Clear View – Leverage

In the world of public health work you often hear people talk about “leverage.” They use the term in different ways, but one definition they often have in mind is something like: “the use of a small initial investment, …to gain a very high return in relation to one’s investment,…”   Let me give you an example to explain this.

Last weekend my wife and I were working in our yard and we wanted to transplant a lovely little holly bush from one spot to a better spot. Sounds simple, right? Just dig a new hole, dig up the holly bush, plop it in the new hole, add soil, water, good to go.  You haven’t seen our yard. We live in the path of an old glacier and we have enough rocks to make the most stout-hearted Maine farmer weep. So, of course, I had not dug very far in the new hole when I heard and felt that familiar clang of my shovel hitting a large rock. Now, little rocks (and I mean up to football size) aren’t any problem at all and I’d already taken out a number of those. You usually don’t need leverage to get them out – just dig around them enough and as soon as you can get your fingers around the edges, you haul it out.

This rock was bigger – a lot bigger. I had to widen the hole further and further before the edges of it appeared. I could not even make that thing wiggle with the shovel. Enter leverage. I grabbed my handy five-foot iron pry bar to use as a lever. Levers can do amazing things, taking a small initial investment of effort to produce a big return in moving something that doesn’t want to move. As it turned out, even my trusty pry bar was not enough alone. I had to get a six-foot section of galvanized pipe, slide it over the end of the pry bar to make it longer, stick another rock under the bar for a fulcrum, and park my wife on the end of the pipe and bar combination, using her weight to push down. All that together is called “more leverage” and we got the rock out.

Now, back to public health. Most of the problems we tackle are like that big rock – they just don’t move without a lot of leverage. Take tobacco use. Knowledge alone is not enough leverage – people who know better still smoke, chew, vape, etc. Think of all the money the tobacco industry pours into advertising and manipulating young people into trying tobacco and getting hooked. That makes the rock bigger, heavier and harder to move. So what makes a long enough lever to move that rock? Lots of things add “pipe” to lengthen the bar: parents who don’t smoke and discourage their children from it; No Smoking signs in public places and businesses; on-going ad campaigns and public service announcements; and more. And here is a big lever: raising taxes on tobacco products. This requires legislation, which depends on another form of leverage: groups and citizens advocating and calling their legislators to take appropriate action. Each call, each vote, is a small investment, but the return in the form of fewer people dying from tobacco-related diseases is enormous.  With the right leverage, no rock is too big to move, and no public health issue is too difficult to change. And the more people adding their weight to the bar, the faster the rocks move.


Jim Douglas, M.Ed. is the Partnership Director for Healthy Oxford Hills, your local Healthy Maine Partnership and a project of Stephens Memorial Hospital. You can connect with him at 739-6222 or at   Like us on Facebook at


Reprinted with permission of the Advertiser Democrat.