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Abstract
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In public health practice, decision-making, and training, we often stumble when dealing with existential problems, global pandemics, climate change, food crisis, and wars, among others. These problems are complex, multifaceted, and convoluted. When the crucial question is difficult to formulate and when no answer is straightforward, they often have characteristic features of conundrums, dilemmas, and riddles. While some public health issues appear to have general solutions, such as vaccinations to control infection, the implementation of a specific solution could be plagued with challenges, just as side effects or low effectiveness of vaccines hinder immunization programs.
Public health conundrums are related to three areas of public health policy: health promotion, disease prevention, and treatment services. Public health dilemmas create situations when the answer often starts with "it depends" because one size cannot fit all. For example, during my research career, I worked with a team of public health professionals, epidemiologists, and water engineers to understand the relationship between drinking water quality and pediatric enteric infections in urban slums of India. The team warned local communities about the health risks of microbial contamination. In a separate project, working with climatologists and nutritionists, we were developing recommendations for preventing dehydration during heatwaves by increasing water intake. Here is the dilemma: When safe water is scarce or unavailable in hot summers, how could communities achieve our recommendations to drink plenty of water without harm to health?
Public health dilemmas call for in-depth discussions across fields and disciplines in search for mutually beneficial solutions. Dilemmas evolve over time--old ones are replaced with new ones, sometimes without resolutions, and thus become more convoluted. New conundrums emerge as new technologies influence public health policy. For example, rapid advance of information technology created many ways people can connect and stay connected with each other, form social groups, and find information simply using a phone. The new venues allow dissemination and update health-related information in real time. During the recent pandemic, high-quality surveillance systems and data dashboards proved their value for communicating the risks and tolls of infections with spatiotemporal resolution the public had not seen before. Local health authorities and news channels reported cases and fatalities almost daily in many countries of the world. Intergovernmental and international organizations collated information to guide massive efforts to curb the spread of infection. At the same time, misinformation disseminated through the social channels fueled social discourse and polarization. Emerging findings suggest an array of harms from dysfunctional use of social media, including mistrust, social isolation, emotional distress, and loneliness. This maladaptation to social media affects young and old, manifesting in ways similar to behaviors of substance abuse, addiction, withdrawal, and relapse. Here is the social media-loneliness conundrum: How can we enhance the benefits of information technologies in protecting public health and minimize harms of pervasive social media use?
Information technologies, including tools powered by artificial intelligence (AI), are part of social and economic processes and on the public health agenda. AI is a...
Language: en |