Imagine Doing Better: Public Health, Prevention & the Power of Writing with Dr. Paul Fleming

What if the biggest challenges facing our communities—from healthcare and housing to education and public safety—could be addressed by thinking upstream?

In this episode of IDEA Exchange, host Miranda Bosse sits down with Dr. Paul Fleming, Associate Professor of Health Behavior and Health Equity at the University of Michigan School of Public Health and author of Imagine Doing Better: Why Policies Backfire and How Prevention Thinking Can Change Everything. Together, they explore how a prevention mindset can transform the way we approach public health, policy, and systems change. 

Dr. Fleming reflects on his unexpected path into public health through the Peace Corps, the importance of community partnerships, and how listening, relationship-building, and co-learning continue to shape his work as a researcher and educator. He also shares the inspiration behind his new book, discussing why public health perspectives belong in conversations about criminal justice, education, housing, and other societal challenges—not just healthcare. 

Throughout the conversation, Dr. Fleming offers a hopeful vision for the future, encouraging listeners to imagine healthier, more equitable communities by addressing root causes rather than reacting to crises. Whether you're a student, educator, policymaker, or simply interested in creating positive change, this episode offers practical insights on prevention thinking, systems change, and the power of collective action. 

Order Dr. Fleming's book, Imagine Doing Better, here. 

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Transcript

Speaker 0:00

Hello, everyone, and welcome to Idea Exchange, a podcast by the Association of Schools and Programs of Public Health. I'm your host, Miranda Bosse, and today we are joined by Dr. Paul Fleming, who is Associate Professor of Health Behavior and Health Equity at the University of Michigan School of Public Health. Dr. Fleming is also the co-founder of the Collaborative for Transformative Public Health and author of the new book, Imagine Doing Better: Why Policies Backfire and How Prevention Thinking Can Change Everything. Dr. Fleming's work focuses on the root causes of racial health inequities and the policies and systems that shape community well-being. Through his research, teaching, and partnerships with community organizations, he challenges us to rethink how we approach prevention, equity, and social change. His work has been featured in major journals and outlets, including NPR and the Detroit Free Press. Dr. Fleming, thank you so much for joining me today. I'm really excited for this conversation.

Speaker 1 1:03

Yeah, thanks for having me. Excited to talk.

Speaker 1:05

Yeah, absolutely. So first, I really want to dive into kind of where you got started in your career. So you have built a career at the intersection of, you know, public health, equity, and systems change. So first, what drew you to public health? And when did you realize that this was what you wanted to dedicate your life to?

Speaker 1 1:26

Great question. I always love starting, starting at the beginning. And for me, you know, I think in a way I ended up in public health by accident. I always was interested in tackling big problems. I was interested in policy as an undergraduate. But quite frankly, I didn't have that much of an interest in health. I, I, you know, a lot of people's path within public health is, oh, they wanted to be a doctor or a nurse, but then they stumbled upon public health and realized that was the type of work they wanted to do. In a way, that wasn't me at all. I was, I was never drawn to life in the medical field. I was much more interested in politics and policy making. But then along the way, I stumbled into the field of public health. And it was really through uh Peace Corps. I was a Peace Corps volunteer in Nicaragua. That was something I did right after my undergraduate. And I was really interested at that time in living in a different country, uh, giving back to communities and partnering. It sounded a bit like an adventure. And they assigned me to be a health volunteer. And that was sort of the accident that really pushed me into the career that I have now. Because once I got going doing that work as a health volunteer in Nicaragua, I started to realize, wow, this is really, I really love this thing. And ultimately, what they assigned me to do, I was essentially a community health worker working alongside and in partnership with the community I lived in in Nicaragua. And we did health promotion, we did different education activities, we tried to organize among different uh organizations in the town. And I started to learn what community-based public health really was. It was trying to enable folks to have the opportunity to live a healthy, happy life. And that was the piece that that really sort of grabbed me because I knew I wanted to make change in some way. I knew I wanted to contribute to the greater good. But before that, I didn't, I didn't know exactly in what specific area. And I started to see health as, you know, not an end in and of itself, but health is is along the pathway to happiness and thriving. So when we think about building healthy communities, that's sort of a prerequisite for thriving communities. And a lot of people really care about health. And so it's it's also a hook and an anchor for people to come together to make change in their communities. And so that's ultimately what hooked me. And from there, I went on to pursue a master's of public health to get more grounded in training and and ultimately on the research path I'm on today.

