Last year, when I was considering joining the Davidson faculty to help shape a public health program, I didn’t know that when I arrived on campus in late January 2020 we would be facing a global pandemic. But those of us in public health knew this day would come, as it has before in my career and throughout human history.
Many of us were worried about features of contemporary life that made the situation we are facing likely to be more frequent, severe, and unjust: globalization, anthropogenic climate change, economic inequality, war and conflict, nationalism, racism and xenophobia, distrust of expertise, and lack of investment in or commitment to public health and health as a human right.
While it has become reflexive to say this pandemic is unprecedented, most of what is happening is not. Public health crises lay bare who and what we value. They are rarely the surprising, acute, or circumscribed events they may appear to be, though this conception often drives the approaches we take to address them.
The reactions and responses to the COVID-19 pandemic have many echoes in recent epidemics, some ongoing, including HIV/AIDS, 2003 SARS-CoV, 2009 H1N1 influenza, and Ebola virus disease.
These events are also opportunities, as past crises have demonstrated, to reevaluate our approaches and undertake reform. One such area for reflection and innovation is in relation to how best to educate professionals and communities to address and participate in the transdisciplinary and collective action required for complex public health challenges like COVID-19.
What qualities, values, and expertise are necessary to do this work?
My vision of this has been shaped by my nontraditional path to the kind of work I ended up doing. Towards the end of my graduate studies, I realized I wanted to pursue a different kind of focus and career setting than I had originally contemplated, combining medical anthropology, ethics, and public health in an applied setting. I wasn’t sure what this would look like, but I decided to take a chance and apply to the Epidemic Intelligence Service (EIS), to see if I could figure it out. The EIS is a two-year postdoctoral training program in applied public health and epidemiology at the Centers for Disease Control and Prevention (CDC). Often colloquially referred to as “disease detectives,” EIS officers are most often physicians who have completed a medical residency, nurses or veterinarians with master of public health degrees, or those with doctorates in epidemiology or behavioral science.
I wasn’t the first medical anthropologist accepted to EIS or to work at CDC, but it wasn’t common. After EIS, I stayed at CDC and in U.S. government public health for nearly 20 years, working on public health policy, programs, research, and ethics in many different contexts. Through the challenges and rewards of my own unorthodox path in public health I developed a richer understanding of the nature of the work and what qualities and expertise are needed to meet contemporary public health challenges.
Since I left federal government service in 2017, I have been on the faculty of two undergraduate liberal arts institutions: Macalester and now Davidson College. I have come to see the role that these kinds of institutions can play in addressing the immense public health problems we face by providing a kind of education that can foster a more holistic approach to understanding and addressing them.
Intellectual curiosity, creativity, critical thinking, and the ability to communicate in many forms are all essential to public health work. Addressing complex public health issues requires having frameworks and tools to understand the social, cultural, political, and economic contexts in which they take place. The ability to identify and analyze ethical issues and justify courses of action is critical when the choices we routinely face entail considerable uncertainty and navigating tensions between different values and public and individual goods. The kinds of problems public health must address require an inclusive interdisciplinarity with public health professionals conversant in and appreciative of the contributions of a wide range of scientific and humanistic disciplines. These include anthropology, behavioral sciences, biological sciences, the arts, history, economics, languages and literature, philosophy, political science, and many others.
Contemporary public health practice must also be grounded in humility, public service, and advocacy. Davidson College is an ideal place to advance this vision of public health, with its commitment to “developing humane instincts and disciplined and creative minds for lives of leadership and service.” I am honored and excited by the opportunity to contribute.
Kata Chillag is the Hamilton McKay Professor in Biosciences and Human Health.