Embracing Imprecision

Cathleen M. Connell, PhD

Cathleen M. Connell, PhD

Interim Dean and Professor, Department of Health Behavior and Health Education

Words have power. In our scientific community, precision in word choice is paramount. Take for example, "safe, effective, and potent," which is how the Salk vaccine developed at the University of Michigan School of Public Health was described in 1955.

Or think about the Affordable Care Act, part of which was written within our walls on Washington Heights. Those three words are significant for the people of our country, and carry so much more weight than the colloquial "Obamacare."

The precision and power of these words helped bring understanding, changed the public health landscape, and transformed lives.

During my career in public health, I have seen how the power of words has reshaped our approach to our work. We all watched the uproar recently over the news reports of the "seven banned words at the CDC." While the truth was much more nuanced, the reactions across the country reminded us that our words and how we use them are sacred.

To me, a pointed example is the shift from the term "health disparities" to "health equity." This word change signifies a significant refocusing of our mindset, and therefore altered resource allocation. Instead of concentrating on differences linked with economic, social, or environmental disadvantage—which "disparities" does—the focus is on creating fairer—and more just—opportunities for everyone's good health. This subtle shift can truly change our collective work. 

To meet the evolving landscape of public health challenges, we need to build the public health workforce to be responsive to what comes next.

To meet the evolving landscape of public health challenges, we need to build the public health workforce to be responsive to what comes next.

As we always try to do in this field, we remain focused on innovation and impact. The word "innovation" comes with its own power, but that power is perceived differently by different people. The preconceived notions we have around what is innovative can create some selection bias. For some, innovation relies on leaps in technology. For others, innovation is predicated on a process change. This spring at Michigan Public Health, we focused on all the different ways innovation takes shape in our world— the imprecision of the word. Innovation comes with nuance and requires a level of comfort with ambiguity.

I believe that innovation—as one of our core values—needs to be incorporated in all that we do because it leads to lasting, meaningful impact. To contribute to public health, you have to be innovative. We are an eclectic group that converge on public health because of our desire to address health inequities and create a healthier world for all.

So how might one describe innovation in public health? I believe it is a call to be restless rather than settle for the status quo. And as educators, maintaining the status quo shouldn't be an option. Our restless nature has propelled us time and time again to create greater impact. To meet the evolving landscape of public health challenges, we need to build the public health workforce to be responsive to what comes next.

Look back at our history and you will see how things that feel so permanent now were triggered by significant innovations to address evolving landscapes.

The Office of Public Health Practice is a good example of how we altered our approach to education. Its creation nearly two decades ago charted a new course for Michigan Public Health. Its strength continues to be felt not only in workforce development but in recent contributions like student trips to post-hurricane communities in the Virgin Islands and South Texas to provide much needed help with assessments of damage to the public health infrastructure.

Our physical space is another manifestation of innovation and impact at work. For graduates prior to 2006, the seven-story tower that crosses Washington Heights was not part of their experience. But for the past 12 years, Crossroads Tower has vastly increased our capability to bring people together to solve problems, launch research projects, and teach new approaches.

The students filling the tower and our classrooms have also undergone a change, most notably this year. For the first time, we now have public health majors taking classes here as part of our new undergraduate program.

We must ensure that our students are prepared to be innovators for public health in big and broad ways. They will need skills to advance the cause of population health—communication, engagement, and the mindset to bring people together with different points of view to dialogue in civil and constructive ways. Public health problems require interdisciplinary approaches to problem solving.

Our invited graduation speaker this year, Rashid Njai (MPH '03, PhD '08), spent 30 days in Sierra Leone with the CDC during the Ebola outbreak of 2013. His training here at Michigan Public Health taught him specific skills to assist the response and instilled in him that an interdisciplinary mindset would strengthen the impact.

"Ensuring collaboration in public health relies on humbling yourself—admitting what you know, considering how you can look at a problem in a different way, or just asking someone for help," he says.

As Dr. Njai sees in his work, public health epidemics like the Ebola outbreak—or the current opioid crisis—require people coming together to engage and try new ideas. I am looking forward to hearing more of what he has to say on April 26 when he takes the stage to deliver our commencement address.

As you read stories of innovations in public health on The Pursuit, on our We Are Michigan Public Health platform, and in the spring issue of Findings magazine, I encourage you to reflect on how your work embraces restlessness and challenges the status quo. Let us all embrace the power in the word innovation and not simply adopt it as the latest buzzword. It is deeper than that. As one of our core values, we must remain committed to the imprecise power of innovation.

This article first appeared in the spring 2018 issue of Findings, the magazine of the University of Michigan School of Public Health.

About the Author

Cathleen M. Connell, PhD, is Interim Dean of the School of Public Health and Professor of Health Behavior and Health Education. Since joining the school in 1989, she has also served as the associate dean for academic affairs and as chair of the Health Behavior and Health Education department. Her research focuses on the psychological and social context of chronic disease self-management and dementia caregiving.