How I learnt to talk about public health without losing the room — and why it matters now more than ever.

9th May 2025

5 minute read

At a social event last weekend someone asked me what I do for a living. Briefly after the pandemic everyone was an expert in our profession with their own opinions on lockdown, vaccination and new variants. Now, with the collective amnesia society has about 2020 to 2022, we are returning to glazed expressions when we say we work in public health.

I laughed and said how long do you have? Then I gave a short answer about how good health comes from how and where we live and my work is on structural factors that improve health and wellbeing rather than responding to the causes of disease. My friend who knows a bit about this gave me a pat on the back and said good answer.

Once upon a time this question filled me with dread. I might even have resorted to saying I was a nurse in my early days when I knew the odds of getting any glimmer of understanding were low.

Why language matters

As health outcomes decline and social problems rise, we need people to understand that poor health isn’t just bad luck. The language we use in public health is crucial. Too often, we speak in academic jargon, appealing to policymakers with rigorous theory and data. But this is completely inaccessible to most people.

The World Health Organization published the World Report on the Social Determinants of Health Equity on 7^th May. My algorithms worked well and I saw lots of commentary about this on social media, yet not even a ripple on mainstream media.

This is a big and meaty report of 214 pages and over 1000 references which is overwhelming for me, let alone people who don’t work in public health. I did let out a cheer on reading one of the 14 recommendations to Support Community Engagement and Civil Society and the clear recognition of the role that power imbalance plays in health inequity and poor health.

“Without social participation, there can be no true health.”

Reading this is hugely welcome and gives a strong lever for those of us working in the intersection of social democracy and public health, it also gives me hope that the weight of WHO might bring democratic rights and justice front and centre.

But hope is not enough. First we need clarity and consensus for what social participation means in the spaces we are working in. Reports like this fail to have an impact when there is no clear route map for implementing recommendations.

For me, the first step on the journey of increasing social participation in order to improve health outcomes is our language, and that is why I now love the opportunity to talk about my work. (Maybe too much according to my sister!)

Public health in pop culture

One of the best ways to make public health relatable is through storytelling—and I love when it shows up in mainstream media. A big shout out to Tracy Daszkiewics who was a judge on BBC One’s Great British Menu back in February when she spoke about the Salisbury poisoning and wider emergency planning. The alien invasion question was a standout moment handled with flair.

Public health issues are also regularly woven into story lines of Call the Midwife and this year early prescribing of opioid replacement was covered in a heartbreaking but sensitive way.

My absolute favourite public health story line is in Two Doors Down, a mundane and hilarious observation of neighbours in a Glasgow suburb now seven series in. In episode five of series 5, the interplay of a 12 pack of Krispy Krème donuts and new neighbours – a cardiologist and public health consultant, made me LOL. The pity and wonder about the public health consultant having failed at being a real doctor and her description of her strategy and policy work were met with faces more glazed than the donuts. This is so insightful, the script writer 100% has insider knowledge. Dig it out and have a watch on iplayer.

A family moment

At a family gathering last year, older relatives spoke about someone they called “an alcoholic.” Then they turned to me and asked, “What actually is an alcoholic?”

Now there are several options in this scenario, only one of which is to face it head on, which I decided to do on seeing expectant expressions. I replied we tend to use the term alcohol problems nowadays rather than label people as alcoholics. Then there are signs – like missing work, drinking more than the recommended 2–3 units a day, or blacking out. They listened intently followed by silence for several seconds, maybe as the penny dropped that we really do have a collective problem with alcohol in Scotland. Then the ice broke when they both roared with laughter and we all agreed they have reached a good old age and are doing just grand.

Bringing humanity to our work

That moment brought home to me: we don’t need to strip the humanity out of our work. In fact, we should bring more of it in. If we can talk in plain English, if we can make complex ideas meaningful, we can inspire people. And if we inspire people, we can build citizen power – the kind that influences democracy and in turn the wider determinants of health.

Because a better future is possible. And it starts with a conversation.