Speaker 4:09

Wow, that's so interesting. You know, how you just kind of stumbled upon public health, right? That you were never really intending on going into that. So hearing your story of, yeah, I was interested in politics and policy, and then here you are doing, you know, community-based public health work. And now how you've transitioned into what you're doing today. And so I think so many people enter this field through, you know, different lived experiences or moments that fundamentally change their perspectives and help them see, okay, this is really what you know I'm meant to be doing. So it seems like your early experiences and your career really had a lasting impact on your perspectives. So, what lessons from your experiences still shape your work today?

Speaker 1 4:50

Absolutely. There, there's so many. When I think about the work I'm doing, I am constantly reflecting back that, oh, I'm actually using a skill that I learned back back at the very, very start of my career, right?

Speaker 3 5:04

Yeah.

Speaker 1 5:05

So one of so a couple of those things, and some some of the listeners might not be that familiar with Peace Corps, but one of the things that uh, at least in my experience with the Peace Corps, really drill into you is the importance that you are not going somewhere with the answers, you are not going somewhere with all the knowledge to, you know, bestow on some other community. But rather you are there to listen, build relationships, understand a community, and then, you know, figure out where do you fit in? What, what, what do you have to share that might may partner well with what they are trying to do or what problems they're trying to solve. And and ultimately, that's how I try to approach my work today. I do a lot of community-based participatory research, which means that I partner with organizations and try to understand what their needs are, what type of research they want to do, what type of information do they have, what knowledge do they have. And then where might my skill set or my resources fit in and partner with that? And I think that's the power of public health. And it's it's something that I learned early on. And you know, one of the things they they really taught us was the first few months that you are living in that new community, in my case, it was a community in Nicaragua. The first few months that you're living there, don't try to do anything. Or rather, the thing that you're trying to do is build relationships, hang out. Just uh just sort of be getting to know your neighbors, getting to know the people you're working with, ask them questions, learn more about what makes them happy, what is a struggle for them. And you start to get to know the life and the needs and the joys of a community. And that's when you can, that's when you can start to do work together that is really meaningful. And so again, that that ethos I try to bring into my work today, that I'm not somebody that's coming to you as an expert with all of the answers, but rather I am coming to you as somebody with some experience, some lived experience, some knowledge, some skill sets, just like you have skill sets and knowledge, just like the communities I work with have skill sets and knowledge. And we're gonna see how those pieces fit together so that together we can make a stronger solution. And so that that's really something that I learned in those early days, frankly, before I even knew what public health was. But then as I got formal training, really learned that that is that is a core part of our field as well. And so I've carried it with me even today.

Speaker 7:41

No, I love that because I think the core of what you're sharing is relationship building and conversations and really just getting to hear people where they're at, meeting them where they're at, and then figuring out, okay, how do we move forward and you know, build stronger together? Um, and that's kind of what we're doing here, right? Like sharing stories, getting to know each other. How did you start out, you know, in one place and get, you know, from point A to point Z? So I think that's that's really apparent in the work that you're doing. So I appreciate you sharing that perspective. You know, one thing that stands out in your career is how consistently you've worked across various disciplines, you know, kind of in uh community-based work and now in education, you know, really in your public health leadership. So you've spent a lot of your career as a public health faculty member and also as a researcher, you know, and a public health educator. So, how has working with students and of course these future public health leaders uh really influenced your own thinking and approach to your work today?

Speaker 1 8:42

Students, I think, are so inspirational in a lot of different ways. And I can think about kind of key career points over the last decade. Uh, I just I just realized that I've been a faculty member for 10 years as of this month, which is which is pretty wild to me.

Speaker 8:58

Congrats, that's exciting.

