In 1968, Dr. Morris Schaefer, a Professor and Head of Department of Public Health at UNC, Chapel Hill wrote a striking paper about the current issues in delivering better health services. He presented it at the 95th annual meeting of the American Public Health Association and many of what he shared then resonates with the state of public health today. In it he shared ‘how our incapacity to appreciate the character of the problems we face, may render us helpless when we encounter future challenges. Our field is not only confronted by new challenges, but also an increased urgency attached to old problems, new responsibilities, new functions, all at an increasingly rapid rates. Also with each
new challenge, comes the need to respond to continuing changes, all while maintaining the stability necessary for effective Public Health Service.’
If only our field heeded his advice in 1968. That and the idea that Public Health for better or worse is deeply enmeshed in political activity, despite the fact than antipolitical ideology persists. The handling of the pandemic is a glaring example of this. One section though that I choose to keep today is his focus on how ‘the past is still present.’ He was so thorough with the significance of the past and why we all need to have a reorientation in our attitudes about public health that it only makes sense to render it in verse for the present.
Without no further ado, read my keep below inspired totally by Dr. Schaefer entitled the ‘keep knowing that the past is present in public health:’
Public health faces a new day. While a hangover still remains.
Unsolved longstanding problems remain. Unfamiliar areas of services too.
Shortage of personnel remain. Solutions for the future too.
Conditions of uncertainty remain. Clamor for demands too.
Varied programs and goals remain. Complicated disciplines too.
Target populations remain unknown. The public we serve too.
Useful but limited textbooks remain. Old, standard associations too.
Struggles between agencies remain. Tensions across disciplines too.
Uneasy frontiers for public health remain. Uneasy boundaries between agencies and governments too.
Delusions of a old and well-propagated myth of the non-political character of public health remains. The persistence of the non politics myth too.
Lost opportunities remain. Lack of clarity of vision too.
Unsolved current problems still remain. An extension and intensification of past problems too.
Social problems significantly remain. The hands of the past on the future too.
Discerning local interests remain. Harmonizing initiatives too.
The need for imaginative and highly capable actions remain. Increased competency with information technology too.
Enormous strains on coordination remains. Responsibilities and resources too.
Long standing tensions among professional groups remain. Equal status of groups too.
The need for greater visibility with public health remains. Shortening lines of communications too.
Loss of potentially fruitful research remains. Duplicating research and services too.
Existing fragmentation of agencies remain. Business as usual too.
The urgency of problems affecting particular groups remain. Disruptive and limited responses too.
Struggles for allocations remain. Visibility and authorizations of those allocations too.
And so the continuing problems of the past remain. In the midst of new problems too.
Limited understanding of the persistence of these problems remain. So too our inability to solve them still (whether in 1968 or 2021).