Thread by @Faussenurse

My PhD is in public health. So I went through all the disciplinary blah on equity blah blah transparency blah no victim blaming blah patient centredness blah…

But now I realize I have been fooled. In real life, public health’s motto is “You don’t need to know, shut up and obey”

Public health, as a discipline, is a crossbreed between a state bureaucracy and medicine.

Both origins share a deeply engrained respect for hierarchy and discipline. With a healthy dose of paternalism inherited from medicine and a love for procedural logic from bureaucracy.

In its actions, public health thus tends to be a slow-moving, highly conservative and somewhat toxic practice whose self-perception is deeply at-odds with the reality of what it does and how it does it.

When the pandemic will be over, public health agencies all over the world will self-congratulate (independently of the magnitude of their failures) and lobby hard for more money and resources.

But it would be a lost opportunity to buy into this.

If anything, COVID has shown that the problem wasn’t “how much” public heath our societies had but “what kind” of public health capacity we had.

To be prepared for the next challenges, we need to de-medicalize, de-paternalize and de bureaucratize public health.