University of Washington School of Public Health
Read Ben Danielson's 2018 UW School of Public Health Graduation Speech
Dr. Benjamin Danielson delivered a speech about the importance of a public health perspective to graduates of the UW School of Public Health on June 10, 2018.
"I am deeply honored by the invitation to join your celebration today. Thanks for inviting me to the party. The work of public health is so vital and this time is so exciting. I hope you all know how well prepared you are, coming from this school. You’ve got good reasons to feel a sense of job security regarding the future. This school is building the public health canon of wisdom, and it’s preparing the next generation of public health experts. That is honorable work of the highest order.
You are rock stars (and I feel like a fan with a backstage pass). I usually start talks with some form of professional disclosure or disclaimer so here goes. I come as a community partner and as a guest in your house. You’ve walked halls, shared discourse, steeped yourselves in an environment that I have not experienced. I am showing up today as a believer in the power of beloved communities and as a social justice activist. So if I miss the mark, with my remarks, just write me off as your naïve houseguest, spouting off and embarrassing you at your dinner table (‘oh that’s just uncle Ben’). Please know that anything I say comes from a place of love and gratitude, because I’m so glad we have champions like you in our world today. We will do so much good work together. There are big, irascible challenges out there, as well as inspiring, soul-feeding opportunities. And we, together, could play both a vital role in the former and a fulfilling role in the latter.
I look to the work you do and I get so inspired, because you ask all the right questions. I look at this School’s knowledge-output, and it’s amazing: Work such as shedding light on the chemical soup that Puget Sound’s Chinook Salmon swim through and ingest as they migrate. You’ve expanded our understanding of the accoutrement of modern society, like the finding that e-cigarettes may be helping adults quit smoking, but is also leading youth to start smoking regular cigarettes. You’ve given us a peek into our remote past, like sharing steamy, salacious news of human origins wherein early humans laid down with Denisovans (dinisivens), a group related to Neanderthals. Talk about your 50 Shades of Admixed Genomes (sorry). You are increasing our awareness of the price some in our society pay for our environmental choices, like the extent of pesticide exposure children of farm workers face in the dust of their homes. Or the price we all pay for our environmental choices, like the finding that says, the higher the particulate matter in the air, the greater the severity of mental health problems. You are surfacing hard, but important realities, like the finding that war-trauma exposed veterans die at the average age of 43, of things like suicide or assault. These are just a very few examples of your work from the last few months. The full body of work done by this School is the story of our lives. It is our scroll, our codex. It is our roadmap and often our cautionary tale. You explain our world to us, it’s all there.
I just wish we, as a society, were better at learning from you. Actually, the point of this address is that society is starting to listen more attentively. I think you are on a catalytic brink of a broader kind of role. You rising public health stars, are breaching the academic training realm at just the right time. Your contributions are much more sublime than a data dump. You are the artists, who paint the landscape that is our communities – creating a better picture, a better understanding of our well-being. You are the weavers. Your looms thread together the causes and the effects. You create a fabric that links far-flung reaches of our society together. You are the storytellers. The authors of literature that depicts our ethos and pathos. Your stories, your literature, create windows onto that other world: The better world that becomes possible, feasible and graspable, because of the inkling that your story has sparked. You are the explorers. From probing the depths of our inner selves, to the spans between us and the far-flung things that affect our health, we are confronting stubborn, critical challenges. Some rise out of ideology, some are based on fear, some are from un-excised legacies of othering and privilege, but some are almost more straightforwardly operational and come from failing to use the right skills and methods in solving our toughest problems – skills and methods that you possess.
I think that a Public Health Perspective (PHP) is the critical lens that is underutilized in important decision-making circles. We need more of a PHP at a broad range of tables; in quarters that never used to see their work through that lens. To me this is a natural extension of a 'Health in All Policies' approach – an idea that gained a foothold in policy work over the past decades worldwide, with an accelerated implementation in the past ten years in the U.S. You know what? I am less qualified than any of you to relate ‘Health in All Policies’ philosophy to current policy practices. But I will say that, from the community perch, it seems like things are evolving. Whereas past efforts aimed to identify the health outcomes of policies, now I think another infiltrating effect is also at play. Something more related to the grounding thought processes inherent in the foundations of public health practice.
