Others Oriented?
Philippians 2:3 Instead of being motivated by selfish ambition or vanity, each of you should, in humility, be moved to treat one another as more important than yourself. 4 Each of you should be concerned not only about your own interests, but about the interests of others as well. (NET)
The Apostle Paul appears to grant self-centeredness as our default setting in these verses from Philippians, but he admonishes these church members that it should not be so. This is especially true within the household of faith, but believers should extend this love to every person. Jesus says in Matthew 22:37-39 (ESV) that we should love God supremely and “your neighbor as yourself.” Jesus did not allow waffling on the question “Who is my neighbor?” (Luke 10:29-37)
The discipline of public health seeks the greater good. In a nation of rugged individualists who don’t like to be told what to do this call to an others orientation may feel downright Un-American. The preamble to the Constitution of the U.S. says otherwise. This is a collective document in which “We the people” (the public) aim “to form a more perfect Union” (of disparate groups), to “establish Justice,” “insure domestic Tranquility,” and “promote the general Welfare” (Wellness of a sort—what’s best for the public and not just special interests).
An anonymous sage of the nineteenth century uttered this minimalistic guidance for a nation of individuals, “Your freedom ends where my nose begins.” In the midst of the COVID pandemic transmitted primarily by long-lasting airborne aerosols generated through speech, and especially through singing, it seems my nose extends farther than envisioned in the 1800’s.
What follows is an approximate transcript of a podcast interview with Dr. Amy Hicks, Chair of Health Sciences at Bob Jones University:
[00:00] Mike Gray: Welcome to this, the 7th season of the Deep and Durable Learning podcast. I'm your host, Mike Gray. I have 45 years of teaching experience in higher education. I've taught over 10,000 students. Many of my students would say that I taught them how to think. I've also been involved in faculty development for over 30 years, and many of those faculty participants would say that my approach to teaching was personally and professionally transformational.
This season will be a series of interviews with faculty whose teaching has been transformed. My guests will come from a variety of academic disciplines, but they're all applying the principles of transformational teaching.
We welcome back today Dr. Amy Hicks. Amy has a PhD in biochemistry as well as a Master of Public Health. She's currently the Chair of Health Sciences at Bob Jones University. Welcome, Amy.
[01:17] Amy Hicks: Thank you. It's good to be back. I really enjoyed our conversation a while back this summer, and I am excited to come back and talk.
[01:25] Mike Gray: I enjoyed it, too. Let me set the stage.
As a nation [and I guess since I remember right, you're from Colorado originally, correct?]
[01:36] Amy Hicks: Denver.
[01:37] Mike Gray: So I'm from Utah. So the ideal of rugged individualism.
[01:44] Amy Hicks: That's right. We're good westerners.
[01:46] Mike Gray: Yeah, absolutely. And self-determination. Don't mess with me. I know what I'm doing, and I'm quite capable, thank you very much. So that kind of individualism combined with lack of understanding of principles of disease transmission sometimes sets us up to violate the self-determination of our neighbor— that is the public, since we're talking about public health.
So, here's an instance that I heard last fall. It was inadvertently offered by Whitney Williams on a podcast called The World and Everything In It, which I listen to during the week. This particular podcast aired on October 18 last fall, which would have been 2022 when the U.S. was on its way up to a new spike in the incidence of COVID-19 that reached a peak around January.
So, Whitney, in this podcast, recounts getting her family ready to go to church and discovering when everybody was in their minivan that her youngest, who had complained about his stomach earlier, was actually in earnest. She pulls him out just in time for him to lose his breakfast on the driveway. The family reluctantly goes back into the house to watch the church service online. Over the next hour, as they wait for the service to come on, her son seems to have made a miraculous recovery. They decide they'll attend church in person after all and drive off. As they walk up the front steps of the church, the young boy vomits on the steps. I'll let Whitney tell the rest.
