The Public Health Writing Umbrella

Writing Clear, Direct, Succinct Prose Is Rarely Simple or Quick

Public health writing is deceptively difficult. At its best, it is simple, clear, and succinct. It gives the impression of having been effortless to write. But the opposite is usually true. A piece of writing that is concise, clear, and a pleasure to read is usually the final of many iterations, revised over time (and often with a certain amount of angst). Writing prose that others appreciate, willingly read, and learn from is deeply gratifying. But, just as often, writing can be a frustrating, lonely, tedious, time-consuming process.

You might be thinking, all writing is difficult, time-consuming, and frustrating, so public health writing is no different. That’s true. Writing demands focus, courage, discipline, humility, patience, and more time than you ever want to give it. The difference, as introduced in an earlier post, is that public health writing can be especially daunting because we are writing for a reader who is looking for information packaged in prose that is clear, concise, accurate, and engaging. We need to be vigilant about not wasting words and paying attention to how our message is landing.

Taking Care of  Your Bewildered Reader

Does the reader understand easily? Does she want to keep reading? Does she feel like the time she spends reading will be a worthwhile use of her time. The answer to these questions takes root in our sentences, how we structure them, and the words we use. Lazy or muddled language can have, as we have seen again and again with messaging about Covid prevention and vaccination, real-world consequences.

For me, this quote from E.B. White’s introduction to the fourth edition of The Elements of Style says it all. He is writing about William Strunk — White’s professor, colleague, and the original author of this timeless guide: “Will felt that the reader was in serious trouble most of the time, floundering in a swamp, and that it was the duty of anyone attempting to write English to drain this swamp quickly and get the reader up on dry ground, or at least throw them a rope. . . . I have tried to hold steadily in mind this belief of his, this concern for the bewildered reader.”

The other complication is that those of us who work in public health have no single genre, audience, language, or voice we can pinpoint as ours. Rather, we must be able to write many types of documents for many types of readers for a wide variety of purposes. The types of documents we write include: policy briefs, peer-reviewed journal articles, scripts for health campaigns, proposals for funding, protocols to get institutional review board clearance to start a research project, literature reviews, email, Tweets, Instagram posts.

This is by no means a comprehensive list. Every time I host a workshop on public health writing, I ask participants what type of writing they do most frequently in their classes or jobs. I hear about all the genre’s listed here, and I inevitably learn about one or two I’ve never heard of.

So how does one set about mastering the many different types of documents that fall under the umbrella of public health writing. My answer is simple (again belying the very real challenge):

  • Learn by doing;
  • Read the instructions — again, and again, and again;
  • Ask questions — When in doubt about any aspects of the instructions talk to your professor, teaching assistant, supervisor, grant coordinator/program officer, the person most knowledgeable about the project you are working on;
  • Talk to colleagues — ask if they have written the type of document you are working on, ask them for their writing tips, ask about their writing process;
  • Use the internet to find descriptions, guidelines, and sample outlines then adapt as needed — The Purdue OWL (Online Writing Lab) has extensive resources for professional and technical writers that are relevant to public health.
  • Start early to give yourself time for revision
  • Share your draft with peers, writing coaches, or even friends for feedback on clarity, readability, etc.

And here we are, back at deliberate practice.

Each type of document has some standard expectations about language and organization and, over the course of our careers, we get familiar with some of the basic formulas. But we are never on completely firm ground because reader expectations differ, sometimes dramatically. For instance, a policy brief can look very different depending on the subject matter, purpose, and audience expectations. You, the author, are always adapting outlines and formats typical to the genre.

How Public Health Students Can Develop a Deliberate Writing Practice: Part 3/3

Read Part 1:  Public Health Writing as Deliberate Practice

Read Part 2: Stretching Your Attention and Ability: Deliberate Practice 

To apply the concept of deliberate practice at a student level, I can offer my experience in learning how to write for my public health classes. All my academic training before I arrived in the MPH program at Boston University was in English literature. I wrote a book-length dissertation on the mid-twentieth-century author, Barbara Pym. And I wrote dozens of meandering 20-page papers interpreting the writing of other people. I had no idea what a literature review was (though it turned out my English lit papers were a type of literature review). I had to search for examples and online guidance to figure out what a policy brief was.

Aside from the email and newsletters I wrote for my program coordinator job in the Center for the Humanities at the University of New Hampshire, I had never consciously written with the goal of conveying useful information to a specific reader. But I had a vague idea it would be easy. Much easier than writing my dissertation, where I was never sure what I would put on the page until I sat down to write.

