Monday, May 09, 2005

Five Questions: The Fifth Question

Taking the questions out of order, I'll start with the last question:

5) Do you have any advice for young people like me who are embarking on careers in Public Health?

I've spent a fair amount of time thinking about this one. It would be easy to try for some flippant response like: Have you considered a career in law instead? But there is a crying need for more public health professionals in our country. I don't just mean nurses and physicians and what not. I mean people who are trained to look at health in terms of the whole community. These folks are often emplyed by the government at various levels and, therefore, will by definition be low-paid. They could probably make more money as nurses.

But health is not simply a matter of how I or you are feeling today. It's also about whether we are part of a group of people who are feeling the same way for the same reasons. It's about discovering those reasons and looking for solutions. It's about helping to shape health policies and carrying them out. It's about making our communities healthier, safer, better places to live.

My advice? I suppose there are any number of things that I might recommend, but the one thing that I think I would strongly encourage is that you add a second language to your toolkit.

By this I mean become fluent in another language, not just take a couple of years of college classes.

We are a nation of immigrants. Like it or not, immigration--perhaps legal, perhaps not--will increase in the coming years. Many of our nation's residents do not speak English as their first language. Learning the language of the community that you will be working with will give you extra tools to do your job.


The first thing is what I as a former language teacher (more on this later) particularly liked. By learning a second language you will learn more about your own language and become more skilled in using it. Not that that will help you in public health, but it will make your old English teacher happy.

The second, and more important, is that knowing the language of the community that you will be working with will help give you entre. You will be less "other" and more easily accepted as someone who can be listened to.

The third, and most important, is that knowing the language of the community will allow you to hear more clearly what they are telling you about their problems because they will be more comfortable and articulate in speaking about those problems. The burden of understanding will be placed, of course, on your shoulders but the people you are working with will be able to concentrate on what they want to tell you and not how to tell it.

A fourth thing that is important, but I won't rank it, is that with the language will come some better understanding of the culture in which the language is spoken. This matters. We tend to think of health as a medical issue that is itself all about science. But health is also a cultural concept. What is meant by good health, what is considered to be a healthy practice--these are all influenced by the culture in which we are raised. It's a good thing to recognize, even if we don't know the specific differences between one culture and another, that there are likely to be differences in surprising places. Language can sometimes signal those differences.

I don't work directly with clients on most days, but I can tell you that it was very powerful to attend a hearing on a rule change this summer and see the Commissioner of Health be able to understand a woman's testimony when she spoke in her native language. She first attempted to speak in English, but she was clearly struggling--and most embarassed. The Commissioner allowed her extra time to speak and asked her to speak in Spanish. I had no clue what she was saying (although I--and the Commissioner--already knew her point), but she was so clearly pleased to be able to say her piece then and did so with what appeared to be both skill and passion.

So which language? Depends on the general area where you think you might work. Spanish seems like a good starting place, but Vietnamese or some other language might be used in the area where you end up working. Indeed, you may end up with more than two languages in your toolkit over a lifetime.

My recommendation, after some preliminary classwork, is to just immerse yourself in the language. Read the newspaper, listen to the radio, make some friends. You'll never be a native speaker of the second language, but any progress that you make in learning will pay off with big dividends later on, I think.

If nothing else, certainly learn the basic greetings and courtesies of the language.

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