Public health professionals need to maintain their scientific credibility to be effective in a political world, keynote speaker Dr. George Hardy told nearly 200 health workers attending the annual Public Health Association Convention in Park City on Thursday.
The theme of two-day convention is "The Power of Public Health: Science and Politics."Hardy, who is both the assistant director of operations of the federal Centers for Disease Control in Atlanta and an assistant surgeon general, opened the conference by telling the group, "You've got to have the support of elected officials, and the only way you can have that is to be a credible public health official."
Being well-educated or technically proficient is not all public health workers need to have an impact, he said. Although the level of scientific or technical knowledge is important, such skill is only one aspect of a two-pronged approach to solving the nation's public health problems.
Citing findings from a yet-to-be released Institute of Medicine study, Hardy said the second prong includes public values and popular opinions about health issues.
And that means politics are integral.
He encouraged those in the audience to put themselves in the public's place and ask, "Would I have been satisfied with the response" as often as possible.
"The community perception must be that an agency cares and wants to solve rather than create problems."
Part of that strategy is emphasizing the training of staff members who work directly with the public - nurses, secretaries, etc. - so they are able to respond to public needs.
He also offered the health workers some tips on how to deal with a political world. "Keep debates at the level of the issue," he said, noting that because health is a technical field, it could be "argued from the level of science."
He advised program managers and their bosses to make sure that those involved in a program or solution have reached consensus that the solution is a good one. "You never know what personal relationships have developed over the years," he said, adding that his own experience on Capitol Hill showed him members of his staff might shoot down a proposal if they had "not bought off on it."
When approaching a very busy legislator or governor, Hardy said a one-page fact sheet outlining an issue or program is essential. "You may think (he issue) is the most important thing in the world, but they have lots of things to deal with," he said.
Rehearing the presentation, knowing what kind of response is needed, having thought through the kind of opposition the proposal might receive and lining up support were emphasized as key political steps to take.
He ended by outlining what he felt was the immediate future of public health in the United States - and how to deal with it.
"You are not going to like this," he warned. "But I see an intensification of demand for public health services, with decreasing resources to provide them. That calls for creativity."
For instance, he said, health officials should ask themselves a number of "threatening" questions about their programs, such as: "Is what I am doing necessary? Could it be done by someone else? Or, could we cut some of the time we put into it so we could work on other things?"
Another proposal may be to raise fees for services provided, he said, or find matching funds and new sources of revenue. Hardy said he and his staff worked for seven years to get an additional half-percent sales tax added to the state health public when he worked in Alabama.
"It may not happen the first time, in fact it won't happen the first time. But if it's repeated often enough, a statement has a way of becoming truth," he said.
Finally he urged those in his audience to use their "power to convene, persuade and advocate" their own positions by calling meetings of all parties able to help. "It's credibility coupled with creativity that will allow you to exceed society's expectations," he said.