An invited presentation to the University of Bedfordshire Postgraduate Public Health Conference on 7th July 2022

1. Why is Public Health Important?
The Landscape Beyond Covid
Jim McManus, CPsychol, FBPsS, Csci, Chartered FCIPD, FRSB, FISSR
Executive Director of Public Health, Hertfordshire County Council
President, UK Association of Directors of Public Health
Jim.mcmanus@hertfordshire.gov.uk
University of Bedfordshire Postgraduate Public Health Conference
7th July 2022

2. Emerging from Covid
Trends and Challenges
• Exacerbated already worsening
trends
• Lots of misclaims about impact
of Covid (suicide for example)
• Syndemic impacts of Covid
• Cost of Living Crisis
• War
• Increasing emergent infections
Public Health
• The art and science of the
organised efforts of society to
promote and protect the health
of the population
• New knowledge means new
tools for Public Health
• Systems approaches
• Complexity
• Transdisciplinarity
• Social and Behavioural Sciences

3. Waves of Public Health – the time is ripe for behavioural and
social sciences and complexity approaches
Waves of scientific models (Biomedical to Sociological)?
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62341-7/fulltext
www.hertfordshire.gov.uk/behaviouralscienceresources

4. Impacts…what do we mean by
trauma
• La Pandémie…a surprisé, desorienté
et desorganisé dans toutes leurs
structures tous les pays du monde
Petite théologie pour les temps de
pandémie (editions-syrtes.com)

5. The Syndemic
impact of Covid,
multiple issues
for recovery
A syndemic is a synergistic epidemic
See Singer (2009) Introduction to Syndemics: A Critical
Systems Approach to Public and Community Health
Syndemic Prevention Network Syndemic Prevention
Network: Home (archive.org)

6. Why is
Public
Health
Important
post Covid?
Complexity
Syndemic impacts
Population Perspective
Inequity
The NHS is NOT “Health”
Sustainability – Economy, Society, Environment
Emerging Infections
The PH Mindset – Four Ps
Leadership

7. The Public Health Population Mindset
Understand the distribution
of risk, vulnerability factors
exposure, impact and
disease across lifespan and
social strata
•It is almost never equal, there are
always unequal impacts
01
Understand the same
distribution for protective
factors (eg social cohesion)
02
Identify what may work at
different levels
•Individual
•Group
•Population
03
Identify actions
04

8. Five Post Pandemic Societal Taks
Build Back Fairer
• Address the
structural
determinants
and causes of
inequity, don’t
just expec the
NHS to solve it
Trust and
Confidence
• Help people
build confidence
in managing risk
and confidence
in public health
communications
Sustainability
• It is crucial to our
future
Resilience
• Help people
grieve, make
sense of what
happened and
be alert to
mental health
issues. Social
Identity
importance in
“social cure”
Hope
• Help people
vision the next
years – i.e. life
after the
pandemic
hopefully. But
also prepare for
the next

9. Build back fairer to
build back better
1. ADPH recently published it’s “Living in a covid Endemic
environment guidance” Living with Covid
2. Key PH Issues – equality, access outcomes – a PH approach –
feels like some areas still focusing on how many more RMNs will
we need
3. Collective trauma, covid displaced and covid generated need (
the need generated by long covid and worklessness are just two
examples) – multiple whammies
4. Work together on a population approach – multifactorial
approach to
5. Good physical health and good mental health both vital

10. The Wider
Determinants of
Health: Poor
Housing, Jobs
which cant use
sustainable
transport
The Work of our
NHS
(eg carbon
reduction,
sustainable
footprint,
treating people)
The Work of the
Public Health
Directorate at
HCC
(Action on Wider
determinants,
evidence, data)
Our Sustainability
The Application of
Behavioural
Sciences and
Psychology to
Behaviour Change
The Work of District
and Borough
council
Environmental
Health Teams (Like
HCCPH Directorate)
Example, the Five Pillars of Sustainability from a Public
Health Perspective
Partnership. Shared Understanding of Issues.Shared Ambition
Sustainability is a major Public Health issue (i.e. one which affects the health of the public)
but requires a system response

