Noone at the Helm

From Confined Space comes news of a new public health blog, Effects Measures, published under the pseudonym “Revere” by a “senior public health scientist and practitioner. His name would be known to many in the public health community and to a few others in his (very specialized) area of scientific research.” It’s quite good, and he pulls no punches. In discussing the need for anonymity, he says:

The choice of a "virtual" rather than a specific identity allows Revere to speak with a distinctive voice and a diction (choice of words) not constrained by the careful words required of public persons. Revere wishes that voice to include the language used daily around lunch tables and water coolers in agencies, health departments and universities when health workers are speaking plainy. Revere's language on Effect Measure can be saltier, more direct and blunter. We need plain speaking at this moment. But that kind of language can also provoke reprisal and retribution. Revere does not wish any program staff, agency or university funding to be jeopardized by his/her/their utterances off the job. Could that happen? This is the Bush Administration, dear Reader. They play rough and by their own rules. We must expect that.

Public health in America is leaderless, rudderless and dispirited. The failure is across-the-board, including the leadership of virtually the whole federal health establishment, our state health departments, our universities and schools of public health, and our labor unions, among others (Revere is an equal opportunity offender). We must not only feel free to Speak Truth to Power, but just as importantly, to Speak Truth to Each Other. That might mean challenging long held "conventional wisdom" in public health. Revere wants the freedom to do this without unintentionally alienating respected friends and colleagues. It is Open Season.

One of Revere's (not so modest) objectives is to jump-start the process of reconstructing and re-invigorating the progressive public health movement in this country and by speaking in a distinctive voice, to advance the conversation. When wrongheaded, Revere will rely on your astuteness and passion for public health to correct, cajole and inspire. We are all in this together.

I was particularly drawn to the thought of public health in America being leaderless, rudderless and dispirited. Investment in public health, in the same manner as investment in education or the arts or workplace safety, is an indicator of an advanced society, and the worrisome thing is that the disinvestment is a sign of us slipping to a lower-tier status.

I wonder what is going to have to befall us for public health to become important once again: have the water and wastewater treatment infrastructure finally collapse from lack of investment, so that it’s no longer safe anywhere to drink from the tap? Have the healthcare infrastructure collapse from treating a substantial fraction of the population suffering with degenerative diseases incurred through poor lifestyle choices? Bacterial or viral epidemics brought on because there’s no profit margin in developing vaccines or antibiotics? Cancer epidemics from exposure to persistent organic pollutants? Worse yet, discovering that we’ve made an entire generation of children cognitively impaired from exposure to POPs, mercury and lead. International terrorism pales in comparison to the woes awaiting us if we fail to reinvest in public health.

Thank you, Revere for sounding the call to arms.

Postscript: I learn from the masthead that Paul Revere was a member of the first local Board of Health in the United States, in Boston, 1799.