Speaker 1 9:00

Thank you. Yeah, yeah. It's it it's uh surprising. It's just like kind of coming, coming to realize you had a 10-year high school reunion, or in my case, 20, and it's a little bit mind-boggling. Um But, anyways, along the different way, I remember early in my career, you know, students really pushing me. I I had, of course, come from my own experiences. I already mentioned Peace Corps, but my my graduate school experience, getting different internships, doing research projects in various parts around the globe. So I was coming into faculty life with certain ideas and perspectives and and and training, frankly, that I thought was really important. And along the way, it's been students that some somewhat times push me into new directions. And, you know, now it sort of makes sense, but in some ways, I mentioned that I started from a place of being really interested in policy and politics. And then I found public health. And frankly, while some of my public health formal training did include policy and politics, it actually was more in the realm of behavioral sciences and in the realm of building interventions, which isn't always policy, although it sometimes can be. And so as I started faculty life and started teaching students, it was my students that were really pushing me of like, but what about the policy change? Look at these policies. This is what needs to transform and change. And you know, of course, it was something that I knew and had inside of me, but I think somewhere along the way, it became slightly less of a focus. And so students were able to push me in that place. Um, along the way, I've learned different advocacy and organizing from students, watching the ways in which they push their own institutions or their own communities to be more equitable. And so I think I really think of the faculty-student relationship as it's it's a co-learning relationship. So, yes, I do have things to share. Yes, I do have things that I want you to read and learn and that are going to be important for your own trajectory. But to think that I don't have things to learn from them and their experience and what they're bringing to the table just isn't true. And so I try to set up classrooms in a way that it is a it is a co-learning environment and that we're all learning from each other, students from students, uh, students from faculty, and faculty from the students. And so I think it it really has shaped me. I I have, as I have gone through the career, I have seen uh I have seen new things, I learned new things from students, and it's kind of shipped my perspective.

Speaker 11:41

Yeah, no, I think that's really interesting to hear, right? That it's always a kind of give and take, a co-learning situation that you're in with your students. And that really just speaks to that lifelong learning element that is public health that you're always learning from, whether it's the community researchers uh that you're working with, the community members that you're working with from your students, and vice versa. Then of course you're giving back to those students and those individuals that you're working with. Um, and so the the wheel just keeps on turning, right? You're never stagnant in what you're doing. Um, so I want to touch on something that you kind of mentioned and these different interests that you've had and different segments of public health that you've worked in, because I think sometimes public health can feel a little bit fragmented, right? Like healthcare can be in one lane, policy in another, community work in another lane, but your work really kind of pushes against that fragmentation, that separation. You know, much of your work seems to focus in prevention and equity and community partnership. And so, at what point in your career, or was there a point in your career where you really started to see prevention not just as a public health strategy, but as a much broader framework for addressing societal issues?

Speaker 1 12:49

Great question. I I wonder, I wonder when exactly that happened. But I think one of the things is that just like I mentioned, that I kind of I stumbled into public health. Health wasn't always my focus. And so I think part of what that did for me is the lens that I was bringing always to the work I was doing was much broader. It was, it was about bigger systems and policies and other things. And while I might work on projects that had a health focus, I was I was seeing all the perspectives and tools that we have in public health and really thinking, well, wow, these these could be applied across the board. These could be applied. And when we think about conversations that are happening in immigration policy spaces, or we think about conversations that are happening in criminal justice reform, for example, they're not always using a public health lens. And I think one of the one of the key moments for me was um locally here in Ann Arbor, there was uh some different efforts to really think about what public safety looked like in Ann Arbor, which means thinking about not only reducing the potential harms of police violence, which is you know a big concern, but how do we think about building public safety systems that aren't solely police focused? Rather, we are uh bringing social workers and other people who are conflict de-escalators to emergency situations. So really building that kind of care support within a community. And I started to enter into those conversations, both from kind of my interest as a community member to build public safety systems that I felt like were equitable and were going to be less harmful for people. So that was on a personal level. But on a professional level, I also knew the research on the harms that police violence can have on communities, not just the person who's harmed, but the wider community. And so I had a sort of professional interest in that as well. And I started to share public health research with folks who are not in public health, who are more in the policy-making space or the advocacy space. And I started to share the public health perspective on things like police violence. And I would see their eyes kind of open up and and and be really interested by the idea of, oh, we could, we could think about this from a prevention angle, or oh, we could think about this from providing care for people. And not to say that these people never had those thoughts, but it became clear to me that we were working with a framework in public health that really could be applied across these other spaces and be really impactful. And so that's what started to really open my eyes of okay, it's this issue in my city, but it's also when we think about any transportation policy. It's also when we think about how we structure our education system. It's also about how we think about our budgets in a in a community or in a state. And so that really got me kind of going along that path.

