Writing with Juliet Iwelunmor

In 1988, the Institute of Medicine published a report that explored the future of public health. They concluded then that “public health was a vital function that requires broad concern and support in other to fulfill society’s interest in assuring the conditions in which people can be healthy.” Back then, they echoed the critical importance of communities and how organized efforts at the community level maybe both valuable and effective. They also called attention to how public health issues where inappropriately politicized and public health responsibilities fragmented, that deliberate action to intervene would be difficult if not impossible. The year was 1988.

The last sentence in the report’s concluding remarks ‘urged readers to get involved in their own communities to address the present dangers now and for the sake of tomorrow.’ That we continue to ignore the community, ignore their assets, ignore their possibilities too, is my keep for today.

I spent yesterday in a very beautiful campus and with some very beautiful souls, speaking from my heart about the work we do with communities, not with them as passive recipients but as partners and leaders. The truth, true engagement will require us to step aside for a moment and let communities lead community health, public health. It seems impossible, seems risky even, but like Bessie Heard would argue, communities have tolerated our strange ways for so long that it shouldn’t come as a surprise that 50% of our research never continue after the initial funds end. They will never keep what they didn’t build. Hence the need for understanding why and how to do sustainability research, yet few funders choose to see sustainability as a science worth pursing on its own.

This school year though, I found myself becoming a lion for sustainability through seven presentations that changed every time and were so different but helped me to expand my thinking of sustaining evidence-based interventions. Chinua Achebe said it best, “until the lions have their own historians, the story of the hunt will glorify the hunter.” So even though my schedule was crazy busy, even though I literally had to transition from one school to another in 3 days, I kept all my engagements for the year, especially every single one that asked me to say something about sustainability. So in September my notes on sustainability started out at NYU. Then I shared briefly, the notes to a consortium I belonged to at WashU. Then I went to NIH campus in January and shared an addition to the first two insight to another consortium I belonged to. In March, I went back to New York, this time Columbia University and once again, expanded my notes. I then went to Chicago in April, with another expansion. I traveled to Mombasa for a meeting with an expanded version of all the six versions to date.

Finally yesterday, I went to the University of Washington, with an evolving version, the seventh version, that maybe the best of all. We are finally coming to our own with this topic is what I shared yesterday. One where there are contexts that matter, connections too that literally serve as foundation and creativity which is at the heart of my love for studying the science of sustainability. It’s a science the requires all of us to learn the ABC’s or activities, benefits and capacities that matter with any effort at sustainability, one that also begins with a PLAN.

The conversations on this topic are evolving. Money matters but people too, learning for sure, adapting and nurturing the possibilities within. There are strategies we need to uncover, taxonomies that some of the students suggested the field still needs. I agree and agree and said please be the lion. We need your stories and papers. We can only move the field forward if more of us are arguing that this isn’t an after thought but what the field needs if we are to confront the new challenges the field faces while continuing to work to address the old ones. In 1988, the report noted that the general public was confused due to our fractionated interests and programs.

In 2024, the same issues persist. The hope for a sound public health, one where communities are in the middle may seem futile but in the words of Jason Shinder, this hope is all the way down within communities from where it can never be judged. This hope must also be encountered again and again until the truth of how communities lead stand. The highest point for this year’s long journey on sustainability isn’t the notes, but how my thinking evolved throughout the year. It takes communities to see communities and we see you.

Communities feel, see, and shape their health in ways that are enduring and they call us to do the same. This unseen magic within speaks to the highest within me. It’s why I say we all should plan to sustain our engagement with communities otherwise leave them alone. If you choose to ensure they lead, then begin with a plan. Know their core values, work with the right people, learn, adapt, and nurture what the possibilities we all know exists in every community. Do all of this and maybe public health, the communitie’s health may reach the zenith with health, reach the highest to within us. I know, because following yesterday’s presentation at UW, I feel, see, the zenith within me, within all I do. Keep, keep sustaining the public’s health.