A public health perspective makes you think better; makes you ask questions about the upstream issues driving your policy decision; makes you connect dots between broadly disparate sectors in society; makes you understand humanness, like brain development, socialization, mental health issues, population dynamics; makes you understand strengthening factors, like a sense of belonging and social connectedness in communities; makes you understand inhumane factors, like racism. Using your thinking simply drives better decisions, makes better policy. As our artists, weavers and authors, you describe issues and opportunities panoramically. That’s a skillset that makes you a valuable asset at any table. That’s what makes you rock stars.
Promoting this way of thinking more broadly is overdue, but doors are opening and that’s exciting. New opportunities are burgeoning. In the obvious corners, like our healthcare agencies and in healthcare partnerships, but, as I said, I think your influence is spreading even more broadly. Simply applying your words, to important conversations, has a potency. The language you use is helping to reframe seemingly unresolvable problems, like homelessness. Seattle’s homelessness rates continue to rise despite extensive attempts to address it. By naming homelessness a public health crisis and drawing parallels, for context – with infections that sweep through communities – it raises a call to action with the same fervor we might apply to an epidemic illness. I make no claims of easy solutions, yet I do think this crisis calls for a greater sense of crisis. So, even as a rallying cry, the public health perspective is an important lens.
Moving beyond health outcomes, I think about King County’s Best Starts for Kids initiative. Investing in efforts that aren’t health outcomes per se, yet they employ your trained way of thinking about needs and opportunities. In doing so, more strongly weaving the fabric that connects a baby’s earliest days, to a 24-year old’s best days. I also think about your influence on philanthropy. The public health perspective has long been a component of philanthropy. Today, it is not just expertise about health outcomes that helps them do good work; It is actually your enlightened thought process, your multilateral accounting, your upstream view, your knowledge of rippling consequences, your desire for equity – for an ethical soul in decision-making, your basic ability to connect the dots will make philanthropies better.
I believe more and more audiences are ready to embrace that view. I think about what the future of youth detention should look like. Your thought processes are a key component to this discussion locally. Promoting a re-categorization of youth detention from criminal justice-oriented to public health-oriented. A PHP says that youth in detention are youth in crisis, not young criminals. It says that the solutions to youth 'offenders' must include the broad community spaces upstream. It calls on us to disrupt racism-informed patterns of discipline that start in preschool. It means that judges and community center staff, police and early learning educators alike must all be on the same page, all aligned in their work. Most critically, a PHP lens reveals that young people have an incredible capacity for restorative healing. We would be a better society if we offered more youth, particularly youth of color, broader paths to success and fewer vortices to prison. Suddenly, a somewhat heartbreaking conversation about youth ‘offenders’ becomes a very different, hopeful, conversation about restorative opportunity. Thanks to you, and the super power that is your perspective.
Society needs you, and the opportunities are only growing. Again, I don’t just mean public health expertise. I mean a better way of thinking. At this moment in our history, there is absolutely no need for a recent public health grad to ask the question, 'what role can I play in influencing the world around me?' I see more and more tables with an open chair and a placard that reads, '(your name here) public health leader.' I see a country weighing hard decisions and feeling underprepared to address them, because the PHP has not fully informed the conversation – yet. Because your untraditional partners are waiting for you to take your seat.
It is time for you to sit at the table and bend an ear or two. Bring your data files, but also the earned wisdom and stories from communities. The many stories, not just the singular story of one group’s experiences. Don’t co-opt those stories, and don’t force a person in need of support to feel they have to sell their story in exchange for your help. But do try to assure that narratives, stories, are lifted up. Stories do wonderful things: Stories enter someone’s mind more quickly, nestle in someone’s heart more fully. They complete your role of authorship more realistically, more beautifully. To your many future tables, bring your calm reason, but also tap into your passionate voice. Get a little uncomfortable, get out of your lane a bit. Public health work is an ethical endeavor. Public health is an ethical endeavor. You shoulder a responsibility that transcends mere reporting, mere distribution of data. You bring morality along with enlightenment. You prompt harder conversations; ask us to take on bigger issues.
Your journey is an ethical endeavor and I see how your ethical lens has helped evolve your own field. Something as fundamental as data, has an ethic to it. Data creates visibility. You’ll continue to do the work to assure that every voice is heard, every person is counted, everyone is included, because you know that casting an especially bright light on certain populations casts broad shadows of invisibility across other populations. That’s an equity journey, that’s an ethical journey. Data has an ethic to it, and you keep taking more steps along equity’s path. You have advanced data disaggregation. You asked a moral question when you saw that, for instance, historically, lumping all Asian Americans into one category was unfair. Unethical for many who fell under that broad brush stroke. You encourage me to think and think again about how I talk about data. Like the names I give to categories. Even categories titled: outcomes based on race, or the term racial disproportionality. They’re wrong, because I’ve learned that this may imply that there are differences about races that impact health.
