide a shout out to Dr. David Chavis of Community Science in Maryland. He entered the session late, having just returned from South America and still suffering from a bout of intestinal distress. In his presentation, entitled “Paradox of Public Health and Social Justice: Being a Professional in the Social Change Process,” he noted that factors such as poverty, discrimination, poor education, lack of political voice, and other social justice issues are strongly associated with poor health, and that public health as a science has recognized the need to integrate social change work with classic health improvement models. However, he cites two challenges in successfully integrating these two approaches.

First, public health professionals generally work in risk adverse institutions such as government, foundations, academia, and funder dependent non-profits. There are few rewards, and frequent resistance to actual social change. Conflict, a critical component of change, is denied as an option.

Second, unlike many other social movements, the need for scientific knowledge is substantial in health justice work, yet public health and other professionals often see their knowledge and the status it gives them as disempowering to disenfranchised communities. The blanket position that "the community knows best" frequently unnecessarily puts communities in the position of having "to re-invent the wheel."

Dr. Chavis offers several suggestions to address these two challenges:

1. Be the organizational change that you would like to see in the community. Embrace social justice within the organization.
2. Learn how to use power and conflict for progressive social change.
3. Form true partnerships with community leaders.
4. Engage and learn about other movements (e.g., education and economic).
5. Prepare students for social change work.
6. Treat community leaders and residents as adults. Stop “dummying down”. Educate.
7. Treat this work as if it’s life or death.

I think Dr. Chavis’ recommendations are on the mark. Non-profit organizations like the Asian Pacific Community in Action are right at the intersection of public health science and health justice. To be most effective, our disease specific work (e.g., hepatitis B screening and breast cancer education) needs to be integrated with purposeful community organizing and mobilization efforts. The challenge for us is to lend science and rigor to community work while recognizing that community interests and assets are at the heart of social change. I thank Dr. Chavis for his insights and encouragement.

- Doug Hirano, MPH, APCA Executive Director