Gabriel Scally: If it isn’t controversial it isn’t important

A standing ovation greeted every paper delivered at one of the sessions I attended at the American Public Health Association annual meeting in San Francisco. I thought the first paper or two were good, but the standing ovations seemed generous to a fault. Then it dawned on me that the session was organised by the physical activity section of APHA and they took their duty to help people avoid being sedentary very seriously indeed. I’m told that the paramilitary wing of the physical activity community stack the chairs away and everyone stands throughout their gatherings!

This admirable enthusiasm for physical activity doesn’t seem to be universal, however. My hotel is 0.4 miles from the conference centre and it takes about eight minutes to walk. Despite this proximity a regular shuttle bus is provided as it is deemed to be beyond the distance that is easily walkable.

One of the reasons for going to faraway meetings is to hear about things that you would never otherwise stumble across and, hopefully, bring some of these ideas to life when you get home. My favourite so far has been the idea of the “Medical Mile” in Little Rock, Arkansas.

Doctors raised the money to pay for the construction of a mile long stretch of a riverside trail in the centre of the city. It is an outdoor linear health museum that encourages exercise in an environment enhanced by artistic and architectural expressions aimed at promoting the health benefits of physical activity and other elements of wellbeing. It would be wonderful to see the health professions in other places copying this great idea and raising a banner for primary prevention.

The use of social media has been a feature of the meeting. It’s a Twitter intense environment and the veritable storm of tweets on the meeting hashtag comes in so fast that it is virtually impossible to keep up. It also seems, perhaps because of the huge volume of tweets, that there is very little critique emerging in the twittersphere and most tweets are promotional or giving information rather than discussing or debating issues. This may well be a highly unfortunate, and perhaps unavoidable, consequence of the enormous size of the meeting.

“If it wasn’t controversial it wouldn’t be important” was my quote for the day. I love expertise, passion and commitment in public health. To see all three of these together gives me hope for the future of a specialty that suffers badly in times of recession and retrenchment. The quote came from Alexandra Desautels who presented brilliantly on ‘Prosperity Project: Systems change for health and economic equity‘.  She was talking about what they were doing in Alameda County, California to push for economic security for individuals and the community as an important component of health equity.  It was impressive to see public health engaging with serious issues such as loan-sharking. Alexandra epitomized the gutsy attitude we need to push forward on public health. Great stuff.
Gabriel Scally is Professor of Public Health and Planning at the University of the West of England and Honorary Professor at the University of Bristol.