Speaker 16:00

Okay. No, that's that's really interesting to hear, right? How one thing, again, kind of builds off another thing, and you start to see those connections. So that broader framework really seems to come together. Um, and of course, I've seen that kind of come together in your book, Imagine Doing Better. So I now kind of want to talk more about that because this book really invites readers to think about what's possible when we prioritize prevention and really think about systems level thinking. Um, so your new book, you know, Imagine Doing Better, it really marks a shift from academic and policy writing to writing for a broader audience. So, really, first, what inspired you to write this book at this point in your career? And could you share a little bit more about this book for our listeners?

Speaker 1 16:45

Absolutely. I was inspired to write the book primarily because I was interested in reaching a broader audience than just consumers of public health research. And while I love consumers of public health research, they're some of my favorite colleagues and friends, and I work with many of them. We know that that is ultimately a limited subset of the world, right? It's it's a small group. And so I do still think it's important that we are publishing research. We are communicating with other researchers, and we're sharing that sort of um that detailed research with the world. But I really felt like we had so much more as a field, and we have so much more perspective to offer some of the biggest conversations that we're having in our world, in our politics, in our communities. Some of these wicked problems that sometimes people talk about related to climate change, related to violence, uh, those wicked problems, we have tools in public health that that speak to them. And of course, we have people that work on them, of course. But I started to realize, you know, if we only focus at the small research project level and make sure that we communicate our very specific findings in journals and even out to the world. Maybe we're good on social media and other things, we're sharing our research findings. That research, still at the end of the day, is just a tiny little nugget of information. Whereas we have something that's a little bit bigger, that's more like frameworks, ideas, perspectives, and mindsets that we use in public health. And I don't want to say that they're solely within public health, but we have some of these uh mindsets. And that mindset shift is really something that when we think about policy change, we need our residents and our voters to shift their thinking, ultimately our policymakers as well, to shift their thinking to better consider uh a long-term perspective and thinking about how do we prevent harms before they happen? So you asked what the book is about, and it and it's ultimately about this prevention thinking mindset and using a long-term perspective to think about what do we have today, what do we need sometime in the future, and that future kind of thinking long range, the next generation, future generations, right? What is it that those generations need to thrive? And then how do we use the tools of working together across communities, building trusting relationships to start working and chipping away at building that future? And so the the book invites the reader to use their imagination, use their imagination to really envision that future world, then to reflect on the current systems and policies that we have and see really who are those policies working for and who are they failing? Because we are leaving a lot of people behind with our current approach. And then finally, thinking about what is the action that we need to take together? What are the steps, what are the concrete things that we can do today, this week, this month, this year, to start building towards that that better future. Those wicked problems are not gonna go away next year. They're gonna they're gonna endure for decades, likely. But what we can do today, what we can do this year is take the next step towards solving them. And that's that's kind of how we gotta orient our thinking is right now our job is to take the next best step towards it.

Speaker 20:28

No, I love that. So I I think that's really applicable, right, to everything that we talk about in public health. And so I totally, you know, can see the intersection of all these different things that you've done in your career coming to life in this book. And and even just the first part of the title, Imagine Doing Better, right? Positioning the reader to imagine a better future for not just themselves, but communities and you know, individuals as populations as a whole, excuse me, I think it is really powerful and really inspirational. And so writing for a general audience is a very different challenge, I'd imagine, than writing for academic journals or, you know, of course, policy audiences. It requires a lot of clarity, uh, storytelling, and of course, accessibility. So one of the central ideas in your book is prevention thinking, which of course you were just talking about. So, you know, how would you explain that concept to listeners a little bit more who may not come from a public health background? Um, and how do we start, you know, envisioning this in our daily lives, that prevention thinking concept?

Speaker 1 21:31

I think in public health, what's what's fun about our field is we already have a really wonderful parable about prevention thinking. And it's the the parable of the the river, right? Where there's somebody drowning in the river and you go to save them, but then all of a sudden you see another person at the same spot drowning in the river, and you go in to save them, and it keeps on happening. And you finally sort of ask the question of what is happening upstream that is forcing people to. End up in this river and be drowning.

Speaker 3 22:02

Yeah.