“Doesn't exactly leave the best first impression for visitors. I joke with the welcome team as I rinse the concrete with a pitcher full of water I borrowed from the coffee bar. But maybe our mess on the front steps of the church sends exactly the right message to visitors, I thought, as we made our way back home to watch the service online. Welcome to church, a place for the sick.” End of Whitney's words.
I think there's more than little irony to her labeling the church as a place for the sick. What's your take, Amy?
[04:19] Amy Hicks: Well, I think that's kind of funny, because if I were walking up those steps as a visitor and I saw somebody puke all over the steps, my first thought wouldn't necessarily be, well, sinners are welcome here. I would probably think, oh, I think I'll go somewhere else, because if this starts at my house, we're going to be sick for a week and everyone's going to miss school, and then that means we have homework. But having four kids, I can certainly relate to her story.
There are a lot of times when you think, oh, maybe they're exaggerating. Maybe they want to get out of school, maybe they aren't too sick, or you just don't even know how sick they are until you get there. So, I know there have been multiple times when I sent kids sick to school just to have the nurse call me later to come get them because they had started a fever. I didn't mean to.
I think that's happened to every mother, and normally this isn't more than a minor inconvenience for most people, but we saw in the COVID pandemic how it became incredibly contentious. During that perfect storm of the pandemic, we had people in society that were arguing very loudly over both sides of this issue. It wasn't funny. During the pandemic, everybody was arguing about this. If I have no symptoms and I've tested positive, I shouldn't have to stay home. Or you hear over and over, they're overblowing this. It's not really that big of a deal. I only had a little cold. Or on the far extreme, you have other people who were hollering that if you had been around anybody sick for your whole entire life, you shouldn't ever come out again. I'm exaggerating, of course. I think both sides of that debate became very, very heated.
[06:03] Mike Gray: Indeed, they did.
I think when we talk about public health, there is a clear mandate in scripture about our concern for and priority given to others.
John 13:35 from the ESV says, “By this, all people will know that you are my disciples if you have love one for another.” And Francis Schaefer, philosopher of previous generation, whom I read avidly, wrote a little pamphlet, I guess you'd call it, called The Mark of the Christian. And in it he made the case that the unbelieving world is allowed to make a judgment about the authenticity of Christianity on the basis of love within the church in particular. And that's referencing the verse I quoted here. “By this, all people will know that you are my disciples if you have love for one another.”
For me, I think this is, in my lifetime, really the biggest failure of the church particularly evident in the current climate of polarization and politics, as well as in matters of public health. The stridency and coarse personal condemnation of others within the body is particularly disheartening. We don't look like a healthy family.
So you've given us a little bit, but what's been your experience within the church?
[07:46] Amy Hicks: Oh, goodness. That's something that I've been talking to with other people a lot recently. I'm very concerned about the division that we see within our churches. It was bad during the pandemic. That was some very difficult times to watch the church go through. Many pastors became so discouraged in the work. I have friends who left or almost left the ministry, so COVID exacerbated it. But even before that, and even now, church members have been split over principles that lie at the root of public health without even really knowing it.
We are much more tempted to be characterized by our performance, by how holy we find ourselves than we are by our concern or by our love for our neighbors. So, you mentioned earlier that individualistic rugged, independence kind of a mindset that Americans are characterized by. And I find that a lot in people's response against public health when we talk about things like social determinants or we talk about social justice. And that's definitely a word that gets a lot of people very worried, and you have to define it. I get that. I get the worry. But the fact that I am responsible to look out for my neighbor and to love my neighbor, no matter who that neighbor is, is incredibly biblical you know; look at the story that Jesus told about the Samaritan—the Good Samaritan, but we often find ourselves saying, like, the Pharisees, yeah, but who is my neighbor? So, if I can pick and choose my neighbors and love those, then I'm perfectly fine with it. But when God calls me to love a neighbor who doesn't look anything like me, has behavior that I don't like at all, then that can be a whole lot more difficult. And even loving our neighbors across the political spectrum, that has become very, very difficult to find.
