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Last week the U.S Surgeon General issued an advisory that declared ‘misinformation as a public health threat.’ In a blue document with massive bold letters in white, he argued that we need to begin the process of confronting misinformation by ‘building a healthy information environment.’ I was intrigued and kept scrolling down the document to understand for myself what he meant by the terms ‘a healthy information environment.’

I also welcomed the invitation to ‘limit the spread of health information as a moral and civic imperative that will require a whole-of society effort.’ His words. The table of contents seemed easy to follow with suggestions on the ‘what’ people can do whether as individuals or educators or journalists or even funders and of course the government. There was even a ‘where do we go from here’ section that increased my curiosity with the report. But from the first page, the background, the report lost me and I am sure the public. None of this centered the ‘public’ in public health.

There is a reason why health misinformation is so rampart these days and it has nothing to do with long backgrounds, even those focused on correct health information. We fail and continue to fail the ‘public’ if the words we use to speak to ‘public’ doesn’t include language or even tools that makes sense to the ‘public.’ I wanted to root for this document because of the seriousness of the topic, because this is literally a life and death matter and people, black and brown lives are dying everyday because of health misinformation.

Then it dawned on me, if I took a camera and walked down the streets of Harlem or Newark, or Augusta, or Pittsburgh, or even went to stores like Sam’s Club or Costco, would people be able to tell me what if anything they remembered from the Surgeon General’s advisory. Would they even know it exists?

There in lies the dilemma with health misinformation. While the public health experts are so focused on what it is or what it is not, the ‘public’ is focused on the why in the forms of stories they pass on to each other, through words and languages and other mediums that make sense to the ‘public.’ There is a reason why social media is widespread and content is viewed as powerful. People are expecting from public health, serious comments about their lives using tools and language that make sense to the ‘public,’ that speak to the ‘why.’ They are not expecting the ‘what.’ They are expecting connections, truths, even art and spoken words that say things important to help them with life, their health. The sooner we understand the ‘why’ of health information, the quicker we can begin to center the ‘public’ in public health. This is what is meant by public health to me these days, a deliberate focus on the public’s health, not by us the experts but by the public first.

We spend too much time focused on the ‘what’ of health that we forget the ‘why’ in public. There is a reason why stories live on long after the storyteller has ended the story. We can start there by bringing back stories to public health. Poetry too. As a tool, whether spoken or listened too, poetry can humanize us, make us whole, both emotionally and intellectually. Art can do the same. Art for and by the public can be intentional and life-sustaining with centering the public in public health. While letters to the public, like a ‘Dear Public Health’ can help the public confront the worst so as to be free to experience the best that is unshakable in public health, the ‘public.’

It is always about the ‘public’ after all. Our future depends on listening, seeing, feeling, daring even to center the ‘public’ in public health. We are all amplified when we center the ‘public’ in public health. That should have been the main crux of the advisory, a foundation through which to dismantle the public health threat that is health misinformation. We have miles to go but if we want to end this war, as it’s a war to, with casualties increasing everyday, the ongoing pandemic being a clear example, then we have got to bring back the ‘public’ in public health.

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One of my favorite aspects of the novel Anthills of the Savannah’s by Chinua Achebe is the focus on the power of the story and the storyteller. In it Achebe reminds us of ‘stories being our escorts, and our guides’ through life. Some people, the novel notes, have been given the gift of leadership, summoning their fellow citizens to rise to the sounding and timing of battles. Others have been given the gift of fighting, the gift of putting on war-time garbs and going to engage in the battle. But still others have been given the gift of waiting for the battle to end. Waiting to take over to tell the story of the battle. Achebe shared that the sounding of the battle is important, the fierce waging of the war too. But of all this, it’s the telling of the story that is most critical. The story as Achebe pointed out, ‘boldly takes the eagle feather.’ Stories are indeed connected to all aspects of our lives. Our being and becoming, our penetration and preservation, even our silence and survival or ability to enlighten and empower depend on the stories we tell. It is only the story that continues noted Achebe, beyond the war and the warrior. It’s is the ‘story that also saves us, so much so that without it, we are blind.’ Sustainability or the ‘continued use of program components and activities for the continued achievement of desirable program and population outcomes,’ are like stories.

