November 21, 2016
Good Advice From A Public Health Dean?
By Michael D. Shaw
The Oxford Dictionary defines public health as “The health of the population as a whole, especially as monitored, regulated, and promoted by the state.” Drilling down, the same august reference work defines health as “The state of being free from illness or injury.”
No matter how you might feel about the recent election results, it is clear that there was plenty of sentiment against the status quo. Or, to put it another way, many believe that the conventional wisdom is not offering the solutions they would like. As such, it is appropriate to judge current public health policy by its fruits. (Matthew 7:16–20)
According to the CDC, the ten most important public health problems and concerns are (in alphabetical order):
- Alcohol-related harms
- Food safety
- Healthcare-associated infections
- Heart disease and stroke
- Motor vehicle injury
- Nutrition, physical activity, and obesity
- Prescription drug overdose
- Teen pregnancy
- Tobacco use
The first thing you will probably notice is that none of these problems are exactly new, even if some might be improving. Tobacco use is down, but public health officialdom seems to despise e-cigarettes. Healthcare-associated infections, if anything, are getting worse, and are nothing short of a national scandal. Will we be seeing the same list, ten years from now? Should we judge the conventional wisdom?
Let’s hear from Sandro Galea, MD, MPH, DrPH–Dean of the highly-rated Boston University School of Public Health. Galea is not afraid to share his opinions, and uses Twitter frequently, among many other media outlets. He, like most academics, seems dismayed at the election results: “Trump became president by playing on the very social divides that have created the conditions for health divides.” Brilliant! Galea acknowledges the marginalization of the middle class, yet supports the globalist elite who caused it in the first place, and demonizes the populists who raise the issue.
Galea advances “10 steps the Trump administration can take to make America healthy again.” We’ll consider a few of them…
1. Improve early education. Great idea, only I’m betting that Galea–as a toe-tag liberal–might have a problem with school choice.
2. Control the opioid epidemic. Galea advocates limiting prescriptions, “monitoring” them–as if they’re not already highly regulated–and lots more paperwork. Somehow, he avoids dealing with uncomfortable facts: Many people have severe pain issues, that force them into heavy drug use; and far too much conventional “addiction treatment” is nearly worthless. Note that he cravenly avoids examining any of the reasons behind drug addiction.
3. Do more to control tobacco use. Okay, but he advocates the same old tired government-centric approaches. No mention of his stand on e-cigs, but I’ll go out on a limb and suggest that he’s against them.
4. Reform the criminal justice system. No argument, but he mentions the ill-fated War on Drugs only tangentially. Sandro, why not be bold and suggest that we should end it? Nope, couldn’t do that, as it might affect BU’s federal funding.
5. Limit alcohol misuse through taxation. Oh, that’s original. And, what about how such a regressive tax would affect poor people who don’t misuse alcohol? Careful, Sandro, your elitism and hypocrisy are showing.
6. Hands off the Affordable Care Act. I guess Dr. Galea hasn’t noticed the astronomical increases in premium costs, and the droves of insurers leaving the program. Nor does he admit that most of the people who obtained health insurance via ACA for the first time, just went on Medicaid. The ACA was DOA from the get-go, since the most rational approach would have been to set up a special and exclusive government-backed program for those with dire conditions, who could not obtain affordable insurance otherwise.
Instead, they embarked–purposely–on a grand evil scheme that affected the 80 percent who were happy with their current insurance. Yes, Sandro, that was a home run for sure.
Here’s my polite suggestion: Why not take a break from gracing the world with your tired ideas, and try using logic and right reason to create a few new ones.