[09:47] Mike Gray: How do you think the biblical command that Christians are to love our neighbors as ourselves, which means something bigger than loving our brothers and sisters in the church uniquely qualifies Christians to enter careers in public health?
[10:04] Amy Hicks: Oh, goodness. I might be slightly biased, but I can't imagine a career that is more fit for Christians to enter, because that's what public health is all about. Public health is about protecting my neighbor and hopefully loving my neighbor more than I love myself. And so we see that in people who work in vulnerable groups here, people who go across the world and work bringing clean water to people, bringing immunizations that keep children well. These are very, very tangible ways for us to love our neighbor.
When I was in grad school, in biochemistry. So, before the career that I currently find myself in in public health, my professor, my advisor of my dissertation said something to me that I think also applies to public health. He said, you go into medicine to make money. You go into science to make a reputation. So, the way that I mean that is you go into medicine, maybe you can make a lot of money. You don't make a lot of money in public health. You do not— there's not good funding for it. There's not a lot of money to be made. But everyone I've met tend to be very altruistic. Even if they don't know the Lord, they have a great concern for their neighbor. So, if Christians can't go into a field and be concerned for their neighbor, then I think that speaks very poorly for us, for sure.
[11:32] Mike Gray: And there needs to be some impetus for this that is Holy Spirit driven when we're talking about a Christian, something much more deeply rooted than simple altruism.
[11:48] Amy Hicks: Sure.
So, I can give you an example of that, make that a little bit more concrete. Just this week, the faculty who are teaching in the masters of public health that we are starting our very first class, coming in next week, in fact. And we sat down together over the course of several days to talk about what is our doctrine, if we want to call it, of public health. Because when you're in grad work, you learn the knowledge and you learn the skills, but you also learn a way of thinking, a mindset that you filter all of your knowledge through.
And so, we said, okay, what do we want our students to leave knowing that is distinctly Christian? And so, we came up with five characteristics that we think should define Christian public health. And so those are Hope—the world is without hope. A lot of people are without hope that is either for this life or for the next, that things will get better. If we were born into a good middle-class family and we have attained some level of success that might not resonate with us, but for many people, they're without hope. So, the interventions that we do as a public health professional should bring hope. Secondly, we defined Holism—that we see people and we see their health as being multifactorial. We're not just there to bring clean water because you're going to die of something someday, but to understand that people have multiple needs. So physical needs, mental needs, but also spiritual needs. And you can't bring wholeness to a person until you've addressed all of those. So those would be the two I would say that characterize particularly how Christians should view public health. That we're doing it out of a desire to bring hope for now and hope for the future, as well as viewing all of a person's needs and wanting to bring the gospel into that in order to meet those needs.
[13:46] Mike Gray: We're going to circle around to the thinking of professional and public health more specifically in a few minutes.
The former director of the Centers for Disease Control, Rochelle Walensky, said in a New York Times guest essay quoting here: “The job of public health is to strike an appropriate balance between protecting the health of all those who live in the United States while minimizing the disruption to the normal functioning of society.” And of course, part of the way that happens is through public service announcements, I guess you'd say; through communicating to the public. So, she went on to say, “Delivering information both in scientific detail and in plain language can be challenging, especially when messaging is met by efforts to compromise our work with nefarious intent. As a society, we must be more discerning of dubious rhetoric. People deserve accurate information to make the best health decisions.”
So, what makes this task particularly challenging in our current cultural climate, especially in the U.S.?
