The past and future of public health practice.

Editorials Two challenging articles in this issue of the Journal raise questions about public health practice, especially as we look from the past to the present and the future. By " public health practice, " we mean not so much the details of implementation or evaluation of specific programs, or the many other particulars that make up the daily tasks of public health practitioners; instead, we are thinking of practice in 2 broader senses. First, " practice " as " praxis " means the total framework of one's professional life, including the ideology or worldview that guides one's actions, the framework of values used to set priorities, the commitment to translate these values and ideas into daily activities, and the expectation that by doing so consistently , one can transform the world in which one lives. Second, " practice, " in the sense of " vocation, " means acting according to a sense of calling or mission. In these broader senses of practice, Fitzhugh Mullan's provocative article provides a typology of the characteristics needed by successful public health practitioners, vividly presented in terms of the personality types of Don Quixote, Machiavelli, and Robin Hood. 1 Each public health officer needs a bit of Don Quixote's unflappable idealism , a bit of Machiavelli's political cunning, and a bit of Robin Hood's quest for distribu-tive justice. Of course, these character types should not be taken too literally, as each has some unavoidable negative associations: Don Quixote is dreamy and naive, Machiavelli is cynical and manipulative, and Robin Hood is a violent outlaw. They are, however, imaginative constructs whose characteristics can be usefully recombined by wedding Machi-avelli's pragmatism to Don Quixote's idealism and Robin Hood's sense of justice. If ideals are always dismissed as quixotic, we will never engage in the hard political struggles needed to produce significant change. If our search for greater equity is not joined to an intelligent structural analysis of the barriers to change, we may be left tilting at windmills. If the ideal of justice is abandoned by public health insiders, we have lost the very purpose of our mission. Many important questions are raised by Allan Brandt and Martha Gardner, perhaps none more important than the question of what has become of public health practice and what will become of it in the future. 2 What will public health careers look like? How are students being educated …