What do you learn in 160 years?

October 24, 2016 in Blog by Andrew Furber

The Association of Directors of Public Health (ADPH) and the Royal Society of Public Health (RSPH) had a birthday party this week. 160 years ago saw the formation of the Metropolitan Association of Medical Officers of Health that, after various mergers and demergers, led to the existence of ADPH and RSPH. You can read the details for ADPH here.

The history of changing epidemiology, organisational changes and personalities is fascinating. The first Medical Officers of Health were appointed to control communicable disease. Non-communicable disease is now the major cause of ill health and mortality, but influenza, Zika, Ebola and antimicrobial resistance serve as reminders that we ignore infectious disease at our peril.

But what has the last 160 years taught us about the role of the Director of Public Health (DPH)? Well, here are my 5 Ps:

  • Place – DsPH and our predecessors have always worked within a more or less defined geographical place. Structural reorganisations have often changed the boundaries, but the principle that the DPH has responsibility for all that affects health in a given locality has endured. Today we know it as system leadership.
  • Population – inequalities are nothing new and DsPH have always advocated for the entire population, and especially those who are excluded or disadvantaged.
  • Persistence – public health is a long game; a marathon not a sprint. Whilst we should grab quick wins and be fleet of foot in responding to public health incidents and opportunities, progress in improving the health of the public is probably best measured in decades.
  • Politics – DsPH have always had to sway national and local politicians, and be astute in influencing the politics which occurs within every organisation. This is perhaps the attribute which is most difficult to acquire.
  • Passion – usually this is the reason people aspire to become Directors of Public Health, and without it you won’t last long.

ADPH has captured these attributes in the Director of Public Health role description. These characteristics have endured for 160 years. The nature of the health and wellbeing challenge will no doubt change, but having someone who can lead the response for the people in a place is unlikely to alter.