Public Health is Political

If 2020 taught us anything, it is that public health is political. It has always been political and will continue to be political. There is no way around it at all. Public health is as equally scientific as it is political. Unfortunately, since the inception of public health there has been a distrust between those in the public health and political sectors. Due to this distrust, population health suffers dramatically. The events centering around the SARS-CoV-2019 has shown us it is vital to overcome the mutual distrust to improve the lives of population health.

To begin this conversation around public health being political I want to break down the definitions of each and then discussing the importance of the collaboration between the two sectors.

Public health is defined by the CDC as, “the science of protecting and improving the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury prevention and detecting, preventing and responding to infectious diseases.”

Politics is defined as, “the activities associated with the governance of a country or or other area, especially the debate or conflict among individuals.

How do the two sectors overlap? The real question is how do they not overlap? Public health and politics are two sides of the same coin. Just combining the words ‘public’ and ‘health’ makes a clear statement that health can only be achieved by the concerted action of many people who must work together in pursuit of a common goal.

Even though federal funding for U.S. agencies charged with protecting the nation’s health enjoys broad bipartisan support, many specific public health initiatives do not. These initiatives includes:

  1. Soda Taxes
  2. Reproductive health access
  3. Needle exchange programs
  4. Universal Health Coverage
  5. Gun Control
  6. RACISM AS A PUBLIC HEALTH CRISIS

Why the controversy?

“There is an idea on the part of scientists that politics is dirty, and a companion idea on the part of politicians that science, by its continual qualifications and revisions, is, if not irrelevant, then at least out of touch with the constraints of a democracy: What seems optimal from the perspective of science may be impossible to implement in the political arena…we must find ways to overcome this mutual distrust.” – William Roper

In science there are always unknowns and this presents with many challenges in the public health and political sectors – as policies must consistently change as well. Especially in the middle of a public health crisis. This idea feeds into the distrust, when in reality if politicians were to support public health experts, the community would have an easier time supporting them as well. Politics is central in determining how citizens and policy makers recognize and define problems with existing social conditions and policies, in facilitating certain kinds of public health interventions but not others, and in generating a variety of challenges in policy implementation. It is essential that public health professionals understand the political dimensions of problems and proposed solutions, whether they hold positions in government, advocacy groups, research organizations, or the health care industry. This understanding can help leaders to better anticipate both short-term constraints and long-term opportunities for change.

References:

  1. Oliver TR. The politics of public health policy. Annu Rev Public Health. 2006;27:195-233. doi: 10.1146/annurev.publhealth.25.101802.123126. PMID: 16533115.
  2. Roper W. Science, politics, and public health. Science. 2020 Oct 23;370(6515):385. doi: 10.1126/science.abf2837. PMID: 33093084.
  3. Marleen P M Bekker, Scott L Greer, Natasha Azzopardi-Muscat, Martin McKee, Public health and politics: how political science can help us move forward, European Journal of Public Health, Volume 28, Issue suppl_3, November 2018, Pages 1–2, https://doi.org/10.1093/eurpub/cky194

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