When I started my MPH classes, I quickly discovered just how much work I needed to do. I needed to learn to read the usually detailed instructions and keep consulting them. I needed to write an outline and stick to it, or revise it as the draft developed. I needed to convey correct information (not just creative interpretation), and I needed to do it in a way that was easy and pleasurable to read.

Knowing that someone would read what I wrote because they wanted to learn something, was completely new to me. I realize that sounds ridiculous, but it’s true. I had never done any formal writing with the goal of being useful. I quickly discovered just how difficult writing clear, concise, accurate, and engaging documents could be. So, every paper I wrote during my time as an MPH student was a form of deliberate practice. I didn’t have that language then or for a long time.

I joined the BUSPH faculty in 2005 as an assistant professor and “writing specialist” in the Department of Global Health. I was eager to take the job because I knew I had a lot of knowledge I could share about the writing process and revision. Even though I was often at sea with my own writing, I had been teaching undergraduate composition classes while working on my MA at Ohio University and my PhD at UNH. During those years, I was immersed in a world where we talked about composition theory and pedagogy all the time. I was trained to help students work their way through a multi-draft writing process. And I had empathy and patience when giving other people feedback on their writing. But the “writing specialist” part of my title always made me nervous.

Who is a writing specialist? Alice Walker, Stephen King, James McBride, Ta-Nehisi Coates, David Sedaris, Celeste Ng. Famous people who make their living by their pen. None of them walk around talking about how they have mastered writing. So who was I? An erstwhile English PhD pretending I knew how to write public health documents on critical, complex problems for readers who would use my work to inform and guide their actions. We all have our imposter-syndrome demons, and that was one of mine.

The concept of daily, deliberate writing practice – even for just 15 timed minutes a day – completely changed my relationship with writing and provides a daily bulwark against self-doubt.

My first challenge was committing to that 15 minutes at the keyboard Monday through Friday. It didn’t come easily, and I’m always resisting urges to skip, to focus on other things (like responding to the 30 emails that came in overnight). Once I developed a successful track record over the course of a year (even if I only wrote a sentence or two) I was able to attend to the mechanics of my writing style. I became more deliberate while revising (rarely while writing the first draft—more about that later). I created time and room to deliberate about words and flow. What a gift.

Writing strong, clear sentences where, as Strunk and White say, “every word tells” has been central to my daily deliberate practice for the last couple years. I tend to write long sentences containing multiple thoughts and many unnecessary words. I was always vaguely aware of this habit and thought of it as my natural style, the source of my voice and creativity. Then, when writing proposals and articles with colleagues, I started to notice that they often broke up my long sentences. They also excised words that contributed little to the meaning. I was fascinated by their ability to cut through my fog of words to the nugget of meaning with small edits and punctuation changes. I’ve gotten pretty good at doing the same for other writers. My challenge is to be able to do it for myself as I revise. It’s a path I know I will be on for the rest of my writing life.

As you develop your daily practice, you can decide what’s important to you. You can make sure all your subjects and verbs are strong, or read your work out loud as you write and revise to hear places where wording is awkward, unclear, or overly wordy. For me, these choices depend on where I am in the writing process and what kind of document I am writing.

Stretching Your Attention and Ability: Deliberate Practice Part 2/3

Read Part 1: Public Health Writing as Deliberate Practice

So what differentiates deliberate practice from other types of practice? In a 2007 Harvard Review article called “The Making of an Expert,” K. Anders Ericsson, Michael J. Prietula, and Edward T. Cokely, explain: “When most people practice, they focus on the things they already know how to do. Deliberate practice is different. It entails considerable, specific, sustained efforts to do something you can’t do well — or even at all. Research across domains shows that it is only by working at what you can’t do that you turn into the expert you want to become.”

This quote may have you thinking that deliberate practice doesn’t apply to the writing you do for your public health classes or your job. That thought ran through my head too. I know how to write. I can form sentences and paragraphs and generally convey ideas in a way that other people understand. I write 40+ emails every day. Isn’t that practice enough?

Here’s how I answered the question for myself. When I write and respond to email, write comments on student papers, or text my friends, I am not writing for myself. I am engaging in daily life. My overwhelming inbox may challenge every aspect of daily professional life and my mental health (that’s another story). But it is the antithesis of something I do deliberately, to improve my clarity of thinking and expression, to revel in words and syntax. I may spend 45 minutes crafting a particular email because I want it to be kind, clear, nuanced, and concise. But that isn’t feeding my sense of myself as a writer. It just feeds the rapacious information machine of day-to-day professional life.

