In Praise of Public Health
By: Scott Hamstra, M.D.
I’ve been fortunate to have one foot in both worlds — one in clinical medicine and one in public health — and bear testimony to the amazing positive impact of vaccines in preventing disease and saving lives. Perhaps this pandemic will help people better understand that our policies and public health efforts and successes over the past decades have created a world where our fears have been diminished and we wake each day expecting peace, safety, health and prosperity. COVID has shaken that confidence for the moment. We’ll get through this. When it’s over I encourage you to think broadly about Public Health, far beyond vaccination, that will help us move to a safer healthier world.
Why did we Americans, with all our expertise in medicine and science, bungle the response to the coronavirus?
I think part of the answer is that while we’re great at clinical health, we lag at public health. (Clinicians treat one patient at a time; public health professionals treat populations.)
You get cancer and have the right insurance, and you’ll get amazing care from an oncologist.
But the treatment that has reduced cancer deaths the most is a public health intervention: the cigarette tax.
You get in a car wreck, and trauma surgeons will put the pieces together — but it’s public health interventions like seatbelts and airbags that have saved the most lives from auto accidents.
And public health experts gave us vaccines, sanitation and clean water.
Yet a public health degree is never treated with the respect that an M.D. gets, and some of the worst-paid doctors are those working in public health. We’ve substantially cut the budget of the C.D.C. over the last decade. And public health is mostly the responsibility of local health departments in the U.S., which in much of the country means some overworked official at a desk in the county courthouse. It’s no accident that the countries that have handled Covid-19 best, like Taiwan and South Korea, are those that emphasize public health.
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