[15:03] Amy Hicks: Yeah, so I think the key word there is accurate, accurate information. And that is very difficult in just our culture. We're bombarded with information everywhere we look, and it's very difficult to weed out what's true from what's not true. We're in a post truth society, right? My facts tell me this. And so, I think just the fact that people are constantly hearing other messages makes it very difficult. And not just hearing other messages, but messages that are co-opted for somebody's agenda. But we don't often see that. We just see it as being true. And so therefore, we buy into it. So, the challenge would be the amount of messages, the quality of messages, the hidden agenda behind them, plus they become self-fulfilling. We look for information that confirms to our biases. So, we look to news stations who already agree with us. And that's very difficult as humans to want the truth, even if the truth interferes with my strongly held opinions.
[16:17] Mike Gray: We're wired for confirmation bias.
[16:19] Amy Hicks: Very good. Yes.
[16:20] Mike Gray: We would say something that confirms what we've already decided must be the case.
So, what makes the task of accurate communication particularly challenging for us? I mean, part of this is there's a fundamental distrust of institutions and authority structures these days. In my youth (and believe it or not, I was a youth at one time), but it used to be that distrust (don't trust anyone over 30 from the hippie generation) was a left-wing political item. Today, though, even though there is some distrust of institutions on the left, conservatives are more likely to deeply distrust institutions and authority structures. Which is really paradoxical if you think about what a conservative is. Because these are largely historical systems and institutions, and conservatism normally seeks to conserve what we've already built, not to uproot and tear down or disregard authority. So how does this distrust manifest itself? How does it play into the voices that we give ear to and those that we would rather not have a seat at the table?
[17:54] Amy Hicks: Yeah.
So, I think we listen to the most extreme voices often on either side of the aisle. You're going to find extreme voices. The louder, the more strident people are, the more they're followed, the more viewers they have. So, we certainly see that.
We see it in the political structure. When presidents or presidential candidates come in, they're always promising to overturn the corruption or overturn what's in place. They're going to do better. They're going to bring power to the people or whatever. So that's a constant political message, I think, that we hear and we see it in conservatives. I see this in my Intro to Public Health class all the time that when we talk about what role let's just take, what role does the government play in meeting the social needs of individuals? Highly conservative students come in thinking none. The government has no role in that. That should be the church. The church should be in charge of that. I'm like, okay, great. Well, are all churches meeting the needs of single mothers to feed their children, providing formula? Are they providing health care? Is that even the duty of the church to make sure that people have access to health care? We tend to think these structures, these government structures are wrong. They're bad. They're telling me something that is incorrect instead of looking at both sides.
[19:19] Mike Gray: So how do you think this tendency to be suspicious, this tendency to distrust existing authorities, to listen to the loudest voices, how do you think that can be laid to rest? Or is that the impossible dream?
[19:43] Amy Hicks: I think that's something that we'll be wrestling with for quite a while. The only way that I can see to do it is to consistently lay out reasonable, well-reasoned information that isn't co-opted by either political party. And I'm not sure how that happens, honestly. But when we can give data, we can give scientific data that bolsters our claim. But you'll always have people who distrust science and distrust the research that you give. We're living in a post truth world, so I'm honestly not sure how to answer that question. I don't have that answer.
[20:20] Mike Gray: There isn't a ready-made one, I don't think.
[20:22] Amy Hicks: There is not.
[20:23] Mike Gray: Let's go down the road of trying to dissect the thinking of a public health professional. There is a distinctive, I think, point of view that somebody in public health adopts.
[20:39] Amy Hicks: Okay, so the point of view of a public health professional, there are several there are several important doctrines, I guess, that we could say, for public health.
One of those is the public part that we're not treating a simple or a single individual that comes to us. We're diagnosing and treating—we're treating an entire community. So, the community is our patient. A group of people are our patient. So that's one of the points of view that we're protecting the health of the whole community.
Another point of view would be the health part. What is health? Well, we are not treating disease so much as we're seeking to prevent disease and to pursue wellness. And so those seem like obvious statements that we can all get behind, but they can conflict with our natural well—they conflict with medical care. What we're used to, we're used to going into a doctor when we're sick. We're used to having a very individual approach to our treatment. And that's not what public health is. Public health is an intervention to improve the health of the whole community and to prevent sickness in the first place.
