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Politics & Public Health

PROLOGUE

Politics & Public Health

The papers in this section examine the role of politics in public health, from a variety of perspectives. In the opening paper, which follows closely on post–September 11 events, George Gray and David Ropeik discuss the role of fear in people’s reaction to dangers and stresses. In a political context, they write, it behooves those who communicate to the public about risks to place the risk into context and to provide as much helpful information as possible. It is also crucial, they suggest, for these messages to come from trusted sources; they cite polling data following the past year’s bioterrorist incidents finding that the critical messages were delivered by persons who were not greatly trusted, which may have diminished the effectiveness of these messages.

Next, Sen. Bill Frist (R-TN), the nation’s only physician-senator, reiterates the need to keep the core of public health activities at the federal level, for reasons of national security. He provides an overview of legislative activity to shore up the public health infrastructure—activity that began during the Clinton administration—which culminated in the passage of P.L. 107-188, the Public Health Security and Bioterrorism Preparedness and Response Act, signed into law by President Bush in June 2002. However, he notes that after years of neglect, the public health system cannot be rebuilt overnight.

Ilona Kickbusch, a global health expert formerly with the World Health Organization in Geneva, then examines the U.S. role in health improvement efforts around the world. The growing complexity and urgency of domestic public health challenges do not take the United States off the hook in using its power, influence, and wealth to join (or even lead) efforts to improve health around the world.

Finally, Rogan Kersh and James Morone discuss the politics of obesity as a national public health concern. Using examples from throughout U.S. history, they list seven triggers that have accompanied national campaigns about tobacco, alcohol, and sexual behavior: social disapproval, advances in medical science, self-help, demonizing users, demonizing industry, mass movement, and interest-group action. Several of these triggers have already been tripped for obesity, they write, but so far the government does not show signs of acting on behalf of healthy foods as it has acted to control tobacco and alcohol use and risky sexual behavior.

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