How I explained public health to my relatives

I brought this picture of a triangle to Thanksgiving this year. It helped me explain what public health is to distant relatives who don't understand what I'm going to school for. I struggle to articulate it every year, so this time I relied on the aid of a diagram developed by a seasoned professional: Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention.

Clinical interventions reside at the next level of the pyramid. These usually require a visit to a doctor's office and include things such as screening and treatment for osteoporosis to prevent bone fractures, HIV treatment to reduce viral load and the chances of transmitting the virus, and electronic medical records that improve the coordination of medical care. Although they have preventive benefits, interventions in this category fall short because they reach individuals one at a time – not a population all at once. They also aren't always effective and don't benefit people without access to a regular source of health care, such as those who are under or uninsured.

The construction of a pyramid is a fitting analogy for public health. Like ancient Egyptians who quarried stone, public health practitioners conduct science to create the building blocks for something that benefits society. Neither stones nor scientific knowledge have much value in and of themselves—they need to be strategically pieced together. Like a 10-ton block of limestone, science can be hard to move forward. Sometimes public health practitioners advance only as far as a pamphlet. But we're always working to build structures within society that promote health across a population and withstand the test of time.

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