April 6-12 is National Public Health Week. In honor of Wednesday's theme of "Building Momentum" and the week's overall theme of Healthiest Nation 2030, we present this list, adapted from Chapter 3 of Community Engagement, Organization, and Development for Public Health Practice, by Frederick Murphy, MSPHyg, MPIA.
A larger commitment to our nation's public health requires a fundamental understanding of the key ideas behind community empowerment and community engagement in public health. The following is a list of 11 values and beliefs that are critical to successfully build upon the public health initiatives that have already been taken by influential leaders across the country today.
1. Humans have a right to the resources necessary for health. The Public Health Code of Ethics affirms Article 25 of the Universal Declaration of Human Rights, which states in part “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family. . . .”
2. Humans are inherently social and interdependent. Humans look to each other for companionship in friendships, families, and communities and rely upon one another for safety and survival. Positive relationships among individuals and positive collaborations among institutions are signs of a healthy community. The rightful concern for the physical individuality of humans and one’s right to make decisions for oneself must be balanced against the fact that each person’s actions affect other people.
3. The effectiveness of institutions depends heavily on the public’s trust. Factors that contribute to trust in an institution include the following actions on the part of the institution: communication, truth telling, transparency (i.e., not concealing information), accountability, reliability, and reciprocity. One critical form of reciprocity and communication is listening to, as well as speaking with, the community.
4. Collaboration is a key element to public health. The public health infrastructure of a society is composed of a wide variety of agencies and professional disciplines. To be effective, they must work together well. Moreover, new collaborations will be needed to rise to new public health challenges.
5. People and their physical environment are interdependent. People depend upon the resources of their natural and constructed environments for life itself. A damaged or unbalanced natural environment, and a constructed environment of poor design or in poor condition, will have an adverse effect on the health of people. Conversely, people can have a profound effect on their natural environment through consumption of resources and generation of waste.
6. Each person in a community should have an opportunity to contribute to public discourse. Contributions to discourse may occur through a direct or a representative system of government. In the process of developing and evaluating policy, it is important to discern whether all who would like to contribute to the discussion have an opportunity to do so, even though expressing a concern does not mean that it will necessarily be addressed in the final policy.
7. Identifying and promoting the fundamental requirements for health in a community are of primary concern to public health. The way in which a society is structured is reflected in the health of a community. The primary concern of public health is with these underlying structural aspects. While some important public health programs are curative in nature, the field as a whole must never lose sight of underlying causes and prevention. Because fundamental social structures affect many aspects of health, addressing the fundamental causes rather than more proximal causes is more truly preventive.
8. Knowledge is important and powerful. We seek to improve our understanding of health and the means of protecting it through research and the accumulation of knowledge. Once obtained, there is a moral obligation in some instances to share what is known. For example, active and informed participation in policy-making processes requires access to relevant information. In other instances, such as information provided in confidence, there is an obligation to protect information.
9. Science is the basis for much of our public health knowledge. The scientific method provides a relatively objective means of identifying the factors necessary for health in a population, and for evaluating policies and programs to protect and promote health. The full range of scientific tools, including both quantitative and qualitative methods, and collaboration among the sciences is needed.
10. People are responsible to act on the basis of what they know. Knowledge is not morally neutral and often demands action. Moreover, information is not to be gathered for idle interest. Public health should seek to translate available information into timely action. Often, the action required is research to fill in the gaps of what we do not know.
11. Action is not based on information alone. In many instances, action is required in the absence of all the information one would like. In other instances, policies are demanded by the fundamental value and dignity of each human being, even if implementing them is not calculated to be optimally efficient or cost beneficial. In both of these situations, values inform the application of information or the action in the absence of information.