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Public Health Advocacy: Creatively Applying Medical Knowledge to Social Policy

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I had the honor of being on a panel at the Champion Providers Training, held at the lovely Hotel Kabuki in San Francisco this July. Forty-five physicians and three dentists attended the two-day training, sponsored by the California Department of Public Health, Champions for Change, the Public Health Institute and the University of California San Francisco. The goal of the event was to train medical professionals in public health advocacy, specifically aimed at reversing the interrelated obesity and diabetes epidemics.

Inspiring future health advocates

The conference was organized by doctors from the UCSF Center for Vulnerable Populations. These doctors have not only committed their clinical work to caring for the vulnerable, but they have also successfully applied their health knowledge to the broader arena of social policy. The hope was that they could educate and inspire conference attendees to do the same. Training was offered in communication skills, coalition building, the development of community work plans, and engagement with local health departments and elected officials.

In addition to the activist doctors from UCSF, a number of skilled professionals helped with the program. Mike Miller and Paula Hamilton of Brown Miller Communications shared their expertise on how best to work with the media. This group has used their knowledge and talents to address a variety of public health issues, most recently focusing on obesity. Their efforts have helped to remove unhealthy food and beverages from schools, and to win support for menu labeling legislation. These are exactly the kinds of public health campaigns we need to win.

Dr. Steve Schroeder was the keynote speaker. Dr. Schroeder is Distinguished Professor of Health and Health Care at UCSF where he also heads the Smoking Cessation Leadership Center. Between 1990 and 2002, Dr. Schroeder was President and CEO of the Robert Wood Johnson Foundation, the nation's largest philanthropic institution dedicated to public health. Dr. Schroeder has been a national leader in the successful efforts to reduce tobacco smoking. This work has already inspired many efforts in obesity and diabetes prevention. Dr. Schroeder reminded us that successful public health campaigns require hard work, persistence, and a comprehensive strategy of working simultaneously on multiple solutions to each problem.

"The Bigger Picture"

Creating multiple solutions to the obesity and diabetes epidemics is no small task. The conference organizers shared a creative, exciting and effective strategy, which resulted from a delightful blend of art and science. They call it "The Bigger Picture." Dr. Dean Schillinger, Director of the Health Communications Research Program in the Center for Vulnerable Populations, and James Kaas, Executive Director of Youth Speaks, have formed a unique partnership. Youth Speaks is non-profit organization that uses spoken word education and performance to further youth development. Working together, Dr. Schillinger and Mr. Kaas have created a youth-led diabetes prevention social media campaign. The Bigger Picture is designed to combat the rising epidemic of Type 2 diabetes by empowering youth to change the conversation about the disease, and work to change the social and environmental factors that have led to its spread.

Youth Steal the Show

Two of the young poets from this unique collaboration are Monica Mendoza and Yosimar Reyes. Both are now college students. These young performers brought down the house when they read their work! Each poem shares the struggles of Mexican American immigrant families to survive in the San Francisco Bay Area -- and the unhealthy role that Coca Cola and junk foods have had in their family life.

Monica touched us by sharing her family dinner experience in "A Taste of Home":

Our tongue has been colonized with the belief that this cup of Coke is home...
We are literally killing ourselves trying to find parts of us in Coke bottles.

Yosimar's "Lost in Translation" reminded us of the daily challenges faced by so many immigrant families:

Miles away from home we found ourselves situated between two liquor stores on the same block,
eating poison to nourish our body...
These foods we trust to give us nourishment
are slowing killing us.

Writing for change

The conference attendees were an amazing group of passionate health activists. Many had already made important contributions to public health. They had come to sharpen their advocacy and writing skills in order to better influence policy. The attendees had come to the right place. So had I. I attended most of the two-day conference, including the sessions on "writing for change."

We were given 10 minutes in which to produce a writing sample, which others in our small group sessions would then critique. My own panel presentation followed the writing sample exercise, so I used the opportunity to write about what I should say. At the end of my panel presentation, the conference leaders asked me to read my writing sample to the entire group of conference participants. It was a privilege to share my own thoughts on the importance of public health advocacy with those at the conference and it's a privilege to share them again:

My writing sample
I must be dreaming. Is this a progressive medical Valhalla of some sort, a room of doctors and a few dentists, all of whom are passionate about healing our dear, troubled planet and those of us who live on her fragile crust?

What do I have to offer I wonder? Somehow the Dalai Lama comes to mind. "Kindness is my religion," he explained.

What should be the religion of medicine, the religion of health care? "Kindness through service" I think. That's where I will start my remarks. I make a mental note.

After all, what I miss most about clinical medicine is the moment when I feel in my heart and see reflected in the eyes of the patient the knowledge that I am caring for them as one of my dear family members. At that moment, God herself seems to be in the room.

Yes, service and kindness. That's what will make a great Champion Provider. And, let's add to the list: commitment, courage, creativity, humility and empathy.

But certainly not perfection. The Apollo team to the moon was only on their ideal flight path three percent of the time. No, we never need to be perfect, just attentive and willing and able to make course corrections as we go.

Tell them to follow their passion, to be willing to take risks, to be willing to fail. Isn't that what Einstein did?

Tell them to enjoy the process. Transforming the world for the better is a lifelong endeavor. Others will pick up where we left off. There is nobility, beauty and enjoyment in the process and we become better people by the engagement.