What we owe one another in this moment

How we engage with our communities in challenging times

This is a challenging moment in the public conversation. Across the country, there has been heated debate about issues of central importance to the health of populations and to the safety and stability of our world. These conversations have intersected with an election year which is unfolding in what is arguably a uniquely polarizing moment in our history.

It is important to note—as we engage in these difficult and at times contentious debates—that the fact that we are having these conversations at all is fundamentally to the good. It means we are taking serious issues seriously, not shying away from matters of consequence. Healthy societies are ones that have the maturity to grapple with difficult issues. There have been periods in our history when we have shamefully ignored much that we should have been talking about. The sea change of this moment, in which we no longer turn away from what needs to be said, is, I think, a sign that we are moving, collectively, in the right direction, towards a better future.

However, as these conversations unfold, it is on all of us to think continually about how they can best serve this progress. By “all of us,” I mean the broader community of those who aspire to build a healthier world. This includes those working in my home field of public health, those working in adjacent disciplines, and those who simply have an interest in creating healthier populations. Throughout these essays, I have done a fair bit of reflecting about how we, as a community focused on building a healthier world for all, can support a plurality of perspectives, all being heard, in pursuit of this goal.

The crux of these reflections might be said to be that everyone has a right to speak and be heard in a context of safety, respect, and inclusion. While I have written about what institutions should do to create such a context around speech, I have not devoted much time to addressing our responsibilities as a broader community in interacting with each other during moments of emotionally charged debate. We all belong to many communities (personal, occupational, educational) and in the context of this piece I use the term community broadly, allowing us all to think about our own communities of belonging, within concentric circles that extend to our belonging to national and global communities. I would like, then, to take a moment to share some thoughts about our obligations to each other during times of challenge like the one we are seeing now. This builds on previous writing, but perhaps takes a more inward-looking lens to ask: How can we, as individuals in a local, national, and global community, support conversations which generate forward momentum towards a better world? How can we help each other bring our best selves to debates that deserve nothing less? In trying to answer these questions, I suggest the following points can serve as guideposts for our ongoing engagement with this moment.  

1. We have a responsibility not to make anyone in any of our communities feel unsafe. I realize that the concept of feeling unsafe can be overused and that curtailing speech in the name of safety can be a slippery slope to genuine censorship. At the same time, we owe it to each other to listen when members of our community say they feel unsafe, to think seriously about why they might be feeling this way, and to make sure that nothing that is said, or done, can genuinely be construed as endangering others. And it is on us to use the resources available to a community—such as social norms, laws, and the thoughtful application of policy—to enforce the safety of our community as needed.

2. Conversations should allow space for other conversations. This means that conversations should not shut down the hearing out of other voices. That puts a responsibility on us to ensure that everyone has space to be heard, not just those of us who are noisiest. I have often found myself returning to a favorite quote from Rosa Luxemburg, “Freedom is always and exclusively freedom for the one who thinks differently.” In all our conversations, we should continually be asking ourselves: “Have we yet heard from someone who may dissent from the majority (or loudest) opinion? If not, why not? Is it because we have not done enough to make that person, who thinks differently, feel like she can raise her voice?” A community should always be a place where no one ever feels like they cannot speak because they may have an opinion that falls outside the majority.

3. We should be careful about asserting truth, recognizing that the person next to us may, in good faith, see facts rather differently than we do. We owe it to each other to be careful and judicious about data, to ensure we are not asserting as fact what is, in reality, a contested piece of information. This is particularly difficult in the moment we are in when there are so many sources of information. Gone are the days when everyone watched the same nightly news broadcast and all there was to debate was our individual interpretations of what we all heard a news anchor say the night before. Now each of us has our own media inputs, and they might be very different from those of other members of our community, making it hard to agree on key facts. Nevertheless, we must make an effort to parse the data as best we can, to arrive at some version of the truth, and, in the meantime, we can never forget that we are trying to do so in historically unprecedented waters where one person’s interpretation of facts can be quite different than another’s. This pushes us to be judicious in asserting truths, to allow that others may read data differently, and understand situations differently, and to impose on ourselves the patience to try to understand why others see data differently than we do.

4. We can never deny other people’s identity and humanity. Our opinions are, in many ways, expressions of who we are at the deepest level. The people, places, and causes with which we identify are all tied to our identity. Just as we would wish others to be mindful of this in their engagement with what we believe, we have a responsibility to tread carefully, thoughtfully, in what we say to others, particularly in contexts of disagreement. In taking issue with someone’s opinions, we should be clear, always, that we are not taking issue with who they are as a person. We can deny the veracity of supposed facts, but there should be no denying the truth of another person’s inherent dignity and worth, and our conversations should reflect this.   

5. While sometimes difficult, it is on us to assume that the person on the other side of our conversations is operating in good faith. This can be hard, particularly in this polarized moment. Yet it is both possible and necessary if we are to move forward as a society on issues of core importance. If we commit to the assumption that people we may disagree with are for the most part operating in good faith, it is possible to see how even those on the other side of the most polarizing issues are coming from a morally coherent place. This is the case for any number of important conversations, up to and including support of political candidates we may find abhorrent. We should not be in the business of assuming people we disagree with are monsters—they are not. They are human beings, and we should do them the same courtesy of assuming they come from a place of good faith as we would want extended to us. 

6. We need to devote space, time, to recognizing that emotions can run high, and that at some moments conversation is not helpful, even as other moments may demand it. In October, I wrote an essay suggesting that, in emotionally heightened times, we should take ten seconds before we speak in order to pause, reflect, and then engage from a place of compassion and respect. It is also true, of course, that sometimes the best action we can take is no action at all, simply holding space for reflection and the processing of emotion. It is on us to recognize these moments when they occur and work together to provide our community with what it needs at any given time.

7. We would do well to remember that without community and its structures, there is, well, nothing, and that tearing down the principles that support our community helps no one. And what is our community, at core? We are a group of individuals working together, ideally in a context of care and mutual support, towards our common goal of a healthier world. Within community, we can disagree, sometimes passionately. We can argue and debate. But we should do so, always, while taking care that we do not embrace modes of speech and conduct that fray the basic fabric of community. Aiming, rightly, to tackle injustice, we would do well not to swing too widely and find ourselves striking at the pillars of respect and concern for one another’s safety that uphold our community. If we remove the supports that enable us to be the kind of community that can have difficult conversations, if we seek to nullify the basic ground rules of civil debate, what is left? Certainly not space for the conversations we badly need to have. If we believe in the mission of a healthier and better world, it behooves us to do all we can to support what makes our community function—the basic principles of respect and inclusion that are core to who we are. As we continue to engage with the conversations around issues of consequence, we do right by these issues by first doing right by ourselves—by staying true to what makes the field of health a flourishing community of ideas.

As I write this, I realize that much of what I am writing about, maybe all of it, is difficult and does not come naturally, particularly in times such as these. Navigating these times requires good judgement at every level—institutional, collective, and individual. And yet, as members of a community, as citizens of a country, and as people who live in a confusing, changing, challenging world, we have a responsibility to be at our best in this moment, working together to generate light rather than just heat. My hope is that we can do just that in all our communities. That would be right by the world indeed.

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Also this week.

Thoughts with Michael Stein on how science can create space for innovation in the latest Observing Science.

A new publication in JAMA Forum with Catherine Ettman, “An Asset Framework to Guide Nonhealth Policy for Population Health.” Thank you, Catherine, for guiding this work.