Sustainability is connected to all the life cycles of research from initial conceptualization to implementation. Sustainability draws attention to the struggles, the values, even the quest for efficacy or effectiveness that binds a research team and how all these intersect to enable their intervention to ultimately remain. It is also where the collective memory of an intervention resides. Not the memories as with steps delineated in a protocol, but in the minds of all people influenced by the intervention. It informs the process through which an intervention defines itself from its beginning to the end. It raises awareness and builds consciousness of key values or adaptations that can take evidence-based interventions forward. It highlights the role of key people and resources necessary for any attempt to sustain an intervention, capturing key processes and outcomes that future researchers and implementers can rely on. Finally, sustainability helps implementer to re-imagine and reframe their own stories on what it means to last. It’s their for the telling and they have the capacity and ability to affect and inform the outcome, if only they know their power.

Of course sustainability cannot be separated from the social, ecological, historical or political forces in which evidence-based interventions are implemented. In a seminal review by Pan-African Studies Professor, Tavengwa Gwekwerere on the Anthills of the Savanah, like stories, sustainability ‘binds the past, the present and the future together, making inroads into the past to inspire the present, narrating the realities of the present to imagine the future, all while preparing the future for potential struggles and aspirations with attempts to last.’ Sustainability’s connections to the past, present and future, prepares researchers and implementers to make sense of ‘where they have been, where they are, and where they must go.’ It’s for this reason that having a plan becomes critical. By plan, I mean working with the right people to learn how to adapt and nurture aspects of an evidence-based research so that it lasts. It’s no surprise then that sustainability remains a threat to all statue quo form of research, so much so that those who seek to make this a career are actually called ambitious. But why even bother implementing any research if it never lasts? Keep sustainably in mind and have a plan while you are at it. That and keep remaining ambitious. Sustainability requires, no demands that you remain ambitious. So keep it as well.

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On this Martin Luther King Day, may you always dream big and radiate kindness. These words from my son’s favorite shirts are what I am keeping today. Dream big, not of things small, but even things that seem out of reach, things that seem not for you. It’s in dreaming that you realize your full potential. And when you do, radiate kindness. Let it be you. Be the first to say I’m sorry when you can. Be the first to open doors and help people if you are able to. Be kind when no one is looking. Be kind when no one expects it. I know that it may seem overwhelming at first and people may take advantage of you. They will. But when your dreams are big and you radiate kindness, your future is bright.

You are like that dazzling sunrise with all its golden hue. All its glow like no other is you. Day after day you remain. You rise, you brighten, you glimmer, you dwell, and you cast your essence to everyone alike. Ignored or seen, conflict or peace, vulnerable or strong, you are the touchstone by which all that is big with dreams, all that is kind, can be measured. And you do it well. Your gaze is glorious to all those who want to also dream big, who radiate kindness. You give them permission to do the same. And because of you, they too are becoming like the sunrise. Because of you, they will be all right. I have a dream will always be my favorite speech of all times. Because Dr. King dreamed and radiated kindness, I can also do the same. My children can too. Everyone I come across, everyone that works, learns, even builds with me, is able to also do the same, all because Dr King was our sunrise. Keep dreaming big. Keep radiating kindness for you, for others, today and always.

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Have you tried to put a baby to sleep at 4am?That’s my dilemma now. So I decided to mediate on the word. And here is what the Lord said to me this morning: ‘those who love knowledge want to be told when they are wrong.’ That was my meditation for today from Proverbs chapter 12 vs.1. I want this with me in 2021. To surround myself with corrections, especially from those who really care about me and all the load I carried during this pandemic. Correct me if you think I am wrong. I love knowledge, and if I am wrong, please tell me. I long for this.

