Paradox of Public Health and Social Justice: Being a Professional in the Social change Process

The social determinants of health are rising to the top of the agenda in public health and other fields. Research has been demonstrating that factors like poverty, discrimination, poor education, powerless, access to healthy food and facilities, access to health care, and other social justice issues have the greatest effect on health. There are two paradoxes this challenge raise. First, public health professionals (and others) generally work in risk adverse institutions such as government, foundations, academe, and funder depended non-profits. There are few rewards, and frequent resistance to actual social change. Conflict, a critical component of change, is denied as an option. The second paradox is that unlike many other social movements, the need for scientific knowledge is substantial in health justice work, yet public health and other professionals see their knowledge and the status it gives them as disempowering. The need for knowledge in health justice gives greater power to public health professionals who are uncomfortable with (or often opposed) to having the authority in their work with disenfranchised groups. This blanket position that "the community knows best" frequently unnecessarily puts communities in the position of having "to re-invent the wheel. Many professionals see the same mistakes made over and over again, but find comfort in knowing it was a community decision. These paradoxes will need to be addressed if public health is to be a major force in promoting social justice. Some ideas and examples for how this may be better addressed in the future will be presented.