Public Health Research & Practice March 2015; Vol. 25(2):e2521514 • doi: http://dx.doi.org/10.17061/phrp2521514
Reections on a career in public health advocacy
audience of half a million. I was curious about this and
emailed him for this presentation. He told me immediately,
“because you always answer your phone. The number
of people we rang and they missed out because they
didn’t realise tomorrow morning was their one shot was
Lesson 5: use ‘killer facts’
Every year, people are exposed to thousands of facts,
claims and narratives about hundreds of health issues.
Much of it is like informational wallpaper, forgotten
moments later, contradicted by competing claims and
washed away on the tide of tomorrow’s more arresting
news. Some issues rise above the rest and compel
political action. Many plod along unchanging and others
sink without trace.
A basic goal in advocacy is to have your denition of
the issue in a policy debate become the dominant, top-
of-mind way people – and especially politicians – think
about that issue.
Killer facts12 are like musical earworms: once they’re
inside your head, it is difcult to get them out. They tend
to kill off competing denitions of the issue. If they employ
powerful and repeatable analogies, before and after
comparisons, and humour if appropriate, this can really
help. I heard one recently: “Public health is about saving
lives … a million at a time”.
Here are some examples:
• The US has 13.5times Australia’s population, 5.9times
Australia’s rate of gun ownership and 305times
Australia’s gun homicide rate. So more guns make a
• In the 18 years before Australia’s 1996 gun law
reforms, there were 13mass shootings (ve or more
deaths, not including the perpetrator). There have
been precisely none in the 19years since.
• For four of the past ve years, quad bikes have been
the leading cause of non-intentional injury death on
Australian farms. This is unique internationally, as in
all other Western nations, tractors continue to be the
leading cause of injury deaths.
Every advocate, for every issue, needs to stock up on
killer facts. Plan to use at least one of them every time you
Lesson 6: values are everything
As stated, facts and evidence are the bedrock of public
health advocacy. But unless people care about an issue,
they are highly unlikely to pay attention to it, let alone act
on it. Caring about something is always a necessary, but
not a sufcient, precondition for support and action.
Public health issues often feature in the news because
they richly illustrate narratives about values: mini dramas
and secular parables about adversity and the solutions
needed. These include the humane imperative to reduce
have the power to effect change or defend good policies.
The most important of these are politicians. And guess
what? They don’t read research journals!9
During nearly 40years, I have had countless
occasions to speak to prime ministers, health ministers,
their cabinet colleagues, and thousands of inuential
people in every walk of life. I’ve done this as they lay in
bed, ate breakfast, drove their cars, sat in their living
rooms and relaxed in their shorts and T-shirts on holidays.
By contrast, I have had face-to-face meetings with
politicians perhaps 100times in my life. Let me explain.
When I rst met former health minister Nicola Roxon,
we shook hands and I said I didn’t think we had met. She
replied that she felt she had known me half her life. This
could have only meant that she had heard me and read
of my work in the news media. She was one of the highly
inuential people I had spoken to, often without knowing.
She was already very receptive to various issues that my
colleagues and I had been emphasising for years. If you
avoid the media, very few people will ever learn about
your work and what needs to be done. You and your
research are far less likely to be inuential.
If you care about making a difference, you will put aside
the regrettably still-prevalent attitude in some institutions
that you should not “dally with the Delilah of the press”.10
Lesson 4: study the media
If you want to be a potent media advocate for evidence
and policy change, you need to know how the media works
and how you can best be part of it. Many of you may have
taken days to prepare a 10–15minute presentation. The
lucky ones will speak to 300 or so in a plenary, most will get
only 40–50people in a breakout session.
But a few will be tapped by journalists at the
conference. If you get interviewed for radio or TV news,
your message might be heard by hundreds of thousands
of people – sometimes millions. To maximise these
unparalleled opportunities, you need to understand the
medium and programs on which you appear. On Australian
television news, the time anyone gets to speak in a
90-second item averages 7.2seconds, with an interquartile
range of 4.8–9.2seconds.11 Knowing that, you can plan
precisely what you are going to say andemphasise.
When print journalists request comments (and
this increasingly will happen via email), I try to drop
everything and send a selection of one- or two-sentence
options. This makes journalists’ jobs easier and they
Again, knowing about length restrictions, you can
shape a message with Exocet precision. Try to make
every quote you send a potential ‘breakout box’ rather
than some anodyne, forgettable ‘memo to the public’.
This will mark you as ‘good talent’, and they’ll contact you
again and again.
Above all, be accessible. This should be so obvious.
For seven years, I was a regular guest on Adam
Spencer’s Sydney ABC breakfast program with a listening