[21:55] Mike Gray: I remember during the first year of the COVID pandemic having conversations with MDs who were approaching the issue of COVID transmission differently, in some cases at odds with public health professionals. And I remember reading an article by (I can't remember the author right now), but it was an individual who was an MD, but was also public health professional. And he was confessing in this New York Times essay that he realized that he needed to take off his MD hat and put on his public health hat because he was approaching this thing in a way that was not really productive from a public health perspective. That he was looking at these people as individual patients who might get a disease and not looking really at the prevention side of things or getting ahead of things by trying to determine vulnerable populations and ways in which they could be protected, at minimum inconvenience to the rest of the population.
So, he was articulating that there was a different perspective. And I think during the pandemic, since we worked together on a few things, that there was that collision between a need to know what's the incidence in the community, who are the individuals who could potentially spread this, and people who would just as soon that we not be putting resources into finding the answers to those questions. How do you see this point of view contrast whether with an MD or somebody on the treatment side or just a layperson who's trying to stay healthy but is maybe not sympathetic to these broad scale interventions that seem to be part of the way you're going to have to manage things from the standpoint of the public's health?
[24:11] Amy Hicks: Right? Like you said, we worked together a lot on that, trying to make sure that our campus could stay open. And our goal for that was to stop the transmission of the disease, or at least to slow it enough to be able to handle the number of students that got sick at any given time and to protect those who were vulnerable.
Most of us were not terribly vulnerable to a bad case of COVID but there were a significant number of people who were. And so that's where the love comes out. Do I care about those people if I have to wear a mask? Well, wearing a mask wasn't the end of the world, but our goal in public health was to prevent or at least slow it. And so, because this was a respiratory virus, there are only so many ways you can stop or slow a respiratory virus. If it had been any type of bacteria or type of virus pathogen that we have, we have only a limited number of ways to stop that. And those are the ones that we have to use.
So, our method was using masks. Of course, that's not 100% foolproof, so people get sick. So, the next thing we need to know is, like you said, the incidence, how quickly is this spreading? And that's very important, because if it starts taking off like wildfire, we're in trouble. So, we have to see how effective are our measures. And there were other measures besides masks. Some of us wanted large scale testing, and it became mandated, for instance, for the athletes. They were not allowed to play unless they had been tested.
[25:49] Mike Gray: Mandated by an athletic association.
[25:51] Amy Hicks: Yes. Not by the school, by an athletic association. And so, they were always getting tested. We had performances going on, and they were being tested to make sure that there wasn't a rapid spread of people who were spending long hours together. But there was a lot of pushback on random testing. It became voluntary. People had to agree to be tested. And so obviously, you can't do a significant scientific determination of the incidence and of what groups are at highest risk if you can't do random testing. So, there was a conflict between that.
There was a conflict between whether or not we should wear masks, which at the time, everyone did pretty happily because we were one of a minority of universities that opened their doors back up, and we knew, okay, this is what we have to do to stay open. So, people did it. So those were the things, I'd say that were really at conflict. If we were taking a purely medical view, then we just treat the patients who come in, when they come in, then we put them in quarantine, we start them on whatever treatment is most effective, and we worry about that. But public health, we wanted to back way up and say, okay, how can we keep people from getting there in the first place?
[27:08] Mike Gray: And maybe another illustration to take it out of the live wire, live fire side of things, talking about COVID. I was a faculty member when we had a pertussis epidemic on campus. Whooping cough. But actually, the first case was in the room of a student that I had. The student asked me, so have a roommate who's got these symptoms and to me, like that's whooping cough. Well, they're letting her go to classes, and I'm a little concerned. Yeah, I'm concerned too, but limited in influence.
