All Public Health Is Local


As we look forward to another year of climate change, reflect on the spread of newly emerging diseases, and contemplate the effects of global exchange and internecine conflict, it is worthwhile to think about the public health infrastructures ability to address these developments. Two articles in this issue of the journal reflect the public health community’s concern with developing and strengthening local health departments’ capacity. Beebe et al. describe continuing education courses in biostatistics and epidemiology for local health officials in seven states, while Fraser and Brown of the National Association of County and City Health Officials address the issue of bioterrorism preparedness. A future issue of PHR will focus broadly on capacity building in state and local health departments.

“We Give the Public What It Wants”

Many of the excesses of the commercial media are defended by those who say that the public demands the quality, substance, and emphasis that are being criticized.
Cooper and Roter present some interesting findings that won’t surprise many public health advocates.

“One Picture Is Worth a Thousand Words”

War may be said to be the greatest public health issue. Barry Levy’s preface and David Parker’s photographs in our photo essay are compelling and important; but it is the children’s voices that manage at one time to describe inhuman horror and human longing for peace.

“We Have Met the Enemy and They Is Us”

The three book reviews in this issue deserve special notice. They, too, discuss areas that will be the subjects for a future issue of PHR, with a focus on the precautionary principle. If reduced fertility rates, increased rates of certain cancers, and the growth in diseases of the immune system are too invisible to the public, the horrifying deformities in frogs and other amphibians may be what it takes to raise the questions about chemical use, the lack of adequate health and safety information for most household and industrial chemicals, and the weakening of monitoring and regulatory authorities. And if we don’t do something soon, maybe the Frog Force [see inside hack cover] led by Captain Ribbitt will!


The Letters [Public Health Rep 2000;115:108-9] written in response to Price and Oden’s article “Preventing Firearm Trauma: The Role of Local Public Health Department” [Public Health Rep 1999;114:533-9] typify the gun violence debate in America. NRA members and pro-gun advocates take advantage of every opportunity—in the print media, on call-in radio and television shows, and in the halls of state legislatures and the US Congress—to pound home their message that guns make our country a safer place to live. However, as public health professionals, we must be aware of the fallacy of this argument.

We have learned on both the national and local levels that an armed society is not a safe society. In 1997, there were 32,436 firearm-related deaths in the United States (Personal communication, Alexander Crosby, MD, Medical Epidemiologist, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, June 2000). While the US crime and violence rates are similar to those of other developed countries, our homicide rate is much higher.1 This difference in rates is primarily attributable to firearms.

Public health professionals have led the way in curbing a wide range of epidemics, from polio to smoking to traffic crashes. Price and Oden’s article can jump-start critical networking and information sharing about successful gun violence prevention efforts being used in communities across the country. Legislation alone can not reduce gun violence. We need public health professionals to collect local data on the extent of the firearm problem in our communities. We need community-based programming aimed at preventing gun violence. I commend local public health departments that are presently doing work to reduce gun violence and encourage other departments to begin the process of addressing this epidemic.

Category: Health

Tags: health care, health-risky, medical care, Public Health Department

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