When it comes to engaging in deliberate practice to develop your public health writing skills, the idea of stretching your ability is key. This makes me think of my colleague, David Ozonoff (Professor Emeritus of Environmental Health at BUSPH), who has been doing mathematics for an hour every day for the last 30 years. He started working his way through a mathematics textbook to brush up on his skills. Then he kept going. He has never missed a day.

In the last few months, Professor Ozonoff has switched from doing math to writing a book about it. Now he devotes his daily hour to writing. He’s pushing his deliberate practice in a new direction. As a successful academic, he certainly knows how to write. He has scores of articles in peer-reviewed journals and he wrote daily blog posts for over four years (totaling some 3,400 posts). The difference now is that he is writing about mathematics in a way that is new for him and will advance the field.

Math every day for 30 years, 4,200 blog posts. Dave's example may seem overwhelming, impossible to match. But remember that he started small one day and he kept going. You don't need to write for an hour or write every day to engage in deliberate practice. Start with something small and realistic. Find a way to make it enjoyable. Build your practice as you go.

Read Part 3: How Public Health Students Can Develop a Deliberate Writing Practice

Public Health Writing as Deliberate Practice:  Part 1/3

Developing a deliberate writing practice is a key first step toward becoming a public health writer. Deliberate practice entails focusing on a small part of your routine and intentionally, deliberately trying to improve through daily practice.

For me, this means setting aside 15-30 minutes Monday through Friday to write. I have learned over decades of writing anxiety and frustration that waiting for a block of hours or a full day to devote to a writing project doesn’t work. The time always gets filled and I never get all that I want done. So I end up beating myself up, further depleting my time and energy.

Daily contact with a writing project is critical for me to maintain momentum, to know where I left off and where to pick up. If I only have 15 minutes then I might write or fix a couple of sentences. But I’m there. And, at least for me, showing up makes all the difference. Sometimes I use my writing time to do research or work on things like ensuring my citations are in place and correct. But mostly, I devote the time to reading what I’ve written so far, revising as I read, and building on what’s already there.

The short time period is also critical. No matter how busy I am, I always have 15 minutes. (Thank you Joli Jensen for helping me start small.) Once I made the 15 minutes part of my day, I found that I could easily expand it to 30 on most days. Turning my writing time into a pleasurable routine lured me to the keyboard.

Most days, my excuses for not writing yell at me: Open your email now. Prep for class now. Write that letter of recommendation now. The voice is always loud and eminently reasonable. “After I do X, I will have time to write.” You will be able to focus better. You owe it to your students, colleagues, strangers you’ve never met to respond to their emails now. I used to give in to that voice every day. The problem was that I never finished those other tasks. I never cleared my to-do list. As Jensen says in her book, Write No Matter What: Advice for Academics:

"The point is that things never clear up. They don’t even reliably settle down. Our inbox is always full. Our desks are always crowded. There is always more going on than we want or expect. In spite of this, we can find ways to honor our writing by putting it first and making sure it gets time and attention. Otherwise, everything but our writing will get done."

So my daily writing practice daily starts with something pleasurable to lure myself in and get me past the voice in my head reminding me about my wretched inbox. Below I describe my weekday writing ritual. I started in 2020. Since then, in 15-30 minute increments, I’ve written a book, started a webpage and blog about public health writing, and am now revising the BUSPH Writing Guide. Bit-by-bit, day-by-day. This is both my writing process and my deliberate practice.

I walk from my house to my favorite café. During the 20-minute walk I try to focus my thoughts on the pleasures of being outside (even/especially in a busy part of the city).

I take a sip or two of my mocha and focus on my breathing for a minute. I find the Headspace animated breathing flowers and purring cats amusing and reassuring. (If you are a student or employee at BU you can join for free. The link will take you to the BU pages where you can access it.)

I read a couple pages of a book about writing, practice, mindfulness, or something that contributes to my writing frame of mind. (I’m reading Still Life: The Myths and Magic of Mindful Living by the Boston writer and yoga teacher, Rebecca Pacheco.)

Then I set the timer on my phone and start writing. And I do my best to stop when my time is up. Somedays, stopping can be just as difficult as starting. I also do my best to focus on the experience in the moment rather than on what I am producing/not producing. My goal is what my favorite writing coach, Rich Furman, calls the “cognitively benign writing session."

Read Part 2: Stretching Your Attention and Ability: Deliberate Practice 

Read Part 3: How Public Health Students Can Develop a Deliberate Writing Practice