So, what ended up happening was from that first case, there was in fact an epidemic on campus, only it was treated by medical professionals and not public health professionals. So, the treatment was some isolation followed by prophylactic treatment with antibiotic, with Z-Pak antibiotics. So literally the campus, the gym, became a quarantine center, which became actually a center for transmission because anybody who had symptoms that were remotely like whooping cough got isolated with these people who definitely did have whooping cough. So, we literally went through thousands of doses of antibiotics.
[28:36] Amy Hicks: Wow.
[28:37] Mike Gray: And it kept mushrooming to the point where we had to end the semester early, about a week early. And the solution was actually a public health perspective that should have been adopted. In fact, one of the physicians who was charged with managing the thing, I mentioned to them, I said we should have begun pertussis booster vaccination in the first few weeks that we had this. And this person was quite offended, but that's what we ended up doing over Christmas vacation. Everybody needed to have a booster vaccination, or they were not going to be allowed on campus second semester. So, the break served as a break in transmission, but an opportunity for immunity to be achieved on some level of protection and we had no more problem with it. We were not the only institution that year (of higher education) that had a pertussis outbreak. But the answer was immunization. The answer was not antibiotic treatment for people who may or may not have the disease. So, to me, that's another one of these examples of how a medical professional might handle these people as all potential patients and how we get out in front of it in a way that breaks the chain of transmission.
[29:57] Amy Hicks: Yeah, that's a very good example that we're not looking to treat, we're looking to prevent. And if we look into that, it's much, much cheaper too. So, it just makes sense all the time, all the way.
[30:11] Mike Gray: So, what would you say motivates public health professionals?
[30:17] Amy Hicks: I really do think there's a lot of desire to improve the community that motivates public health professionals. I said altruism earlier and all the conferences I've been to, the different professionals that I see, they put a lot of work and a lot of thought into thinking how can we make our towns better? And not just our towns, but who is at highest risk, who suffers the worst health outcomes? How can we help those people to come up to the levels that the rest of the community has? They are often motivated, generally motivated, I would say, by a lot of compassion and an interest in problem solving because these are pretty big problems.
[31:01] Mike Gray: As soon as you get to public problems, to societal problems, for sure, lots of dimensions.
[31:08] Amy Hicks: Another thing yeah, since you said that, another thing I would say that is really characteristic of public health professionals for the most part is a collaborative spirit. You can't do everything with just public health because public health requires policies, so they work with government officials. Public health requires social services. So, they work with schools. They work with DSS. They work with meeting the physical needs of people. Public health requires us to work with healthcare professionals. We're not at odds. We should be working toward the same goal. Everyone I know that works in public health is very collaborative and open to other disciplines.
[31:50] Mike Gray: So, what kinds of questions do professionals in public health ask that probably the rest of us wouldn't ask?
[31:58] Amy Hicks: We ask a lot of why questions. So, you have let's take for instance, we know that certain groups are more prone to heart disease prevalence and worse outcomes. They're more likely to die of heart disease, more likely to be diagnosed, more likely to die. Public health doesn't just say, okay, those people are so let's put them on medication. We say why? Why this group? Why are they more likely? So, for instance, the lower your income, the more likely you are to die early, the higher incidence of, in this case, heart disease. Okay, so why are they more likely to if you have lower income?
[32:32] Mike Gray: In other words, what does income have to with it.
[32:34] Amy Hicks: Yeah, what does income have to do with heart disease? And this is a pretty obvious one that we're all familiar with, but it's how we approach every disease.
So why do low income people have higher rates of heart disease? Okay. Lower education. And so therefore fewer job skills. Why is education important to heart disease? Well, health literacy as well as opportunities. Okay, so what kinds of opportunities? The diet that you can afford to eat. You're not eating a diet high in fruits and vegetables. If you live in the middle of a food desert, if you're spending $25 a week on groceries, you're not buying fruits and vegetables. You're buying ramen noodles and beans and weenies. Public health is the reason why we continue to ask these why questions. It's what public health was built on.
