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Public Health and Social Justice

Public Health and Social Justice. Edward P. Richards http://biotech.law.lsu.edu April 2, 2001 . The Impact of Public Health. Increased Life Expectancy More than Doubled between 1850 and 1950 Biggest Impact on Children Reduced Acute and Chronic Morbidity Cholera, Yellow Fever

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Public Health and Social Justice

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  1. Public Health and Social Justice Edward P. Richards http://biotech.law.lsu.edu April 2, 2001

  2. The Impact of Public Health • Increased Life Expectancy • More than Doubled between 1850 and 1950 • Biggest Impact on Children • Reduced Acute and Chronic Morbidity • Cholera, Yellow Fever • TB, Malaria, Syphilis

  3. Changing Public Perceptions • Communicable Disease Once Paralyzed Government and Community Life • No More Visible Public Health Crises • Quarantine for TB and Other Diseases • Closing of Public Facilities and Limiting Travel for Polio • Magic Bullet Mentality • Vaccines • Antibiotics

  4. Lowered Public Support • No Crisis – No Political Support • Reduced Funding • Politization of Agencies • Resistance to Interventions • Loss of Academic Support • Research Money Shifts to Social Science and Biotech • Public Health Training Loses Focus • “No There, There” Problem

  5. Public Health as Oppression • Tuskegee Syphilis Experiment • Typhoid Mary • TB as a Housing Problem • STD Control as Sexual Discrimination • Fluoridation Foes • Anti-Vaccination Movement • Environmental Justice

  6. Public Health as Suspect Activity • Shift from Societal Protection to Personal Protection • Shift from Police Power to Parens Patria • Increased Due Process • Increased Agency Cost • Shift from Expert Decisionmakers • Civil Rights Mentality

  7. Lawyers and Law Professors Prefer Civil Rights • Helping the Downtrodden • Empowering the Individual • Distrust of the State • Lots of Money in Suing for Individuals • Not Much Money in Representing the State • No Money or Private Practice in Public Health Law

  8. Was Public Health Oppression? • Was Public Health More or Less Discriminatory than Society As a Whole? • Generally Much More Progressive • The Burden of Disease Always Falls Hardest on the Poor and Disenfranchised • Greatest Benefits to the Worst Off • Separate Out Medical Care • Public Health Was the Most Egalitarian Service

  9. Public Health Elitism • AIDS Think • Driven by White Affluent Gay Men • Privacy and Autonomy is More Important than Disease Control • Ignores Casual Contact Diseases • Self-Empowerment Model • Driven by Political Power in Urban Centers • Aggressive Involvement in Medical Care • Even Private Importation of Drugs

  10. Impact of Public Health Elitism • AIDS and Poor and Minority Women • Denied Access to Medical Care • Left Out of Clinical Trials • No Protection from Sexual Contacts • Environmental Justice • East Fix • Really About the Environment • Just Results in Gentrification

  11. Public Health Justice • Reject Elitism • Empowerment only Benefits the Affluent and Powerful • Is Privacy More Important than Life and Health? • Real Oppression • Underfunded Public Health Services • Incompetent Public Health Professionals • Ignoring the Most Significant Risks to Health and Community

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