Speaker 1 22:02

And so it invites it invites really us to think about different solutions, right? That that parable demands that we say, we can put a lot of energy into staffing that part of the river with lifeguards. We can put a lot of energy into making sure that there are life preservers there. And we can probably spend millions and billions of dollars doing that thing. But what if we shifted our perspective and thought about not just preventing the harm that was happening right in front of us, but really stepping back and thinking, what is the root cause of what is happening right now?

Speaker 3 22:38

Yeah.

Speaker 1 22:39

What is real, what is really going on here? And then invest money in that place. And what you find from the parable is that you in by investing money upstream to prevent people from falling in the river in the first place is going to be a much better use of resources. It's going to save money, first off. But second off, people aren't going to have that traumatic experience of falling in the river and needing to be saved. So it actually prevents the harm to the individual and it saves us money. And so that's, I think, a key shift in mindset that we all need to be making is yes, sometimes the changes we need to make do cost money. But so does our current system. Think about how much money we spend on healthcare in our current system. It is astronomical.

Speaker 23:28

Yeah.

Speaker 1 23:29

And so we, if we we can switch that investment and shift it in a way so that not only are we probably ultimately saving money, but people are avoiding having to become sick in the first place. They're avoiding having that bad thing happen to them in the first place. So that's better quality of life as well. And so I think those are the important pieces, and and we do need to get better as a field, I think, at talking and telling those stories in ways that are compelling to people. In the book, I try to tell many other stories about how this works in specific uh realms of policy or in community. But I think that that parable is really an anchor point for our field and the idea of prevention thinking.

Speaker 24:15

Exactly. And I think, you know, you hit the nail on the head there, right? That instead of thinking about how do we think, oh, what's the problem upstream, but addressing it right in the moment, that root cause is so essential. And then from the public health standpoint, how do we communicate that better with different audiences that we may or may not, you know, regularly work with? And so I think that that's something that, you know, your book has done so well. Um, and so I really appreciate you sharing that perspective. This book examines systems like healthcare, criminal justice, education, and housing, of course, through this prevention lens that you've been talking about. So, was there one issue or example that surprised you the most or challenged you the most while writing this book?

Speaker 1 24:57

Yeah, I think about the chapter I wrote about our criminal legal system. And in many ways, the research were findings that I was already familiar with when I sat down to write the book. But it's a whole nother thing to really be crafting a chapter and writing around the fact to actually put on the page and in the same paragraph just how much money that we are spending on imprisoning people. It's in the billions and billions of dollars. But then right alongside the finding that, you know, and this is research that shows this for every year somebody spends in prison, their two years is taken off their life expectancy.

Speaker 3 25:37

Wow. Yeah.

Speaker 1 25:38

And to me, that really just underscores a really critical fact about uh prevention thinking, which is we are investing billions in taking away life expectancy. Now, of course, and and there's also other research that shows that it's not just the person who's imprisoned who is harmed, but their families, their communities also experience worse health outcomes. So that's what the data shows. But you know, we can dig in, there's a lot of different stories of individuals where it really kind of breaks your heart the way that they and their community and their family were impacted by by these systems and these policies. And so I think that's that's one example that I think about because it really highlights the differential investment. What if we took those dollars and for example, it costs about $42,000 a year to incarcerate someone for a full year, which is about the median wage in the US. So what if we took those dollars that we are using to incarcerate and we invested it in individuals, individuals th thriving, right? Or communities. That person would be better off in our communities would be better off because that person would have a better pathway to contributing to their community.

Speaker 3 26:55

Sure.

Speaker 1 26:56

And so it's again this differential investment that we need to be paying attention to, not just what we're doing, but what are we not spending money on that we could be spending money on.

Speaker 27:05

Mm-hmm. No, I appreciate you sharing, you know, some of the uh different examples and perspectives that you shared in those chapters. Um, and so I encourage, you know, individuals to read it because it you really do kind of expose, you know, to your point, some of the expenses that are happening within these systems. And then the flip side of, well, if we we change some of those expenses and invested in quality of life uh or, you know, rerouted some of the way these things are being done, how could that actually change life expectancy or change population health, which is really essentially, you know, what the book is about, right? Imagine doing better. Um, and I think that's that's really important to kind of shift that mindset for people. And so this systems level perspective, you know, that we've been talking about is something that many academic books, you know, kind of struggle to communicate in a relatable way to different audiences. But your writing feels very intentionally accessible throughout this book. So, you know, academic work is often written for specialized audiences, of course, you know, academics and researchers. Um, but you know, this book has a personal sense to it, a very human-like approach to it. So, how did you balance, you know, this very rigorous evidence in your book while also communicating that storytelling aspect and having that very personal connection in your writing?

