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2003-02-28

When did public health become about anthrax and smallpox? The climate of fear public officials have nurtured since 9/11 (when the weapons were knives, if you'll recall) has found its way to public health research and practice. Many health researchers are setting aside other lines of research to get a piece of the anti-terrorism funding. The American Public Health Association issued a statement following 9/11 (www.apha.org/united/action.htm) that reads like it could have come from the Pentagon (""funding for public health must be bolstered . . . ."").

It is hard to blame researchers and officials, given chronic underfunding of public health and unending frustration about the health insurance crisis. It is exciting to be part of a war that promises victory, rather than a perpetual holding action against countless challenges. But before 9/11, it looked like underserved health concerns were finally recovering (""it's the insurance crisis, stupid!"") from the political debacle of the Clinton health plan.

The preventable health threats from a few malevolent individuals certainly focus the mind. But do they deserve so much more attention than everyday hazards (deaths from auto accidents surpassed the 9/11 toll by 9/30), mental health (suicide passed 9/11 in mid-October), and natural infections (HIV did not catch up with the 9/11 toll until December, but simple influenza did so in September.) This is to say nothing of cardiovascular disease, which killed about as many Americans on 9/11 as the attacks.

Years of peace and prosperity created a growing consensus that we should work harder to improve the health of all Americans. Even though West Nile Virus has returned natural health concerns to the headlines, we cannot help but wonder if our leaders are using hypothetical diabolical threats to our health to hide from the challenges of the things that really are killing us.