The verse goes on to say that it is ‘stupid to hate being corrected.’ I paused for a moment because there are indeed times when I hate being corrected. I hate being told I am wrong or my approach is wrong. But I am also learning that corrections should be welcoming. Correction, especially from the right person with the right heart, can be a thing of pure joy. It can also be helpful, to air grievances in a purposeful way. Correction can direct, help you reflect, help you perfect or even foster empathy. It is better to love being corrected especially when you are wrong. That’s the keep for today. Another short one. That and the fact that as you scroll through the chapter you will see this gem nestled in verse 15; ‘wise people listen to advice,’ listen to their correctors. I love the book of Proverbs. Keep surrounding yourself with those who correct you.

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It seems so simple, that people should matter with efforts to curtail a pandemic. Yet we are our own worst enemies. Case in point, an essay I read yesterday on the blog sapiens one why the CDC needs social science. Robert Hahn an anthropologist and epidemiologist who recently retired from the CDC, shared insights of how people actual interact, their behaviors, needs and even concerns, have yet to penetrate the soul of the nation’s top primary health agency. And we wonder why we are in the mess we find ourselves?

As a public health researcher, why people refuse to wear mask for example, remains one of the public health mysteries of 2020, and one that truly lacks any answer besides the fact that we still don’t keep people in mind. Robert Hahn takes this a step further and offers another explanation. The idea that sickness remains a biological concept. As a result, how even sick people react, what behaviors they engage in even while sick is often an afterthought and not a forethought. It’s no surprise then, that this pandemic continues to persist, 10 months later.

I’ll like to add one more thought to his explanation and that is people should be at the heart of every response to public health, especially during and after a pandemic. We also need to do more polylogue or confront people with diverse and sometimes conflicting points of views that require critical evaluation. These forms of engagement with people will be crucial with efforts to ensure vaccine uptake. Myself and my household are ready for the vaccine. But I do recognize that some folks may not be and so it’s our duty to keep them in mind on the journey to end this pandemic for good.

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In March 1919, as the nation continued to grapple with the 1918 influenza pandemic, Dr. Wilmer Krusen, the Commissioner of Health and Charities of Philadelphia presented a truth to the people of his municipality. Simply put, it stated ‘Spit spreads Death.’ The statement was displayed as a poster on the front of trolley cars and the Commissioner used them to impress on people, ‘the exceedingly important lesson in sanitation and health.’ This striking way of presenting the truth to the public was common during the pandemic of 1918. In 2020, from the beginning of the ongoing coronavirus pandemic, the truth, the whole truth and nothing but the truth, has been withheld from the public.

March 1919, AJPH 9(3) 207

Six months into the pandemic, we are still far from presenting truths to the public and its starts from the leadership in place. If only they started from the beginning with the following: ‘Covid is real. It can affect anyone. It is not a hoax. Anyone can get sick. Test. Quarantine or isolate. Social Distance. Stay six feet away. Wear a mask. Wear a Damn Mask. Wash your hands. Contact Trace.’ Simple truths like this, presented to people, from the beginning, could have averted 209,000 deaths. Simple truths could have prevented 7million infections. Simple truths could have helped my children return to school. Simple truths would enable us go to church on Sundays. Simple truths would have meant we all return back to some form of normalcy, wearing a mask of course. Every infection is a sad one. Every infection is a tragedy. Every infection can be prevented. Every death could have been avoided. Mask, distance, trace, simple truths that matter. Simple truths that should have be presented from the beginning at the highest levels.

Simple truths: Wear a damn mask!

So at this point, I am ready for change and yes my life depends on it. My family, our well-being, all that we love, depends on it. We want simple truths from our leaders. We want leadership that believes in science, leadership that believes in public health, leadership that puts the lives of people first and not their own interests, leadership that cares, leaderships that unites, leadership that brings calm, leadership that represents the best of who we are as humans, leadership that quite frankly, tells the truth!