What Public Health Didn’t Prepare Me For

I entered public health believing in systems.

I believed that access could be built. That education could change outcomes. That prevention, when done well, could protect people before crisis ever arrived. I still believe those things matter.

What I wasn’t prepared for was how often the system fails the very people who are doing everything right.

Textbooks didn’t prepare me for the gaps. For the way access depends on zip codes, insurance cards, and timing. For how mental health and physical health are spoken about separately, even though they live inside the same body.

They didn’t prepare me for caregiving realities. For what it looks like when people are doing everything they are told and still falling through cracks that shouldn’t exist.

I’ve watched people sit in hospital rooms trying to understand instructions they were never set up to follow at home.

I live inside healthcare now, not just academically, but personally.

I see the ways the system fails people who are trying. I see how exhausting it is to navigate care when you’re already unwell. I see how often responsibility gets shifted onto individuals without acknowledging the barriers placed in front of them.

Healthcare should be a right, not a privilege. I believe that deeply.

And I also believe personal responsibility matters.

Both can be true.

What I’ve learned is that health is not one size fits all.

It’s shaped by access, education, support, stress, genetics, and timing. It’s shaped by systems we inherit and choices we make within them.

What frustrates me most is that we often pretend the solution isn’t visible. That it’s too complex to address. That accountability belongs to one group instead of being shared.

The truth is harder and simpler.

The system is broken because we allow it to stay fragmented. Because we separate health from humanity. Because we resist fixing what we can see plainly in front of us.

Public health taught me theory.

Life taught me reality.

And the gap between the two is where the work still lives.

What I know now is this.

Health is never just clinical.

It is human. It is shaped by access, by stress, by support, by what people carry long before they ever walk into a clinic.

If we want better outcomes, we have to stop separating care from the reality people live inside.

We have to listen longer. Look closer. Acknowledge what is working against someone before we decide what they should do differently.

Today is World Health Day.

And while it often focuses on awareness, I find myself thinking about accountability.

Not just at the system level, but in how we see people.

Because real health does not begin in policy. It begins in understanding.

And maybe that is where the work still lives.
Not in theory, but in how we choose to care for people right in front of us.

With Love from Mabank,

Brandy