To ward off disease or recover health, men as rule find it easier to depend on the healers then to attempt the more difficult task of living wisely.

Rene Dubos, 1959

The invisible profession

I recall my professor for Public Health Practice, Dr. Cheryll Lesneski, telling the class that public health is often called the “invisible profession” because its affects are rarely noticed by the public. Only when it fails, like in the current lead water crisis in Flint, MI, do people notice public health. 

In Cheryl’s class I had forgotten about this wonderful quote from Bernard Turnock that I came across again today. Emphasis mine.

[Public health] prevention efforts often lack a clear constituency because success results in unseen consequences. Because these consequences are unseen, people are less likely to develop an attachment for or to support the efforts preventing them. 

Advocates for mental health services, care for individuals with development disabilities, organ transplants, and end-stage renal disease often make their presence felt. But few state capitols have seen candlelight demonstrations by thousands of people who did not get diphtheria.

From: “Public Health: What It Is and How It Works”, Third Edition by Bernard J. Turnock, MD, MPH

Calorie Counts On Menus Won’t Change What Americans Eat

Calorie Counts On Menus Won’t Change What Americans Eat

Ebola primer from Diane Rehm Show

A great primer on Ebola for those interested from the Diane Rehm Show. One quote that really grabbed me was this one from Laurie Garret about why Sierra Leone, Liberia and Guinea seem so affected. 

Cultural beliefs are at play here in part, she says:

[One feature] we’re seeing as a key problem in this outbreak is the resistance of the general population to measures that could conceivably bring the epidemic under control, measures that worked in other outbreaks… Pretty basic things, but scary things for populations, like removing the ill from the care of their loved ones and placing them in quarantine and denying public burials so that there’s no contact with a cadaver.

Going further is a misunderstanding of the nature of disease and how the Germ Theory is not understood:

In the case of Ebola, we’re really up against cultural beliefs that when a disease hits a given family, it’s because your ancestors committed some sin against some other family and they have leveled evil spirits against you.

…[S]o you have a situation where outsiders are trying to say to people, there’s a virus. And this virus causes this disease. And we are outsiders dressed in space suits and we don’t look like you and you should believe us. And meanwhile the average person doesn’t even have a concept of what a virus is.

Dr. Billy Fisher of the University of North Carolina talks about difficulties in health education: 

So education is a big part of this and there have been some efforts, in fact I was met at the airport when I arrived in Guinea by a large placard that announced how Ebola was transmitted. But I think that’s one of the critical pieces that’s missing in this outbreak, and particularly because this is in such an under-served area, is information infrastructure. So there is not a great way to disseminate a lot of information about how this virus is transmitted and how to protect themselves within all the villages that are affected.

The landmark of political, economic, and social history are the moments when some condition passed from the category of the given into the category of the intolerable. I believe that the history of public health might well be written as a record of successive re-definings of the unacceptable.

Geoffrey Vickers, British industrialist. 1958

William Bennett and Robert White: Legal Pot Is a Public Health Menace

William Bennett and Robert White: Legal Pot Is a Public Health Menace