While it is really racism that is driving these differences, I should be using terms like, 'outcomes based on racism' or 'racism driven disproportionality.' There is a powerful moral articulation in the knowledge you share, and I do mean powerful. You reveal the shame of our healthcare system, its spending, its waste. You will guide us as we disrupt and deconstruct our current shame, and then reconstruct a healthcare system that guarantees quality healthcare for every single person, period. A system that costs less, serves more, has better outcomes, is more humane. When that happens, and it will happen, you will be the ones to thank. You have an ethical potency in the work you produce, and in the way you think. If you didn’t have this kind of power, then the NRA would never have seen you as such a threat; would never have historically tried to constrain you from studying gun violence in the thorough fashion it deserves. I believe that if you had free rein in this regard, we would have already gone a long way toward kicking our unhealthy addiction to guns.
Your journey is both a privilege and a responsibility. This promise to walk the path of equity is a choice to take the harder path. But your morality says that the equity path is the only path. Your hearts know this path leads to the primary sources of inequity and illness. Those inequities are in our roots as a country. Systematic inequity has been the engine for this country’s growth. It is systematically ingrained. We are all products of that inculcation. We are a society that has its foundations built on slavery and trails of tears. A society that has systematically sought to disenfranchise women and disempower rural communities. A society that advances the interests of capitalism over the well-being of its people. A society that prioritizes maleness, whiteness, hetero-ness, your public health perspective means you know that and you know that even the most ardent champion for equity still carries those unrecognized roots of bias. It would be hard to look honestly into the soul of any of our professions and claim they are not influenced by those roots, those systems, those biases. You know that privilege and bias exist, flourish, in rooms like this, in institutions like this, in us. And your skills are ready to be focused inwardly as well as outwardly.
You are, in so many ways, equity’s greatest hope. Get out there and do your thing. Disrupt and destroy our most inhumane roots; nurture and advance our better, more loving potential. You’ve already shown aptitude for this. As I mentioned, with apologies, I show up to you today as a community pediatrician, who has found that health is determined so far away from the reach of my stethoscope. That I find I must, if I want to improve health, move toward the roots. The deepest roots are sometimes, oft-times, the hardest ones for us to talk about, and they are also the most important things for us to be talking about today for all our sakes. And I think we are ready as a society, to be bolder, thanks to you. I think we are ready to start sculpting a society that shares its great wealth, its great resources, its voice, its power, based on equity. Ready to heal the longest standing wounds as well as the newest wounds. We are on the brink of change, of a new day, if you’re ready to usher it in.
I don’t know if calling you activist sits right with all of you. Yet think about its most basic definition: 'activist: a person who campaigns to bring about political or social change.' Surely the reduction of chemicals that salmon swim through has its solutions in political and social change. Surely the same is true of efforts to reduce the toxins riding the dust of a farmworker’s pants. Surely early man… well okay, I’m having more trouble with a quick one-liner to connect political and social change to the early-man and Denisovans thing, but I’m sure there’s an argument in there. But surely the connection between air quality and mental health, as you illuminate, has it’s solutions in the political and social realm. E-cigarettes? We definitely need political and social energy on that one. Wait, so maybe you already are the activists and I’m the one who has to catch up.
We are a society replete with gifts and promise that have not yet been tapped. Help us know that potential. There is incredible good in this society, through your artistic talents help us all enjoy that full diversity of goodness. Weave the threads together and reveal our interconnectedness. Our interdependence, our commonality, prompt us to take a few steps further along a moral arc. All through the mechanism of the public health perspective.
Lift people’s vision up. That’s the ultimate prospect of your work. Lift people’s vision up. You are the artists, the weavers, the storytellers, the explorers. You create a window onto that lovely future that beloved community fully realized. Let that role feed your soul; and take that responsibility even further as you move through your life. As Rumi said, way back in the 14th century: 'Be a lamp, or lifeboat or a ladder. Help someone’s soul heal. Walk out of your house like a shepherd.'"