11. 5 Skills PH Officials Need
a new concept of leadership?
Translate
Translate
Science
Frame
Frame
how you
move
from
Evidence
to
Decision
Think
Think Big,
( think
complex,
think
systems)
Spend
Spend
your
Political
Capital
Wisely
Think
Think like
a lawyer –
(in a
British
context
rationality,
proportio
nality,
fairness)
5 Skills Public Health Officials Need to Combat the Next Pandemic (hbr.org)

12. A Public Health Matrix for Recovery
Different
Populations,
Different Issues
Lifecourse
Perspective
Resilience
Self Care
Early
Identification
and Response
Recovery
Normalise, DO NOT MEDICALISE
Meaning, Hope, Questions of Ultimate Concern, Spirituality, Faith

13. Let’s talk about Leadership.
Four Domains of Leadership
© AshridgeHult
Time to rethink and nuance
leadership for recovery and health
equity in our new complex world
Personal Interpersonal
Technical Contextual

14. Collective
trauma, Grief
and grievance
the psychological upheaval that is
shared by a group of people who
all experience an event.
This type of trauma can affect
groups of people of any size,
including entire nations or
societies.
https://www.ncbi.nlm.nih.gov/pm
c/articles/PMC6095989/
When grief may turn to grievance

15. Mental Health : A PH Priority Set
Ensure people with clinical levels of need get service provision respond to clinical need
with a recovery focus
Recover some fundamental things we need and have lost. Good end of life prep for
relatives. Good Bereavement support. Normalise grieving as work and make it easier
Psychological resilience and wellbeing in Organisations (workforce) – traumatised
workforce, collapsed economy
Resilience, recovery, grieving and pro-social culture among population at large – get
upstream, pre-clinical with grieving
Address specific issues for each lifecourse stage in a preventive way – intervene using
existing settings and systems to reinforce positive identity and coping

16. Communications Principles – Public
Health meets Psychology
• Invoke shared identities
• Invoke “our group” values
• What we do do not just should do
• Inclusion not sitgmatizing or blaming
• Self-relevance of information
• Don’t equate measures with restrictions or
freedom
• Support is better than coercion and threats
EXAMPLE
• Hertfordshire Self-Isolation Comms
• “Play Your Part”
• Elected Members. Information Champions Evidence-based guidance on COVID communications :
Public adherence : Groups and COVID : University of
Sussex
How do we communicate for better in a fractious
world full of misinformation?

17. Community
Recovery and
Cohesion
1. Build on every bit of what civil
society has done. Saturate people
with social norms of co-operation
2. Visible, Authentic, Compassionate
Leadership
3. Social support intimately links
with social identity – reinforce
and work with it. Understand and
work with group norms not again
4. Evidence based and pre tested
communications strategies. And
Listen don’t just transmit
5. Identify and use trusted leaders
6. Build shared identities
7. Build narratives of possibility “We
can”
8. Accommodate the Public Urge to
Help
9. Keep Listening
10. Be careful on lessons from
radicalisation. These can backfire
• Multiple lessons – twelve lessons
from Drury et al which should be
read carefully (some of them on
list on left)
• Frontiers | Facilitating
Collective Psychosocial
Resilience in the Public in
Emergencies: Twelve
Recommendations Based
on the Social Identity
Approach | Public Health
(frontiersin.org)
• Lessons from Leadership
Psychology
• Authenticity
• Compasision
• Discernment
• Agility

18. 5 Skills PH Officials Need
a new concept of leadership?
Translate
Translate
Science
Frame
Frame
how you
move
from
Evidence
to
Decision
Think
Think Big,
( think
complex,
think
systems)
Spend
Spend
your
Political
Capital
Wisely
Think
Think like
a lawyer –
(in a
British
context
rationality,
proportio
nality,
fairness)
5 Skills Public Health Officials Need to Combat the Next Pandemic (hbr.org)