Of Communities and Context: Deconstructing the ‘Silos' Metaphor in Public Health Discourse

Objective:Recent public health discourse frequently applies the metaphor of ‘silo’ as a now-institutionalized code to disparage disease-specific frameworks, suggesting these are isolated, fragmented approaches to public health. In using the ‘silo’ metaphor as shorthand for ‘isolation’ and ‘fragmentation,’ such discourse may fail to examine its communication language about disease in the deeper context of communities, prevention and social justice – key constructs of public health.

Methods:

Ethnographic work and observation in rural communities; dialogue with diabetes prevention champions in health disparate communities.

Results:Silos are essential structures on working farms, integral to community systems’ economy, health, and preparation for the future. ‘Silo’ as metaphor can be expanded to apply to the contextual, deeply rooted, prevention-oriented indigenous wisdom and stories needed in these times of globalization. Results

Conclusion:

In contrast to its current use as a negative metaphor without context, silos symbolize a public health framework that respects embedded systems of community knowledge. Participatory approaches can align shared values of traditional knowledge with modern health protection strategies. The landmark Diabetes Prevention Program which demonstrated that diabetes can be prevented or delayed is a prime example of the alignment of science and community wisdom.