Public Health Then and Now I Consider

¶ … Public Health Then and Now

I consider Fitzhugh Mullan's article "Public Health Then and Now: Don Quixote, Machiavelli, and Robin Hood: Public Health Practice, Past and Present" a very provocative yet utmost informative and challenging article for the health practitioner and interested layman alike that provides its reader with precious information about the qualities a health worker will have to have and the relationships he will have to entertain at the various stages of his work if he wants to meet his manifold professional responsibilities. Both the title of the article and its abstract (Mullan, 2000, 702) clearly describe the research problem the scope of which the author has appropriately delimited.

I think that the whole article is of eminent importance for the entire public health profession because it covers two areas that do not seem to have caught much attention in the scholarly literature: Dynamic political involvement of public health practitioners on the one hand and characteristics needed by successful health care professionals.

After a detailed review of the last 150 years of public health history, the author concludes that "The public health official, in fact, must be politician, manager, and clinician in various degrees at all times" (Mullan ibid). He then seeks to introduce the personality traits of a successful public health practitioner at the example of three celebrated figures: Don Quixote, Machiavelli, and Robin Hood. All of them serve as metaphors to explain the additional characteristics that a public health officer will need in different situations and to a different degree to have at his hands in order to meet the daily challenges of his complex field of work. Each of them represents a different type of personality and each of them alone in the author's opinion is not sufficient to constitute the persona of a successful public health care officer. Don Quixote represents the "unabashed, unapologetic, unflappable idealist, locked on his mission, undoubted by the doubters and the halfhearted" (Mullan, 2000, ibid). Italian statesman and author Machiavelli stands as the prototype of "cunning, daring, and doggedness in variable measures" (Mullan ibid). Robin Hood, the legendary hero of 12th-century England, who made his reputation robbing the rich to help the poor, is used as a symbol representing a quest for distributive justice. All 3 personae are important, but it is argued, Robin Hood is the most endangered.

As regards the research design, I would classify the whole article as a mixture of "survey" and "evaluation." While its first part covering the last 150 years of development of "public health" as we experience it today is kind of a historical survey, its second part dealing with the "multiple roles" of the public health officials in my opinion, can be characterized as a sort of evaluation of the various personality traits a public health practitioner will need to have at his hands in order to be successful. The research will contribute to nursing practice, nursing administration, and nursing education in two ways:

First, it will draw the attention of the whole profession to the fact each of its branches works in a public arena that is governed by powerful political forces and politicians whose agendas and constituencies are larger and far more ramified than those of the public health practitioner and scholar. This seems to be a somehow neglected fact both in public health care education and practice and I consider it a benefit of the article to inform very diligently about the matter. Learning about the historical events leading to the public health system of today is a longitudinal study approach that enables public health scholars and practitioners alike to understand that both of them operate not only in a comparative narrow world of academia and clinical practice, but also in the complex and politically contentious world of public health bureaucracies. Knowledge about interrelation between his actual field of (public health) expertise and public health bureaucracies will enable them to better respond to the daily challenges of their work.

I would also imagine that better communication between schools of public health, public health practice, and public health bureaucracies will help to improve the stressed financial situation the public health sector is in. May be this will attract more young people to the profession.