The mid-term elections for all US Representatives and 1/3 of our Senators is less than two weeks away and public health is conspicuous by its absence in the debate. I have been looking for evidence that public health and medical research groups have devoted any resources to producing voters' guides or have been conducting any type of advocacy campaigns to bring their issues into the debate. Maybe the calculation is that the war in Iraq so dominates the discourse that there is no oxygen left for anything else.
Well, thank you for people like Michael J. Fox who is garnering a lot of free media today with his ads for several Senate candidates who support stem cell research.
"Stem cell research offers hope to millions of Americans with diseases like diabetes, Alzheimer's and Parkinson's," Fox says, seated in a dimly lit hotel room, staring directly into the camera. "But George Bush and Michael Steele would put limits on the most promising stem cell research."
..."He wants to take on races and get involved in races that involve a pro stem cell candidate against an anti embryonic stem cell candidate," said John Rogers, a publicist for Fox. See the ad here.
My own limited research for information about where candidates stand on public health and medical research issues found half a glass.
Research America! has the most comprehensive site for voters where they can find out how candidates stand on a variety of health, medical and scientific research issues. One of mine has completed the voluntary questionnaire he was sent by RA! and guess who has at least one vote (no, not that one). The site also has the results of a national opinion poll that shows 79% of Americans favor increased funding for state and local health departments and 63% oppose funding cuts for the CDC. Do you know where your local candidates stand on these and other issues? The Michael Steele mentioned above did not bother to respond to the survey.
Note that public health groups such as the American Public Health Association or the Association of State and Territorial Health Officers who promote themselves as advocates for public health do not support or promote this voter education and engagement effort. In fact, the best the APHA seems to be doing at this time of year is reminding attendees to their annual conference, which meets on Election Day, to cast their absentee ballot and launching (yet another) campaign on preparing for the flu pandemic. Their information on the past voting records of members of Congress on issues of importance to public health are only available to members!
In the meanwhile, ASTHO is silent on the elections all together, despite a set of proclaimed public health advocacy priorities.
Well, these and other organizations can continue to complain about their relatively meager slice of the Federal budget pie, but these types of behaviors (or lack of) need very little interpretation or insight to figure out why the public health patient remains in critical condition.
I sent emails to the public policy staff for both organizations over two weeks ago asking about the availability of voter information. I have yet to receive any acknowledgment or response - must be getting ready for the conference: Evaluating the Intersection of Public Health and Human Rights.
The July/August issue of Health Affairs focused on The State of Public Health, and an article by Tilson and Berkowitz lay out their analysis of the major challenges that need to be confronted by public health policy.
- What will it take to unite constituents, elected officials, the professional community, and others in the larger public health system in insisting on a viable sustainable effective local public health infrastructure?
- Develop a clear vision of what needs to happen to ensure that all US communities have the public health infrastructure that they require.
- Assure that this emerging system is current, competent and connected with the rest of the preparedness infrastructure.
- Develop and implement public health system performance standards.
- Create and maintain a high quality public health workforce through credentialing and certification programs.
- Create a single or substantial source of funding for research into understanding and improving the public health system.
While understandable to (some) public health policy wonks, these types of analysis are hardly the material that is necessary to engage the public and policy makers in any relevant or meaningful ways. Transforming these types of issues into mainstream thought and action are the overarching challenges for the field of public health.
This election cycle is another missed opportunity for public health to engage and set some of the public and policy agenda, and not simply sit and talk to each other in Boston. Well, maybe we can at least start planning for the 2008 election cycle and commit to making people's everyday lives, and our common good, part of the conversation next time?
Wednesday AM update: Guess there was more oxygen, or people looking for anything to change the subject, than expected gauging from the reactions to the Michael Fox ad. Limbaugh self-immolates. Comparisons to 'Willie Horton' and 'Daisy' ads in the NY Times ends with this:
These are times in which most actors seem prepared to do anything, and pay any price, to disguise flaws that could harm their careers. So when a famous one exposes the full, frightening extent of his infirmity in the name of saving lives, it tends to get noticed.