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Epi Wit & Wisdom Resources
Advocacy Advocated at
Prevention ‘90
Faced with shrinking federal
dollars, the public health system is finding itself between a rock and
a hard place. Not only are most state health departments overburdened
with the care of the uninsured and underinsured, but the very people
they are trying to serve view them as being part of the problem, not
part of the solution.
This poor public image is cited
as a barrier to effective action for public health officials in “The
Future of Public Health”, a report by the Institute of Medicine
published late in 1988. Such barriers can be very difficult to
overcome, as pointed out by panel members during a session of
“Prevention 90,” a conference held April 19 - 22 in Atlanta, sponsored
by the Association of Teachers of Preventive Medicine and the American
College of Preventive Medicine.
“We must develop a greater force
of advocacy for what needs to be done, what is being done, and who’s
doing it,” said Lester Breslow of the University of
California at Los Angeles, and one of the authors of the IOM report.
“We shouldn’t be wringing our hands about it (the poor image); that
doesn’t do any good.”
Breslow, speaking to a crowd of
about 650 health professionals, made clear that advocacy is the most
important action that can be taken to straighten out the disarray into
which public health has fallen.
The Advocacy Bandwagon
In a separate workshop at
“Prevention 90” entitled, “Politics of Prevention: Getting Your Fair
Share of the Pie,” several helpful hints were given for those who are
considering jumping on the advocacy bandwagon. While the following
advice might make the ride less bumpy, lobbying for federal funds is
never an easy task.
“The money doesn’t flow down
from heaven,” said Katherine McCarter of the American
Public Health Association. “It happens because there are a lot of
people working very hard.” McCarter recently found herself listed in a
book of the 100 most influential lobbyists in Washington.
Here are a few do’s and don’ts
to remember if you want to play an active role in advocating for your
topic:
• Make a decision to do
something.
McCarter stressed that members
of Congress desperately need information. “When you go to the Hill,
staffer after staffer after staffer will tell you, ‘We don’t hear
enough about public health’.”
• Be in touch with your
associations.
They can keep you updated on the
status of your topic. Assistant CDC Director in Washington
George Hardy pointed out that it is important to also get
agreement from everyone within the organization you’re dealing with
before you begin your lobbying. “This is especially critical at the
local level,” he said.
• What’s your message?
“Know what you want, and be
specific,” advises Hardy. Congressmen are usually always pressed for
time, so the more clearly and succinctly you can make your point, the
better. He also recommends having a one page “fact sheet” listing what
you want and the justification for it. McCarter said to provide
information on how your program will affect the back home crowd. After
all, they do want to get re-elected.
• Never lie or even exaggerate.
Credibility is one of the most
important characteristics to have in Washington, and once it’s lost,
it’s gone forever.
• Know, understand, and be able
to respond to your opposition.
“If your Congressman is going to
go to bat for you,” said Hardy, “he needs to know what he might be
facing.”
• Be appreciative.
“This should be common sense,”
said McCarter, “but so many times, people forget to say thank you.”
• Don’t expect to get all that
you ask for.
Also, don’t ask for too much
more than you need, expecting to have to compromise, and then end up
with what you really need. “It doesn’t work like that anymore,” said
McCarter.
• Don’t forget about the media.
“Editors don’t just wake up and
say ‘Oh, I think I’ll write an editorial about public health’.”
McCarter pointed out. “They probably got a letter from someone about
what they were doing.” Also Hardy said, “Be available and responsive.”
If a member of the press wants an interview with you, it’s in your
best interest to try to accommodate him or her. You might also want to
identify a contact person within your organization to deal with calls
relating to your project in case you can’t be reached. Make sure that
person knows how to respond to certain questions, said Hardy.
• Reach out to others in your
community.
Other constituencies might also
benefit from your proposal--get them involved. If your Congressmen see
that the issue is important to more than one group, you stand a better
chance of succeeding.
Published April 1990
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