Speaker 1 28:23

Yeah, I'll have to admit, it was it was a challenge, especially at first, uh, to sort of strip away that academic style of writing and that real need to anchor everything in data. I think we've learned, especially lately, that data is important. It's vital when you're communicating, but you need to be pairing that with storytelling. You need to anchor it within humans. And I think that makes sense. We we resonate, we listen better when there is a human element.

Speaker 3 28:55

For sure.

Speaker 1 28:56

We are we are drawn into that. And so it was a challenge at first to really think through how to best do that. You know, I have to credit my my older sister because I shared an early draft with her of a first chapter. And and she's not a public health person or public health professional, she's not a researcher. Um, but but you know, she's she has an education and she's somebody I think of as like, this is a potential reader for for the book, you know?

Speaker 3 29:23

Yeah.

Speaker 1 29:24

And I shared the first draft with her, and I hadn't really told her really anything about the writing project at all. I was just, oh, I'm writing a book, and can you take a look at this first chapter? And so she came back and said something along the lines of, oh, so so you're writing a textbook for public health. And that that was not my intention, right? I was I was very specifically trying not to write a textbook. And so that's when it hit me, okay, this person who I actually envision as, you know, more or less somewhat representing my audience.

Speaker 3 29:57

Yeah.

Speaker 1 29:57

Is it's not resonating with them. They're they're reading it like a textbook when I wanted to read like something they might pick up at the end of a workday or in the evening to read because they're interested in learning about how do we build uh healthier communities, how do we build better communities. And so that that forced me back to the drawing board. And it really forced me to think, okay, what are what are stories that I can incorporate in this? What are ways that I can make this more interesting? And as you noted, that that forced me to actually insert myself into the book a little bit, which is something we don't do with academic journal writing. And, you know, in some ways that felt uncomfortable, but in other ways it felt natural. Oftentimes when we're dialoguing with someone, we share things about ourselves within the context of some other point that we're making, right? And so I tried to push myself into more of I'm having a dialogue with a reader. I'm having a conversation with the reader, sharing some things from my own perspective, sharing things from my own life, sharing things from uh or stories that I've been exposed to or I'm aware of through through my work or through just living in this world. And as I started to do that, you could see that the ideas kind of came to the fore better. It wasn't just a piece of data, piece of research after research, right? It was a story that I think a reader can follow and a reader can put themselves into and and resonate with. And so it was a challenge because I don't think, especially in graduate school and public health, although things I think are shifting somewhat, at least my graduate school training, we were not trained to write in this style. That wasn't that wasn't our job. And so I did really have to push myself. And but it was a fun process to do that.

Speaker 31:55

No, that's great to hear. It was a challenge, but it sounds like it was a fun challenge, hopefully, for you, right? To experience that because there's an element of vulnerability in everything that you engaged in, right? And writing this book, you know, sharing a part of yourself in writing this, that it's not just, okay, I'm getting my research and collecting my data and doing my, you know, statistical analysis and then putting it together in an academic journal, that you are really engaging with what this work is and then putting it together in a communicable storytelling format for um, you know, readers to, like you said, enjoy in an evening after a long day of work, um, but be still actively learning in the process. Um, and so I really, you know, I thank you for sharing that because I think there is something that is to be said, a lot of value in reading stories like this that are not just that typical academic journal while still learning a lot of things rooted in public health research. Um, so I also want to focus on the sense of optimism throughout your book. You know, again, going back to that title, Imagine Doing Better. I think a lot of the things, of course, that you're talking about in the book can feel very heavy because we're talking about these policies and these systems that, you know, here's how they're working, but maybe here's how they're not working or how they're failing individuals in society. Um, but there is a sense of optimism throughout the book that you kind of continuously draw back to. And so the belief that change is possible if we're willing to think differently is really, really important. And so for students, um, of course, I know you're working with students as a faculty member and as a leader in this field, um, and even for maybe policymakers listening, what guidance would you offer about how we can begin to, first of all, imagine doing better? Um, and what gives you hope for the future of public health within your own work?

