Public health officers should focus on disease, not politics
Peter Shawn Taylor is editor-at-large of Maclean’s. He lives in Waterloo, Ont.
Public health officials across the country have been getting their smocks in a knot over news Canada’s chief public health officer may soon come under greater political control.
As reported in The Globe and Mail last week, the Harper government’s omnibus budget bill removes the chief public health officer’s ability to set budgets and control resources at the Public Health Agency of Canada. These tasks will fall to the newly created position of president. The country’s top doctor will instead devote his energies to advising Ottawa on public health issues and co-ordinating with other agencies.
Perry Kendall, British Columbia’s provincial health officer, argues his colleagues across the country are “unanimous” in opposing the move. Carolyn Bennett, the former Liberal MP who set up the agency in 2003 called it “bad news.” Having lost the freedom to oversee budgets and allocate staff, critics fear the country’s chief public health officer will be subject to greater direction from government.
If so, this isn’t a problem. The entire field of public health could use more political oversight these days.
Across the country, public health departments at all levels of government have wandered much too far from their original mandates. Instead of focusing on the prevention of communicable diseases, they’ve been indulging in overt ideological crusades, inventing obscure new problems and claiming jurisdiction in areas well past the limits of their competency.
It has become fashionable, for example, for municipal public health offices to condemn income inequality as a danger to public health, and demand higher taxes to correct the situation. While there may be a link between poverty and health, there is no such connection to be found in the gap between rich and poor. It’s an entirely political point of view that owes much more to the Occupy movement than Jonas Salk.
Local food promotion is another newfound obsession for public health departments. The regional municipality of Waterloo, in southwestern Ontario, for example, produced a report arguing all local tomatoes should be consumed locally and any consumption of ‘imported’ tomatoes should be considered unpleasant evidence of “redundant trade.”
Waterloo has proven particularly inventive in creating previously unknown public health crises. Earlier this year it announced 97.7 per cent of residents eat an improper diet and their region has become a “food swamp,” defined as a locale where junk food is more readily accessible than healthy food. This diagnosis was confirmed when a research project found most residents live closer to a convenience store than a full-service grocery store (shocking!) and more local shelf space is devoted to snack foods than fruits and vegetables.
When not inventing new problems, public health departments are typically demanding a variety of draconian measures such as bans, taxes, advertising rules and zoning restrictions in order to exert more control over the everyday decisions of adults. And in the absence of any democratic legitimacy. When New York City’s health board tried to implement its famous Big Gulp ban, the move was struck down by the courts as beyond its remit.
The mission drift rampant in public health extends all the way up to the World Health Organization. At the peak of the Ebola scare and with her organization under fire for mismanaging the on-the-ground response to the outbreak, last month executive director Margaret Chan was in Moscow attending a tobacco conference where she argued cigarettes are a bigger threat to global health than an African virus. Last year she threw her lot in with the anti-corporate crowd, railing against “Big Food, Big Soda and Big Alcohol.”
The original − and very necessary − purpose of public health was to combat infectious diseases and impose sanitary standards on water, food and waste. From this perspective, the field has enjoyed many successes, such as the eradication of polio and smallpox and the remarkable safety of Canada’s food system. Lately, however, public health departments seem to have lost sight of their primary mission. In a search for new things to control, or perhaps to pursue personal ideological views, public health officials have pushed their way into areas they simply don’t belong.
It is not the job of public health to have an opinion on taxes, economic policy, free trade or corporate control. Neither should it be their business to interfere in the freely-made choices of adults.
Public health ought to stick to their needles, and leave the economy alone.
via Globa and Mail