So, John Snow in England is kind of the father of epidemiology. So there was a bad outbreak of cholera in London and everyone else just kind of said, oh, we have cholera. Too bad. How can we treat these people? Jon Snow started saying, okay, who's getting cholera? And he started mapping the city and he found out that it was located within certain regions. Okay, what do they share in common? And he just kept asking these questions until he got down to the fact that patient zero was a baby who had died of cholera. The mother had thrown the feces, the diarrhea into a pit which leaked into a well that supplied a particular hand pump.
And so, people who came to that hand pump pumped up that well that water, drank it and got sick. And so, he said, well, let's cut off this well, cut off the hand pump. And he actually got a lot of pushback on that and he kept saying it and finally they cut off that well and immediately people quit getting sick of cholera in that area.
So that's a very public health approach. We don't just say this is happening, how do we treat it? We say why? Why these people? Why this area? Why now? And we keep looking for those links.
[34:41] Mike Gray: So a succession of whys until you have something approaching a cause and effect.
[34:47] Amy Hicks: Exactly.
[34:47] Mike Gray: You may have done this in some form, but can you give us an example of a public health principle?
[34:55] Amy Hicks: Big one we've kind of talked about here—Primary prevention is most cost effective.
So, what I mean by that in public health or healthcare, we talk about three levels of prevention. Primary prevention is when we do some activity to prevent the person from ever getting sick in the first place. So, you said vaccines. Vaccines are primary prevention. You never get sick in the first place. Secondary prevention is when we catch it early. So, a mammogram is an example of secondary prevention. We're not preventing breast cancer, but we are hoping to catch it where we can reduce it as much as possible and the patient's going to live. We can treat them much more successfully. Tertiary is where we have full blown disease. We are just going to treat this patient. We're trying to slow the progression, we're trying to reduce the symptoms, but we're treating the patient.
If we take heart disease, primary prevention says let's prevent it by eating a diet full of fiber, fruits and vegetables, reduce our sugar intake, have physical activity. That's primary prevention. Tertiary prevention is a bypass. That patient has had a bypass. Primary prevention costs a whole lot less and it is so much cheaper on our healthcare system to have shifted to that viewpoint. The US healthcare system has typically been a very tertiary type of care. So public health says let's not focus all of our efforts and our money on giving people bypasses. Let's put our effort into making sure that they eat healthy and exercise as.
[36:34] Mike Gray: Much as we're able to. As much as we can influence their choices. Right?
[36:38] Amy Hicks: And that's the hard thing. It's easier to go in for the surgery than to change your lifestyle.
[36:43] Mike Gray: I read an article that used the phrase public health in a context. I think it's related to something we talked about last time we chatted on previous podcasts. But Los Angeles, which of course is notorious for its traffic problems, is probably going to implement an automated traffic ticket system based on cameras on streets that are known to have problems with speeders. And there'll be a ticket issued if they're 11 miles an hour over the speed limit that will automatically be sent to the owner of that vehicle. And they called that a public health intervention to get on top of a problem on the prevention side of things.
[37:37] Amy Hicks: Correct.
[37:38] Mike Gray: You agree that that's a public health intervention? Because that sounds a whole lot different than preventing bypass surgery.
[37:44] Amy Hicks: It does, right? So public health concerns itself with everything that impacts health. So, the fact that we wear seatbelts is a public health prevention. The fact that we have airbags is a public health prevention. So, decades ago, when I was a kid, seatbelts were your mother throwing her arm out across you at the last minute and there was a high rate of injury and death from traffic accidents. The government came in and mandated improvements in car safety, road conditions, seatbelts. And so those seatbelts then prevented so many of those deaths.