Speaker 1 33:43

Hope is such a fundamental thing that we need to anchor ourselves in in this moment. I talk with a lot of students that, you know, it's pretty clear that they've they've lost some level of hope. Even even some, you know, colleagues or other other people I work with, you know, really feeling like the moment that we're in is so challenging. And it is, yeah, but that it's not, it's not gonna get better. It's only gonna get worse from here. And I think, you know, the moment that we let ourselves go into that place, then then change really does become less possible. When we believe that change is possible, we can make change, we can take action, we can hold, we can work together. And and it's actually pretty impossible to look back through history and see it and think that change is impossible. So we have to draw our inspiration. I'll admit it it can be hard to hold on to hope at certain points, right? Especially when we're seeing some really challenging moments in our country and around the world. But the thing is, is that every there are so many moments in the past, there are so many examples within communities of communities facing a challenging moment, but pushing and pushing and pushing and ultimately making change. And so that that is the piece we have to hold on to. And that's part of the reason the book is called Imagine Doing Better, is that the really the first step, the first step that we all need to do and and do collectively is envision what that better world looks like.

Speaker 3 35:21

Yeah.

Speaker 1 35:22

If and and not just not just sort of take 30 seconds and think about it, but really sit in it and try to feel it. What does it feel like to live there? Use all of our senses. What might you hear while you're in that future world? What's happening? What's what's going by your your front door? What systems exist? What policies exist? What does that world really look like? Once you have that vision, it becomes a map. There's a book called Freedom Dreams written by Robin D.G. Kelly. And he writes in that that the map to a new world is in the imagination. And I really believe that. So if we want to create a better world, we have to think about what that world looks like. And then it serves as a map. It's it's our roadmap because we can chart a path from where we are today to how we get to those systems, those policies. We're not going to be able to do it today. It's a long-term thing. It's something that we are doing to plant seeds for future generations that are going to be able to live in that world. And so what we can do is we can we can back up and identify what are the things that we need to do. What do you and I need to do in our field, in our communities in this moment, so that it takes one step in that direction of that better world. And so I think that's what that's what the book really offers is it invites us to step back and think about what is the world we need? How could we imagine doing better? Not just taking what we have and making small little changes, but really stepping back and thinking, what would we build if we could just build from scratch? And then what is the pathway from our world now to that world?

Speaker 37:16

No, I love that because it's not just like you said, it's not okay, take 30 seconds and figure out one or two things you would change. But really, if you were to start from scratch or if you were really to have all possibilities in the world, what would that change look like? And I think that's so important because especially when we're faced with a lot of, you know, pivotal moments in public health, uh, whether it's because of policy or because of funding or whatever the issue is, right? That's also the perfect time to say, okay, how do we rebuild? How do we imagine for a different or stronger future? You know, so I appreciate that perspective because I think it is really um impactful. And especially for the future leaders of public health, this is the time to be doing exactly that sort of um uh imagination and experimentation. And so I just want to thank you for such a, you know, inspirational conversation today. And before you go, I do have one last question for you. If there would be, you know, one takeaway that you could wish for readers after reading your book, um, you know, what is one idea, maybe mindset, or just one key takeaway that you hope that readers have after reading your book? Imagine doing better.

Speaker 1 38:24

I think the one key shift is thinking about the mindset you hold and shifting it to there is one thing I can do, and I can probably bring two other people along to it, even if that thing is tiny.

Speaker 3 38:40

Yeah.

Speaker 1 38:41

But don't get stuck in a place of feeling immobilized or feeling like there's nothing. There is one small thing, and you can probably find a couple other people to do it with you. And that alone is taking a next step towards that better world.

Speaker 38:59

Yeah, that's that's really powerful, right? And that's that finding a couple other people to support you in that nature or support you in that mission is, you know, that's the community building right there. So uh, Dr. Fleming, I want to thank you so, so much again for this conversation. Um, this was really important and really an imperative conversation uh to be having, especially at such a pivotal moment in public health and in higher education. So thank you so much for joining me today and for sharing your insights and, of course, your experiences throughout your own journey in public health. So, to our listeners, I do encourage you to check out Dr. Fleming's book, Imagine Doing Better, and we will be sure to drop some resources on where you can find that book. If you are interested in sharing your work and participating in a future episode, we invite you to, of course, stay connected with both the Idea Institute and ASPPH. Thank you so much for helping us turn ideas into action within academic public health.