health public health

Public health

Oladele Ogunseitan

If a country can afford to keep its population healthy, then it should do so.

Dr Oladele Ogunseitan is Professor and Chair, Department of Population Health & Disease Prevention, Programme in Public Health; and Professor of Social Ecology at the University California Irvine. He is interested in the environmental and human health effects of industrial development with respect to prevention and remediation of hazardous pollutants. We start by talking about growing up in Nigeria and what led him to public health.

Talking points

You would think that we would have learnt our lessons

Regrettable solutions to long term problems have become a sustainability term.

In our quest to solve problems that took many decades to understand and find alternatives we often don’t learn the lessons of doing the work ahead of adopting the alternatives.

Despite all the research about mercury and lead, these chemicals keep turning up in new ways.

Understanding things we don’t see.

The role of public health as a profession is to prevent disease and promote health.

Human health has immediate effect- we want action now – the effect on ecosystems and wildlife takes longer but is no less a problem.

It is a mistake to take humans out of the context of nature. We are part of it, all of our activities, our behaviour, our inventions.

We didn’t bring anything extra to the planet. Having a planetary view requires that we include everything else into the sustainability equation.

The public health impacts of climate on health are beginning to sink in for many regulatory agencies.

It is very difficult to draw the link (between climate change and health), causality is the core of Public Health scienc…but the link is strong enough that we’re about to have a summit on climate and health. And we can frame issues, clearly health increases resilience.

How to deal with scientific uncertainty? It is the responsibility of all scientists to communicate uncertainty, but this is not a licence to not act. Take smoking for example, we know smoking causes cancer but it is not a perfect relationship, some people smoke and don’t get cancer. We cannot afford to wait to get rid of all uncertainty before we before we formulate policy. When the weight of evidence is strong, and we use statistics to identify that strength, we say “let’s protect people, even if not everybody would succumb.

Public health is pitched against some economic interests, people want to sell things and make money doing so, and this group always underestimate risks, it’s the same with climate change.

Public health is grappling with population growth – just how many people can the earth sustain.

In the petri dish there is a plateau coming followed by a crash, that’s the normal cycle and we may not be exempt from that. We’re very clever though and we can keep the lag phase – the growth phase going indefinitely, on and on and on – but we know that’s not the nature of things.

Understanding limits does not give us instruments to regulate ourselves below those limits.

We don’t have to follow the course of what took America to a quality of life that it is desired by most people on earth, but it was extremely expensive. Msot houses in California still don’t have solar panels, but there’s no reason why African countries have to brun through a ton of petroleum to have lighting in every house, running water…we can do that with current technology and not have to reinvent the wheel in an expensive way.

How can we get to what we really want, without going through that expensive process?

(how does ethics scale in public health). One of the biggest challenges is equity.

I set my students this question: “If public health was to accomplish its mission, is that a desirable goal? That is to say, does disease play a positive role in human society? Can we imagine a world that didn’t need public health, what would that look like?”. We are so far from accomplishing this goal however, we need to put all our energy and passion and resources into correcting the equity issues.

If a country can afford to keep its population healthy, then it should do so. And I believe that every country on this planet can do that. Part of the reason we have not done so, is we prioritise other things more than health: we spend more on defence.

You can’t imagine how angry I am that African countries, including Nigeria, spend more on defence than public health or education.

We need to keep vigilant on expenditure on health care, and it’s not just about money, it’s investment in translating what we know – what we we already know how to do for actual benefit.

We get close to tipping points, and retreat. How do we recognise what is desirable and here are some ingredients, we’ve already taken two steps, maybe another one, lets keep going. How do we engineer getting to those tipping points?

(Success in last couple of years?) Strength of programme in Public Health. Maintaining collaboration.

(Activist?) Yes, more recently than in my earlier days as a professor. I think I was reluctant to put my own ideas expressed more in a message way than just reporting the science. These days I’m very conscious of the importance of discussion section of a paper. I’m responding positively to journalists – I want this work to mean something to people because it can move things forward. I’m part of California Greening Panel – I wanted to be part of the process of translating science.

(Motivation?) Opportunities to change things. The t-shirt says reflect, reveal and reform. I’m challenged by students to keep doing those things.

(Challenges?) Forming a School of Public Health.

(Miracle? or smallest thing that would make the biggest impact?) A world where we all die of old age.

(Advice for listeners?) Collectively we can move if we all individually take a step.

This Sustainable Lens is from a series of conversations at University California Irvine. Sam’s visit was supported by the Newkirk Center for Science and Society, and coincided with Limits 2015.