Continuing along yesterday’s theme, I’ve been taking an interest in the Royal Society for Public Health’s Re-thinking the Public Health Workforce, which is all about trying to co-opt various unrelated professions (the ‘wider workforce’) to advance public health interests in the ordinary course of their work – e.g. health tips from barmaids.
My interest today lay mostly in the English that it employed, which seemed to be a sort of private language or jargon adopted by Public Health professionals, which is quite unlike simple, plain English.
For a start, there seem to be a number of words that are routinely used in these circles, which include ongoing, stakeholder, workshop, sustainability, challenge, engagement, intervention, and commitment, among others. These words seem to act primarily as badges to identify the authors as members of a select group of Public Health insiders. And these words can be strung together in more or less any order to to construct impressive combinations of words without any identifiable meaning (e.g. ongoing stakeholder workshop sustainability).
One example from fairly early in the text:
Tapping into this diverse range of human contact could provide significant opportunities to promote health messages and initiate or embed behaviour change through healthy conversations and signposting to other services.
What on earth are healthy conversations? On the face of it this would seem to be conversations which steer clear of unhealthy topics (e.g. war, sex, drugs). But what is probably meant is health-related conversations (i.e. conversations about health) which have the aim of changing people’s behaviour permanently (this is probably the meaning of embed). And signposting probably means giving people the phone number of a smoking helpline.
The authors show signs of being aware that there is a problem with the language they use. For they have found that even the term public health (another ambiguous term) is not widely understood:
A primary concern identified across the entire engagement process was the need for the wider workforce commitment to speak the same language. For many wider workforce professions, there is a lack of understanding and familiarity with the term ‘public health’. This is a considerable barrier to further engagement and development as many professions will lack an awareness of how their role relates to public health and the potential impact of their work. Positioning the contribution of the wider workforce as promoting ‘wellbeing’ instead of ‘public health’ has been suggested as a more widely understood alternative.
There is also no suggestion that the wider workforce will be remunerated for their efforts in pushing health messages – because no extra work is required:
Many of the case studies demonstrate that, rather than increasing workload, this can actually be a natural extension of their work and over the long-term make it less demanding.
Then there is the question of moral scruples that some people in the wider workforce might have.
Kemble Housing, for example, found that their staff were initially uneasy about having healthy conversations and were concerned that they may be seen to be ‘judging people’ and telling them what to do. To overcome this challenge, the case studies demonstrate that involving staff in the development of wider workforce initiatives is essential. This encourages a feeling of ownership and also aids understanding of the projects. The GMFRS found that it was important to ‘ensure that a uniformed member of staff is seen to support the initiative and preferably be present during the initial briefing sessions’. The case studies also demonstrate that it is vital to ensure that there is strong strategic leadership.
“Judging people and telling them what to do” is of course what Public Health is all about, and what it does all the time. But they can never openly say so. And this is probably one of the main reasons for employing ambiguous jargon which serves to conceal the true purposes.
The moral question posed by Kemble Housing staff is not addressed directly, of course. That would give the game away. Instead the ‘challenge’ is to circumnavigate such moral scruples by getting people involved in the design of new ‘initiatives’, and ensuring that authority figures show support for these initiatives. People will go along with something if they’re all in it together, and everyone concerned approves. In this manner, ordinary people can be successfully converted into interfering busybodies.
One of the key goals of Public Health professionals is to get other people to do their dirty work for them, unpaid. And this is what the document is essentially all about. In the case of Tobacco Control, it was the proprietors of bars and cafes who were successfully co-opted as unpaid policemen to ensure that nobody smoked on their premises. The Tobacco Control professionals never had to do it themselves. And the same will probably be true when it comes to initiating healthy conversations. Public Health intends to co-opt other people to do that, once again without pay. They are to act as the puppet-masters of their co-opted puppets.
Since the goal of Public Health is to initiate or embed behaviour change, it seems likely that its practitioners are behaviourists of some kind. Behaviourists assert that the only thing we really know about other people is how they behave, and we have no direct knowledge of any thought processes they might have, which are invisible, and which may not exist at all.
Behaviorism is primarily concerned with observable behavior, as opposed to internal events like thinking and emotion. Observable (i.e. external) behavior can be objectively and scientifically measured. Internal events, such as thinking should be explained through behavioral terms (or eliminated altogether).
Its theoretical goal is … prediction and control.
This may explain the complete lack of interest by Public Health practitioners in what anybody might think or feel about their various interfering initiatives. They have no empathy whatsoever for the subjects of their social engineering programs, any more than for lab rats in a maze. They can’t put themselves in the shoes of the people they browbeat and bully.
This does however suggest that they might take notice of at least one kind of observable external behaviour which they can objectively and scientifically measure: to wit, a fist in the face.