And so, we see, even though as Americans, we travel vastly more miles than we did back then, we have fewer as a rate, we have a lower rate of death from car accidents. That's also a really good example. We've gotten used to that public health measure. But when that first came out, I remember that was pretty contentious. My grandma, who lived to be 100 years old, she hated putting on her seatbelt. And I remember her saying when I was a teenager, and I'm saying, Grandma, I'm going to get a ticket if you don't put your seatbelt on. And I remember her saying, the government can't tell me I have to wear a seatbelt. So, we take it now as like, yeah, of course you wear a seatbelt. Many public health measures are pretty contentious when they first come out because it's . . .
[39:11] Mike Gray: Somebody else telling me. So, I guess. Last question. Why should laypeople value the expertise of trained public health professionals? Sounds like there would initially, probably from a layperson, particularly if this is a new idea about prevention, be a potential collision. So, we're encouraging laypeople to give the benefit of the doubt to the public health professional. Why should laypeople be willing to give that benefit of the doubt?
[39:47] Amy Hicks: That's a good question. Public health, like any other discipline, is a discipline. It's a field of study. People go to college and get a bachelor's, they get a master's, they get a doctorate in this. There's a lot of rigorous scientific evidence that underlies what we're asking people to do. In many cases. Now, in COVID, we saw that things changed. We were dealing with an evolving situation as it came. But often there are years and years and years of studies that are looking at public health situations. But public health has become a victim of its own success.
So many things in our society are public health based, but we don't recognize it anymore because we just take it for granted. So, the water that we drink here in the US. Is very, very clean for the most part. (Flint, Michigan, had some big issues with that.) But for the most part, our water is very clean. And so, we don't see children getting dysentery or cholera. We have still a high percentage of vaccinations. So, we don't see kids dying of polio. So, we don't see the importance of these. And so therefore we can tend to discount it or say, yeah, I know that I already know that’s better.
And public health is intensely personal. It asks us to do things sometimes that put our choices and our rights behind the needs of the greater community. And so, for all of those reasons, I think people feel like public health should be my decision, it should be my own decision or they distrust it. And I think it's very fair to say public health has been co-opted to serve political agendas. And people see that, and it makes them very distrustful. But just as you go to your doctor and you get diagnosed and he diagnoses you and you're not going to an herbalist to treat your cancer, (hopefully) they have their specific field of study. We have our specific field of study. And so, in that way, I would say we have to learn to value the knowledge that other people have.
[41:58] Mike Gray: Yeah, absolutely. And I mean, that's true within the body of Christ. But there is such a thing as common grace. And people have been given abilities for the greater good not just for their own professional reputation but many of the things that we take as good things in modern society were created by somebody with unusual sets of gifts. That we now benefit from this idea that I'm not the locus of all of the expertise that I'm willing to not only benefit from but give space for other people to exercise their gifts and particularly for the greater good. And I think we're back to where we started that we're commanded to sacrificially love others and love acts in the best interests of the other people. Whether that means that I need to create a set of priorities that allows the ability of this piece to help other people even though I may not be convinced that I need it myself. That there are people who, as you say, have an expertise that when it's allowed to be applied can make a significant difference and when it has been successful, it kind of disappears.
So, I think you're right that at the point of intervention or suggestion of an intervention that might be effective, there are people who are not persuaded and fight back against the intervention in ways that really prove to be misguided over time. Once that intervention is processed and becomes part of the way we live a civilized life
[44:08] Amy Hicks: I think that tends to be a fairly American way of looking at it. Because in America, public health has for the most part been operating under the radar. Most people don't knowingly—they don't know when they come into contact with public health every day. But in many other countries public health is esteemed, it's elevated. It's something that's developing. And so, it's considered much more of a foundational discipline where we've just kind of lost that because we felt like we're good.
[44:40] Mike Gray: We don't need it right where we are. We're just fine, thank you very much. Yeah, except that we don't necessarily represent the populace as a whole. And we do need to love our neighbors as ourselves. Well, thanks for an interesting, helpful discussion, Amy. Appreciate you coming back.
[45:03] Amy Hicks: Thank you so much for having me. I always enjoy it.