A perspective on the future public health practitioner

In the centuries following the Enlightenment, scientific and technological developments gave 'modern people' an unprecedented ability to understand, predict and control the natural world. This has brought health and social benefits unimaginable to our ancestors and sets us apart from all previous generations. Yet there is a wide-ranging body of evidence that suggests that modernity is now in decline, largely because its methods and mindset are increasingly recognized as unsustainable. Problems are manifest in the emergence of new public health epidemics such as obesity and addictive behaviours, the loss of well-being and increase in anxiety and depression in affluent society, and the persistence of ever-widening health and social inequalities at national and global levels. Still larger problems now confront us, such as climate change, peak oil and the loss of biodiversity, all of which are linked to the 'modern' way of life. We are potentially faced with the collapse of certain aspects of modern society: we are certainly faced with the prospect of inevitable change. While the broad public health community has an important role to play in developing workable solutions to such daunting problems, we argue that some profound changes will be needed in order for us to cope successfully. No blueprints for dealing with change exist, which means that we will need to learn our way into the future. In this paper we take a perspective on the role and nature of the future practitioner in public health and health promotion. We argue that future practitioners will need to develop new ways of thinking, being and doing; new perspectives and new forms of understanding the world. We believe our discipline - and people generally - to be capable of such development, as insights from multiple sources tell us that human nature is malleable, not fixed. We use this analysis to trace, as examples, the imagined lives of five women living in different eras over the course of history in a Western society, and the emergence of different mindsets or worldviews, as the social, economic and cultural context changes. Post-modern analysts might insist that we have no basis for making value judgements between such different worldviews. In this paper, however, we argue that future practitioners should be empathetic to different views and willing to move beyond them, as necessary. We will need to learn and develop in ways that are compatible with our intrinsic needs as human beings and the needs of our ecosystem. We conclude by suggesting just some of the supportive processes of change needed in mapping out a more sustainable future for the public health community.