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Talking About Public Health: Developing America's "Second Language"

by Lawrence Wallack, Regina Lawrence

The mission of public health—improving the health of populations—is difficult to advance in public discourse because a language to express the values animating that mission has not been adequately developed. Following on the work of Robert Bellah, Dan Beauchamp, and others, we argue that the first “language” of American culture is individualism.

A second American language of community—rooted in egalitarianism, humanitarianism, and human interconnection—serves as the first language of public health. These values resonate with many Americans but are not easily articulated. Consequently, reductionist, individualistic understandings of public health problems prevail.

Advancing the public health approach to the nation’s health challenges requires invigorating America’s second language by recognizing the human interconnection underlying the core social justice values of public health.


Developing the language of interconnection is crucial because once the moral focus is broadened, the definition of and response to public health problems can expand. As a moral and conceptual lens on the world, individualism restricts the range of public understanding, oversimplifying complex and multifaceted problems, boiling them down to their individual roots while leaving social responsibility and collective action largely out of the picture. Although personal responsibility is undeniably a key to health, so are a range of social conditions that are shaped not just by our individual choices, but by our collective choices manifest in public policy.

Accepting C. Wright Mill’s32 challenge to “continually...translate personal troubles into public issues,”32(p187) public health advocates can help the public to see the causal connections between their own well being and that of others. All humans have needs that others must help them to meet, especially in the complex social, economic, and political systems of today. A society that accepts the reality of human interconnection and effectively structures itself so that egalitarian and humanitarian values are more fully reflected in public policy will be a society that better understands the meaning of public health and responds more appropriately to its challenges. It will be a society that not only talks about community but translates its values into caring—and more effective—public policy.

Lawrence Wallack is with the College of Urban and Public Affairs, Portland State University, Portland, Ore. Regina G. Lawrence is with the Hatfield School of Government at Portland State University.

This article first appeared in the American Journal of Public Health. Requests for reprints should be directed to Regina Lawrence at

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