What Public Health Really Means
People throw the term “public health” around a lot—but what does it really mean? And more importantly, how does it shape the lives of Black women and girls every single day?
Public health is often invisible—until it fails.
It’s not just hospitals or doctors. It’s not just hand sanitizer during flu season or PSAs on your timeline. Public health is the air we breathe, the water we drink, the systems that feed or fail our communities. It’s about policies, protections, and power.
And when done right, public health can be the quiet, steady force that prevents harm, protects life, and promotes equity.
The Work You Don’t Always See
At its core, public health is about prevention. It’s the reason seatbelts are required. It’s why there are smoke-free indoor air laws. It’s how vaccines are distributed during an outbreak. It’s why your child has access to a nutritious school meal—and why your employer is required to keep your workplace safe.
It tracks disease.
It monitors climate impacts.
It enforces clean water and food standards.
It researches the causes behind rising cancer rates.
It sets the stage for healthier generations.
Public health is also how this country had to face the uncomfortable truth: that racism is a public health crisis. And that crisis affects Black women and girls in deeply personal, measurable, and preventable ways.
When Public Health Works Against Us
Let’s be honest—public health hasn’t always protected us. In fact, it has often excluded us. Black women face higher rates of maternal mortality, diabetes, asthma, and breast cancer—not because we are somehow less healthy, but because we are more likely to face bias, underdiagnosis, poor-quality care, and systemic neglect.
These disparities aren’t rooted in individual choices.
They are the consequences of structural inequality, underinvestment, and a lack of representation in the rooms where decisions are made.
Case Study: When Public Health Fails
Adriana Smith – Brain-Dead, Forced to Stay on Life Support
In Georgia, 31-year-old nurse Adriana Smith was declared brain-dead while nine weeks pregnant. Due to restrictive abortion laws that grant personhood to fetuses once cardiac activity is detected, doctors kept her body on life support for nearly three months to sustain the pregnancy. Her family had no choice. She was only taken off support after the baby was delivered prematurely.
This wasn’t a failure of science—it was a failure of policy. Her care was dictated by politics, not medical ethics or compassion. When public health systems are shaped by ideology instead of evidence, Black women pay the price with their dignity—and sometimes, their lives.
The Public Health Imperative
These stories show that true public health isn’t just about vaccines or regulations—it’s about ensuring laws, systems, and providers do no harm. When the system fails Black women, the outcomes are dire: loss of life, violated dignity, and shattered trust.
We urgently need:
- Policy reform that centers patient autonomy and aligned clinical guidelines
- Bias training and accountability in healthcare delivery
- Expanded access to comprehensive maternal and reproductive care—especially in states like Georgia
Public health must be more than a system. It must be a promise—one that protects, respects, and honors Black women.
The Work BWHI Is Doing
This is where our work comes in. At the Black Women’s Health Imperative, we believe public health should work for us—not against us.
We’re fighting to make sure Black women and girls are at the center of every public health conversation:
- Advancing reproductive justice—which means ensuring that every person has the resources and support to decide if, when, and how to have and raise children in safe, sustainable communities
- Fighting back against Medicaid cuts that threaten our families
- Addressing chronic conditions with culturally relevant interventions
- Protecting access to affordable medication by pushing for drug pricing reforms that prioritize patients over profits
- Leading a breast and cervical cancer research study to better understand and dismantle the barriers Black women face in accessing timely, equitable care
We do this through policy, research, education, and unapologetic advocacy.
Public Health Working For All
It means building a world where Black women and girls:
- Are seen and heard.
- Have access to safe, affirming, high-quality care.
- Don’t have to navigate a broken system alone.
- Can live full, healthy lives—without fear, without bias, and without delay.
Continuing a Legacy of Truth-Telling and Transformation
Our work is rooted in the legacy of our founder, Byllye Avery, who boldly declared that Black women must be at every table where decisions about our health are made.
She knew that public health wasn’t just about numbers—it was about justice.
It was about reclaiming power.
It was about telling the truth about systems that were never built with us in mind.
And that promise still drives us today.