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As we prepare for Thanksgiving, I have been reflecting on the importance of tradition, and how we can weave together the past with the future. Public health is, by nature, forward-looking. We aspire to a progressive vision of the future, one that supports health through a radical reimagining of the status quo. This calls on us to envision new ways of structuring our world, with an eye toward optimizing it for health. Our pursuit of this vision leads us to explore novel approaches to supporting health, to innovate, and to embrace new ways of thinking about, and living in, the world.
Having established that this vision of progress matters, we can then ask: Is it all that matters? Is a relentless focus on the future both necessary and sufficient for getting us to a healthier world? It strikes me that such a focus is not, in fact, enough. For public health to be most effective, it should balance a focus on the future with a respect for—and a willingness to learn from—what has served us well in the past. We should pay special attention to what has been handed down to us through the generations—namely, tradition. A focus on tradition also aligns with the themes of the Thanksgiving season, as we pause to reflect, with gratitude, on all we have. This reflection can inform an appreciation of the best of our traditions and how tradition has helped shape a healthier world.
There are three key reasons why tradition matters. First, innovation is rarely completely original and forward-looking. More often, it tends to resemble a quilt, a patchwork of ideas old and new. We stand on the shoulders of giants, and if we are to uplift future generations, our efforts should start with respect for the traditions we have inherited—from religion, to philosophy, to inherited cultural knowledge.
Second, when we engage with tradition, we maintain a connection to the best of the past, to the cultural richness that emerged from what came before. This includes the tradition of “small-l” liberalism that has done so much to support a better world, through an embrace of freedom, human rights, and the legacy of the Enlightenment that informs many present-day goods, from our political system to the scientific method. This inheritance helps us advance a liberal public health through the pursuit of gradual reform through reason. The framework within which this pursuit unfolds—one of free and open debate, civility, respect for the individual, and the broader context of representative democracy and a rights-based social order—is itself a tradition, of which we are temporary stewards, and which can help us create the better world we wish to see.
Third, respect for tradition helps support the humility necessary for building a healthier world. It is tempting to think that we know better than our forebearers, that our science, technology, and moral sophistication put us miles ahead of where they were. But they were people just like us, confronting many of the same issues. We should have the humility to recognize that those who came before us may have been attuned to certain truths which we in our modern age have missed. This is not to say we should embrace everything that has been passed down to us, but when tradition serves us well, we should have the humility to acknowledge this, with gratitude.
This is not necessarily easy. We see the challenge of this reflected in our understanding of American history. America has committed great crimes—centrally, the injustice of slavery, and genocide against indigenous populations. This history should be taught honestly, in full, even as we engage with the values and traditions that have come to us from our past. These traditions include religious liberty, freedom of speech and assembly, the acknowledgment of the rights of ever-greater numbers of people, the triumphs of our art and culture, and our capacity to integrate a diverse range of nationalities and ethnic groups into a cohesive national project at a scale never before seen in human history, all while maintaining a standard of living which—for all the deep inequality which remains with us—is likewise unprecedented.
Striking a balance between appreciating the best of our tradition and acknowledging the often-ghastly history with which it intersects is a challenging, at times contentious project. But it is one in which we must engage. Throughout our history, the good in our tradition has served as a lens through which we have seen with ever-greater clarity how we are not living up to our ideals. Indeed, a key reason why we are now able to have more nuanced conversations around issues of justice, race, and health is because of our longstanding awareness that we have fallen short of our founding values that all are created equal. These values may have emerged in a compromised context, nested within the hypocrisies of those who first articulated them and a system which did indeed oppress and exploit. But just as gold is no less valuable for being found in dirt, the all-too-human failings that characterized our country’s founding and subsequent history do not negate the truth of America’s core principles and their importance in shaping a better world. We should think critically about our traditions, interrogate them, never let them off easy. But we should also recognize the world-changing good they have done, and how necessary they remain in our present moment. We need to balance respecting the uses of tradition with maintaining a forward-looking approach to health. Core to this is recognizing we can only look to the future when we are supported by the achievements of the past. We should recognize these achievements, celebrate them, and build on their success.
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