Helen Barratt: Public health – sewers and kebabs?

I’ve begun to dread new social situations. Since starting training in public health, I’ve yet to work out a way to succinctly describe what it is I do. When new acquaintances look baffled at mention of primary care trusts, I usually find myself muttering about working in an office for the NHS. Small wonder they look confused. A medical friend asked me recently if I’m involved in “shutting down dodgy kebab shops,” whilst one relative – a former nurse – remains convinced that I spend my days down sewers.

The definition of public health as “the science and art of preventing disease, prolonging life and promoting health through the organised efforts of society,” first coined in 1988 in the Public Health in England report by Sir Donald Acheson, sounds very grand, but doesn’t really help my plight. The UK Faculty of Public Health describes three domains of the speciality, which are a bit more useful: health improvement, improving clinical services, and protecting the health of the public from threats such as infectious diseases. I suppose the latter encompasses sewers, kebab shops and environmental health more generally, although thankfully these don’t fall within my remit.

Whilst working as an SHO in gastroenterology (undeniably easier to explain at parties), my colleagues were baffled when I confessed to having applied for a public health post, and – despite what my husband says – I didn’t do it just so I could wear high heels to work. I’m still using my medical knowledge, but have also been introduced to a vast range of other topics, from economics and management, to sociology and psychology. I also get to pursue my interests in writing, medical ethics and epidemiology, which got neglected when I was doing hospital medicine. I can’t say I miss the on calls or nights either.

I’m completing an MSc at the moment but, over the coming months, I’ll be returning to my Primary Care Trust, and spending some time at my local health protection unit. As an academic trainee, I’m also working on a health services research project examining the delivery of care for patients with severe head injuries. I’m looking forward to learning more about the apparently hidden world of public health, and hopefully convincing you that there’s more to it than sewers and kebabs.

Helen Barratt is an Academic Clinical Fellow in Public Health Medicine in London

For more on public health, read blogs by Sarah Chen (Defining public health  and Remoralising health policy)