Is Public Health Modeling Good Behaviour?

Could Public Health learn from this?

Take a break. Life is too short to work all the time. All work and no play makes us dull and boring.

All good stuff — right?

If so, then it must be good for those of us in public health too, right?

Apparently not.

Over the past two days I’ve been attending the annual Canadian Public Health Association convention being held in Toronto and if there is one thing that I’ve learned: we are not taking our own recommendations to heart. Literally.

Stress, particularly that associated with work, has been associated with all kinds of chronic conditions and is a contributing factor to coronary heart diseasemetabolic health, and overall increased risk of cardiovascular mortality.

And from an informal survey of my peers, there is a lot of stress out there among those of us in public health.

Today I met with some colleagues to discuss ways in which information technology could help this problem and make life easier for us. The discussion produced some ideas on what tools could help public health professionals work better and more efficiently in the 21st century, but what stoked the most discussion was speculation that these tools simply place a Band-Aid on a larger problem of work overload.

We aren’t working better, we are working too much and that is what needs changing. Indeed, technology may be making things worse.

For example, email — once a tool that helped us correspond with more people, faster, with less effort — was held as a perfect example of a symptom and cause of stress:

“I get 450 emails a day. This is insane. The only time I get a break is when I’m on an airplane and now they want to introduce the Internet into the cabin! Last time I had my inbox under 100 was 1998” – Full Professor and medical doctor

“I’m not even important and I get 80 messages a day — and classes aren’t even in session right now; it’s the summer!” – Assistant Professor

“I feel like I’m back in school” – Public health official referring the problem of having to respond to emails in the evening when he’s at a conference during the day, just like when he was a student in lectures all day.

“If I don’t answer an email the moment I get it, the chance it will never get responded to is high. I miss very important things that way. I get so much email I can’t manage it all — and I keep getting more” — Senior public health leader

“I feel guilty just taking three days off to spend with my family on a trip. Getting away (to where I can’t access email) is the only way to truly get a break” — Associate Professor

The CPHA conference started on Saturday for those attending pre-conference workshops and continues all week. For those who are using the time to actually attend the sessions (and not sneak off to their hotel room or the business centre to catch up on email — those without Blackberries that is) and maybe socialize with their peers have a mountain of email awaiting them back at the office.

That is email that falls on top of the web-searching, meetings, research. We in public health argue strongly for the need for strong evidence-based research to guide our work and that all public health trainees be training in methods to critically examine the research to make good decisions. The truth is that few have the time to read things in any depth at all.

“I’ll bet the number of people who actually want to critique or critically appraise a research article is very low. They just want to be told what to use and why” — Public health researcher commenting on the public’s and public health professionals’ interest in contributing to the development of knowledge through things like wikis or collaborative writing tools.

We speak of stress as if it is something for others. Systems change is implored, yet considered something ‘academic’ in practice. Leadership is called for, while few choose to truly lead, by example at least.

So are we modeling good behaviour and if not, are we undermining our own credibility in the process? If not that, are we simply undermining our own health and wellbeing?*

* I write this having learned that a particular leader who I greatly admire suffered a massive heart attack recently and recall hearing the news and not being surprised at all, which made me very sad.

No work tonight (writing this blog is something I enjoy). Mazel tov!

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