“One does have joys” | The Healthiest Goldfish

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Public health is fundamentally about trying to create a world that is healthier, better. In doing this work, we must, at times, assume the role of commenting, a priori, on how we are falling short on generating health. This can have the effect of making a discipline that is all about health seem chiefly concerned with sickness, so often do we find ourselves discussing it—its causes and its consequences. This conversation is necessary for the work of public health. But it is worth asking: can this have the effect of keeping our attention fixed on challenges at the expense of a focus on the more positive aspects of health—of all the ways health can enable a happy life? It strikes me that it might be worth taking a moment—perhaps informed by the promise of soon summer—to discuss how public health can refine its emphasis, to better communicate the inherent positivity of the work of public health.   

This positivity can, at times, get lost in translation. Our messaging seeks to curb behaviors which can lead to sickness and preventable harm. This messaging tends to involve statements that begin (implicitly), with the words “Thou shalt not.” “Thou shalt not drink.” “Thou shalt not smoke.” “Thou shalt not eat to excess.” What we mean by these statements is to offer a blueprint for behavior which supports a long, healthy life. Yet it is possible to read them as prohibitions against fun, against the pleasure and joy which are core to living that very life to begin with.

Some might dismiss this as a matter of mere tone, secondary to more urgent priorities. Yet the wrong tone can risk alienating the very public we are meant to serve, and, in doing so, weaken the effectiveness of public health. Consider what we have seen during COVID-19. The threat posed by the pandemic has meant that, during the past year, the population has been receptive to the message of public health arguably like never before. Yet, even under these circumstances, there has still been resistance to public health. Such resistance—even in the midst of a pandemic—suggests that, for some, public health is seen primarily as an attempt to curtail freedom and enjoyment and is, as such, to be resisted. The great irony of this is that curtailing freedom and enjoyment is the precise opposite of what public health should aspire to do. Our actual intent is to ensure as many people as possible are free to live long lives full of the activities and interactions that bring happiness and meaning. Such lives are only possible in a context of health, of being free from the disease and preventable harm that can stand between us the pursuit of a happy life.

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