Sustain or Die: The Rise of Public Health 2.0


It is a fairly simple concept that has been coming back into my mind especially after reading The Blue Sweater – a book about the journey of Jaqueline Novogratz, CEO of the Acumen Fund. If we don’t make public health integrated into people’s lives and sustainable – we will continue to fail.

Let me make it even more clear: for public health initiatives to be anywhere near effective in the coming years, the phrase sustain or die will need to ring loudly.

Sounds a bit morbid right? Well, unfortunately that’s exactly what we are dealing with these days. A deadly lack of effectiveness. According to an August study published in the Lancet – there will be an additional 65 million more obese Americans by the year 2030. That’s pretty staggering number in the next 18 years. How long do we need to look at these numbers and hear these reports before we realize that if we don’t do something drastic, effective and sustainable, the world of public health will lose out on the premise that the discipline is aimed at prevention and saving lives.

No more time for failure. Sustain or Die.

Double Meaning?

To “sustain” (according to Mirriam-Webster): to give support/relief to, to supply with sustenance, to support the weight of (no pun intended?)

To “die” (according to Mirriam-Webster): to pass out of existence

Campaigns do not sustain themselves. Multi million dollar HIV/AIDS campaigns that say the same thing to the same “troubled communities” do not sustain themselves. People who are passionate and invested in their own communities, however are sustainable. Partnerships with credible local leadership is sustainable. Building neighborhoods that encourage health is sustainable.

Coming into a community with a celebrity poster on a bus stop? Not sustainable. The celebrity gets paid and the citizens? They have something to look at briefly while waiting for a bus to take them to a job where they don’t get paid enough and gives them little time to think about getting more fruits and vegetables in their diet. Marinate.

Oh yeah. Sustain or Die.

The Death of Public Health?

Now for the morbid part. Two fold death. The field of public health in which we work to prevent disease/death is on the chopping block. Funding is constantly disappearing and professionals are a) burning out b) switching industries c) losing the passion and interest we so desperately need during these times. Terms/issues like obesity, diabetes, and heart disease have become buzz words in the media (not in a good way). Oh and culinary abominations like the triple stack Whopper continue to thrive in place of real food.

Where does that leave us? If we fail at growing sustainable new ideas for public health – the communities/populations/people that are supposedly in our care are doomed (there’s that DIE part again). Also the field of public health itself will become a shell of its former accomplishments and too, will perish for being a slow moving, ineffective, timid, business-as-usual, aging, just-get-me-to-retirement field.

So Then What?

In November of last year I brought an idea to life by co-founding the first public health innovation film festival – FastForward Health. It was a fantastic experience, not only for seeing the amazing turnout and getting some cool press, but also seeing the inspiration that was cultivated during that short time with all sorts of people interested in making positive impact in the health space. There are opportunities out there folks! Technology, food/water, the built environment – these are just a few of the main places where fresh ideas are being put into place by people who may or may not have an MPH (marinate) or a traditional health background. Urban gardens, mobile health, video games for health – it’s all very real and it’s all very necessary. This is what this blog is about and this is what I am most definitely advocating for and wakes me up in the morning!

Disagree with me? Agree? Let me know. Stay tuned for something else I’m cooking up around this that I’m hoping will add value to the next iteration of public health.

Welcome to 2012.



  1. Thanks for this article Andre! I think it’s also about meeting people where they are. It’s about apps and social tie in. I also really like empowering advocates. Giving people who already live the lifestyle to help others. We need communities around these issue. People just need the tools to make a difference.

  2. Andre Blackman says:

    Always looking forward to your input in this stuff Vinu! You hit the nail on the head as far as communities owning their public health. It’s going to become a very micro focus to make sure that needs are being met and people feel empowered (and actually give a damn) about their well being. You are absolutely right about Craig’s post – we are both on the same page and continually discuss this sort of thing. What are you up to this year?

  3. Andre Blackman says:

    Thanks for spreading the word about what PHSSR is doing, Doug! What sort of things are happening in 2012 that we should be aware of?

  4. Andre Blackman says:

    Thanks so much for chiming in Fran! You already know the ideas are heating up 🙂

  5. Amen. Sustainability is a major weakness among public health (and other social service) initiatives, and you are exactly on point in terms of local leadership and people invested in their own communities being a key aspect of improving sustainability. We need to stop dropping into communities with flashy marketing campaigns into which they had no input, and instead start facilitating their ownership of public health initiatives. As the commenter above said – bring on the revolution! Also, a side note – much of this discussion reminds me of Craig Lefebvre’s “10 what if’s for social marketing” (, which I believe you’ve written about before – his what if’s are right in line with what you are calling for here.

  6. New ideas, new research translated into practice innovations, new ways of doing business, being effective and efficient are all ways of sustaining and moving forward with public health. Public health services and systems research tries to do just that! Our practice based research networks, PHAB and academic health departments provide a way of doing new things and trying new ideas to make us better, so join in our efforts to leave old ways of thinking behind and be a leader!

  7. Great points, Andre. Campaigns need to be part of a more embedded approach that supports, guides and rewards change–in a variety of ways. Putting out glossy, slick pieces is a simple act. Many people can do it. They may inspire momentary change or brief spurts of inspiration (think of all of the new year resolutions gym ads, for example), but they won’t be there when the inspiration wanes or old patterns emerge. For that we need the environmental, political and social change I hope you’re cookin’ up ideas about now.


  8. Andre Blackman says:

    Thanks Leslie! We are in dire need of sobering if we want to stay effective in our efforts! Stay tuned for more on the blog 🙂

  9. Andre, Sobering truth! I totally agree with you! Bring on the revolution!!


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