Next-Generation Public Health: Building A Future Worth Inheriting

“We have to imagine beyond what we've inherited.”


― adrienne maree brown, Emergent Strategy: Shaping Change, Changing Worlds

A ‘Just and Sustainable’ Future

Right now, public health is facing a turning point. A critical opportunity to shift how we approach the well-being of our communities.

Historically, many public health solutions have emerged as reactions to crises. They were selected for urgency, not longevity. As a result, those approaches no longer match the complexity of today’s challenges or what society now expects from public health.

At the same time, the field’s value is increasingly being questioned. Public health professionals are being challenged to purposefully rethink and rebuild the essential principles and practices that are being passed to the next generation of public health practitioners. 

In her book, Emergent Strategy: Shaping Change, Changing Worlds, adrienne maree brown pushes us to radically reimagine a just and sustainable future by leaning into adaptability, creativity, and collaborative action. Brown emphasizes our responsibility, not only to those living today, but also to future generations. Radical imagination. 

The Inflection Point: Why Now?

We live in a world where change happens quickly. Take, for instance, how smartphones rapidly transformed how we communicate. Streaming and social media have completely transformed the entertainment experience, and electricity is reshaping how we envision transportation. Considering these innovations, it’s clear that our society is primed to rethink what we once thought of as cutting-edge.

So, in a world where everything is changing, why not public health?

After 15 years of working across community partnerships, health systems, and national collaboratives, I see this tension playing out everywhere. I see a growing gap between the public health systems we inherited and the ones communities now need us to build. The systems the future of public health will require.

Building for the Future: Decisions Public Health Can’t Avoid 

Public health is in a moment of scrutiny, but moments like this can also create clarity. This is not a moment to just defend the field, but to decide what we keep, what we evolve, and what we should leave behind. 

Next-generation public health is not just about better programs. It is about building systems worthy of the communities they are meant to serve and having the courage to redesign the ones that are not.

In practice, most of the work boils down to four decisions that public health professionals make every day: what to stop, what to strengthen, what to test, and what to create. 

1. Stop carrying what no longer serves us

   Some practices continue not because they work, but because they are familiar. It’s how we’ve always done it, and it’s comfortable. For approaches that we know don’t solve the issue and maybe even reinforce inequities, it’s time to let go. Progress requires letting go of legacy practices that no longer produce equitable outcomes. If it’s not transparent, has no accountability, is not designed for fairness, and is not effective, it must go. 

2. Strengthen what we know works

   Not everything needs disruption. Some approaches do work. Community-driven initiatives, prevention strategies, and cross-sector partnerships are already producing life-changing results. The real work here is to scale what is working, protect it from disruptive funding cycles, and ensure access isn’t determined by politics. 

   
   

   Many public health professionals are already doing this work. They are holding together partnerships, navigating funding uncertainty, and building trust where systems have failed. The future may depend on how well we support and learn from them.

3. Take smart risks

   Public health has historically been cautious, sometimes excessively. Yet innovation requires risk-taking. This means moving beyond merely responding to crises and ensuring public health stays responsive, resilient, and ahead of the curve. It requires piloting new approaches, testing partnerships, and trying tools that may initially feel outside the norm. 

4. Design what does not exist

   Some of our most complex challenges exist because our systems were never designed for the reality of today. We need practitioners who are willing to design models that fill the gaps. Models of collaboration, community governance, and prevention infrastructure. Tomorrow’s challenges won’t be solved with yesterday’s tools. 

The future of public health will depend less on funding and politics and more on whether we make these decisions with courage and intention. 

In my experience, the future of public health is less about new ideas and more about who is shaping them. It is determined by a willingness to share power. The next generation of public health must be built with communities, not just for them. This means trusting lived expertise alongside academic expertise and investing in communities that were there long before institutions showed up. The next generation of public health will require this shift. 

Next-generation public health will require leaders who are not just technically skilled but also willing to convene across differences, share ownership of solutions, and stay accountable to the communities they serve.

Radically Reimagining Public Health 

Radical imagination asks us to envision a world light-years ahead of our current reality. 

In the Apple TV series Dark Matter, the protagonist explores alternate universes. In one instance, he stumbles upon a future utopia where human civilization thrives by prioritizing the environment and living in harmony with nature. Think geo-responsive architecture or ecosystems designed to regenerate themselves. Within this utopian reality, humans nurture the natural environment and leverage its unique abilities to develop a symbiotic relationship that significantly enhances the quality of human life.

Imagine if public health operated similarly. By intentionally designing and re-designing systems that consistently enhance our well-being while also strengthening the systems that shape our day-to-day lives. From the air and water to the soil and the environments that influence our health. 

We could transcend today’s most complex challenges and reset the standards of public health. 

Envision a society that has overcome structural inequities such as racial, gender, and economic biases. A society where access to healthcare, food, housing, and mental health support is truly a human right, and not just a privilege. Community-led decision-making is the norm; no more exploitative data practices. Policies focusing on healing and restoration rather than restrictions and punishment.

A version of public health far beyond what we thought was possible. 

Sowing Seeds for Those Ahead

Dr. Camara Jones’ expansion of “The Gardener’s Tale" teaches that our greatest responsibility is the future of our collective garden, preventing the roots of the disparities we face today from persisting tomorrow. With grace and wisdom, she states, “We must act with urgency, but also with patience, planting seeds now whose fruit we may never taste.”

Planting seeds for a future free of inequity.

Public health professionals, advocates, and communities are gardeners tasked with planting seeds that will be harvested by the generations to come. It is our collective responsibility to leverage the opportunities of our time. To be adaptive, intentional, and forward-thinking. 

The future of public health will belong to those who can build bridges between sectors, between communities and institutions, and between vision and execution.

In a world rapidly moving forward, there’s no reason public health should remain stuck in the past. 

So the question is not whether public health will change. The question is, will we?