in Community Health, Urban Change

Dancing with the Bear

The following introduces trends in professionalism. It is an excerpt from a more substantial project entitled: The Four Problems. The focus of that effort is on planning, architecture, and engineering. The challenge to all professionals today suggests that the dance with the bear has begun, and we can’t stop until the bear stops.

Three Steps of a Four-Step Dance

There are three steps in developing “professionals” in meeting human needs, interests, and concerns. Historically, professional services began in response to a widely accepted set of cultural functions such as healing, leading, and building. A millennium or so later, these functions become more specialized. For example, the healer becomes a surgeon, leaders become law officers, and builders become architects and engineers. Finally, as the culture matures, licensing and certification assure compliance with well-established standards of practice by governing bodies with enforcement power and policies that support internal and external niche functions.

These stages suggest a fourth – the rapid development of interprofessional education to support radically new and deeply needed practices. The implication is an increase in technology transfers between professions with advanced applications and the exchange of data sets for quantifying everything by gram per second in the erg economy. Examples are (political) (economic)

The ability to manage change from minute to minute and, in some cases – milliseconds or decades is a new professional capacity. It is possible to imagine a flawless transportation network, zero-waste systems in building practices, and net-zero energy use with this power. Substitutions and commutation of data between these activities lead to rapid improvements in every aspect of urbanization. We only need to solve the four problems mentioned above (here).

In just the last half of the 20th century, the service economy grew to nearly eighty percent of employment in the United States. In just a few generations, highly trained professionals have discovered an array of new specializations. For example, access to the technology of interprofessional education allows physicians to build a digital model of a patient’s beating heart and petition for the power to prescribe safe housing. Likewise, law officers can replace the prison and chain response to choose hundreds of new intervention tools for building a culture free of fear.

As 2020 began, communities worldwide became confronted with the task of redefining problems in a categorically different fashion. The contagion expressed as SARS-CoV-2 (the one that causes COVID-19), MERS, EBOLA, and others are real symbols in the broad context of climate. The climate of threat is known, but without direct experience, unease becomes the primary evidence of the senses.

The ill-feeling of separation or polarization by forces not fully understood can be relieved. An effort to understand the usefulness of that feeling grows because everyone has it. The central lesson of the first 21st c. pandemic will be to figure out what this sense means to help make it good and not bad. Given limited knowledge of the epidemiology of a viral contagion, it is logical to consider dense areas as to cause but, more importantly, as a source of cures.

Over half of the population of the world is urbanized very poorly. Here, a well-thought-out protocol for ending or expanding the threat of global contagion is effective on multiple fronts. First, the rapid deployment of a testing regime within a limited area with extended containment is possible yet considered unlikely. Second, the source of a good defense is in the bodies of those held for care or distributed lethality. The deployment of serological tests can be as quick as a McDonald’s drive-thru to identify an infected person. Third, serosurveys figure out how widespread a virus is among people who remain asymptomatic. Fourth, define the human antibody response and the possibility of an immune reaction or not becomes Combined. This “urban health data” can lead to stopping the potential of a pandemic. (see details in Contagion (here). It comes down to a question of readiness.

Dense urban areas such as New Jersey (the densest suburban State) and New York City may be hard. Still, they also offer the best capacity for intervention fueled by data and backed with the ability to initiate clinical trials as proof rapidly. The issue was summed up succinctly when State Governor Andrew Cuomo pointed out that we knew COVID-19 was identified in China as early as November 2019. Still, they did not confirm until early January, and so he made a demand.

“…the federal government should decentralize testing and give it to the states. I have 200 labs in this State. Let me use my 200 labs. Why am I waiting on the FDA and CDC?”

(News Conference 16 March 2020)

The State of New York acquired the authority to proceed. Most of those labs are in New York City. The element to remember is the concept of readiness and the effective use of unique human power – the ability to analyze, understand and act. Because events with a global impact can occur without significant warning, the lesson already learned regards the first-level response to energize analysis, define the problem, and determine urgency. All of us know this as a well-known national defense protocol – DefCon One to whatever. Unfortunately, the professionals in microbiology labs got nothing; action did not occur at the national level until a State Governor demanded it.

In the urban world, well before a large construction project begins, technology provides the architect and engineer with services to model highly complex systems in virtual environments envisioning entirely new frameworks for social and economic interaction. For example, these systems suggest the ability to document and envision the impact on a hospital system during a health care crisis; it can mark the flow of every ounce of water, watt of power, and a liter of air in every tube, wire, and opening serving urban life.

Systems with such data authority for day-to-day use or crisis are not a fantasy as their integration is already more fully imagined than a dream. Moreover, these practices have tangible demonstrations that allow any attentive person to conduct their Bayesian inference regarding forming the harmless city. Recognizing the three stages of professionalism as essential to creating new professions establishes the fourth level of enormous importance, but it must be aggressively defined.  Ending the isolation of specific professional skills will lead to the active implementation of anti-silo tasks capable of fully developing the city as a single, fully integrated, undamaging earth entity.

Too many technical proficiencies are organized vertically like silos; they symbolize data segregation because they give their occupants special impact abilities. Examples are seeking competitive opportunities, targeting specific clients or competitors, isolating geographies, and insulating technologies for business purposes. As such, the lack of encouragement or opportunity to negotiate new elements that function laterally within governments, businesses (or groups of them) can be damaging, possibly deadly. An often-used phrase by planners to describe problem-solving is a policy (mostly public) that must end. It is called “catastrophic resolution.”

In attacking the downside of these practices, the four problems I have begun to define call for the city’s recognition as a single construction and rehabilitation problem. It will engage the entire social and economic context of the urbanized earth. With this view of the city as the essence of human existence, I address the need to radically alter the traditional contract arrangement responsible for building cities and connective tissues. The urbanizing earth is singularly crucial to the quality of every aspect of all life. In this context, I attempt to define the professional realignment problem more thoroughly.

If you want to know when the first phase of this effort ends – let me know (here).

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