Public versus Private Health- stop stepping on my toes

“Public versus Private Health- stop stepping on my toes”


Michele Battle-Fisher

Unpublished manuscript

Orgcomplexity Blog


Note: I originally presented with a lively, unpartnered Bachata dance demonstration to the Complex Systems Advanced Academic Workshop (CSAAW) at the University of Michigan in May 2013. Sorry that you missed it…


We let the words, public health, roll off our tongues with ease. But how often do we take time to understand the ontological meaning of “public”? Discovering “publics” would be quite at home with Aristotle. But how often do health professionals take a moment to give the philosophical less than a fleeting thought. I love political theory but I do not remember any mention of it alongside the analysis of randomized control trials. My discussion of public versus private health opens with a short dance lesson of the bachata, a partnered dance that originated in the Dominican Republic.


How to learn basic bachata with a partner, without getting fancy (accent in 4th count)

Basically, it is “Step-together-step touch” with beats at:

Step 1- step 2- step 3 HIP (accent)

Step 5- step 6- Step 7 HIP (accent)


What is public and what is private, anyway?  “Complexity” can be seen as an exchange and feedback of energies. Those energies certainly can be heat. They could be kinetic. They could be communication based. Or the energies could be manifest as directives and choices of the made of individuals in the public. Public health as a mission seeks to save collective lives from often avoidable premature mortality and morbidity. And those private “lives” that we wish to affect can then be collected together as the “population” of interest, or a public. Okay, now there is a term you can find in a cohort study.


As with an energetic bachata, two partners in close physical proximity enter an agreement to “lead and follow” in order to perform the dance. Like taking a cue from your lead partner to start movements, we also take cues from our social networks. Do we not? Partner dancing requires “real-time coordination between a human leader and follower”, and resembles other decentralized systems with “supervisory control & coordination of agent teams” (Gentry & Feron, 2004). Each partner is an agent who must take cues often relate physically and verbally to move in a hopefully harmonious display. More often than not, there are glitches. One person may dominate another. There is a breakdown operationally in satisfying needs of the network. In the end, the dancers become a small public where each must abide by the rules of gestures of bachata as they are to be performed. Bachata is different from Lindy Hop. There are rules in place to guide the anticipated actions of the partner to actually Bachata. In essence, there is a give and take among all dancers (or even social agents) toward a collective end result of a recognizable Bachata. This is not unlike the give and take of navigating health as a person that is a part of a public. How could this be? While living as a social creature may lack the audible musicality of a bachata song, effective public health action requires that the private sphere be under the watch of the public for the sake of the society as a whole. According to scholars such as Habermas (1989), the “private” sphere is possible when there is no intervention in order to act under his own personal authority. One partner cannot do Waltz steps while the other performs Dominican Bachata. In other words, an entity such as a government or even a bachata partner should not demand to have a say in his status. But this would not make sense for dancing bachata, which is by design a partner dance. Likewise, when we evoke the idea of “public health”, the idea of intervention into the “private sphere” is central to improving the health of the larger public. Some of our private has to give for the sake of the public.





 Gentry, S. & Feron, E. (2004). Musicality experiments in lead and follow danceIn Systems, Man and Cybernetics, 2004 IEEE International Conference on, Vol. 1 (2004), pp. 984-988.


Habermas, J. (trans 1989) The Structural Transformation of the Public Sphere: An Inquiry into a category of Bourgeois Society. Cambridge: Polity.




About Michele Battle-Fisher

This is an archive of the Orgcomplexity Blog. Please follow me at the following sites: Michele Battle-Fisher (Facebook author page) mbattlefisher (Twitter) michele.battle.fisher (Skype) Author Website

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