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Don't kid yourself. By its nature, public health work is always political and it's frequently controversial. In Massachusetts, there were battles when the colony tried to control smallpox during the 1700s. In recent years there have been political battles associated with AIDS/HIV and with COVID-19 and with lung cancer, nutrition, substance abuse, energy justice, and a long list of other public health concerns. No need to look for controversy. If you're involved with public health work , controversy will soon appear to pound on your front door. It happens in every decade.

Public health workers need a better understanding of public health history and public health philosophy. There's also a need for some political "smarts." Much has been learned during the COVID crisis and more lessons are being learned because of the public health impact of climate change. The summer of 2023 was filled with disasters. There were hundreds of forest fires in Canada and the air pollution that resulted was measured in Boston. Expect some additional climate

problems for medical and public health workers during future months.

"When should we speak?" Community groups, especially, are starting to ask questions about health equity and about the social, economic, and environmental determinants of public health. In Massachusetts, some of the neighborhood groups that have questions about public health are active near schools of public health and medicine. Local people will soon arrive at the universities to ask their questions. Try to be helpful.

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The call for civil, respectful and knowledgeable discourse is fundamental. Our words, as well as our silence, convey communication and messages.

I fully support the emphasis to focus on topics relevant to public health (although, when you consider this, there's not much that falls outside our purview...). Although we unfortunately tread a thin line in calling for a cease-fire on humanitarian grounds related to the devastating consequences associated with the war in Gaza, to fail to stand up for for human rights diminishes our humanity.

APHA faced these challenging issues during its Annual Meeting in 2023. Passionate discourse sometimes had to be curtailed when it veered into ad hominem attacks. Despite the levels of disagreement, however, APHA's Governing Council was finally able to craft a statement that advocated for a cease-fire without casting blame on either of the opponents.

Speaking truth to power is never easy, but it is essential. By refining our thoughts and words and focusing on fundamental tenets of public health, we can potentially bring some light, not heat, to this voluble conflict.

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One of the challenges for HOW academics to speak out is that deans, instructors, researchers have a position of authority. It can be hard to make space for other ideas. Will students and colleagues feel comfortable disagreeing. Seeking opportunities for 2-way conversations, debates, dialogues as opposed to one-way speeches and protests will be important when speaking out.

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