
I recently met a friend for lunch. They read the chapter of my autobiography about time we shared on the county board of health, ending in 2010. Rather than continue a discussion on email, we decided to meet in person. Ambient temperatures were above freezing and that made for a sloppy day. The restaurant parking lot was full of puddles.
One of our joint projects was working to reduce toxins in the environment across the state of Iowa by advocating with other boards of health. As chair, I wrote a letter to every board of health in the state about reducing reliance on coal as a source of energy. Likewise the two of us made our case to several boards of health in person. It is difficult to know the impact we had, yet projects to build new coal-fired power plants in Waterloo and Marshalltown were killed by the public utilities after we began our campaign.
One board of health said they wanted to keep politics out of it. Is public health political? If you have any familiarity with a health department, you know it is. My friend emailed me the following after our meeting:
When we were talking about the folks in the other Health Departments I was about to say something then forgot. It was about “politics” er. the fact that public health is political — it is a social science and reflects competing interests of those who would choose to pollute with impunity in the name of their god-given right to pursue profit in their business, and the interests of the public that require clean air, water, and a livable climate.
If we don’t these days believe public health is political we never will. But, at the time, I thought it important to remind people of that simple fact because so often (not unlike now) people want to say things like, I understand you want to control or study or advise about…. but don’t make it political. Yikes. And that’s the whole story.
I think the word “political” was a precursor to “woke.”
There is nothing political about mobilizing a public health work force to deal with an infectious disease outbreak. Likewise, there is nothing political about providing clean water by using drinking water standards to regulate what is and isn’t in public water supplies. These procedures and regulations don’t come out of the blue. A political process is behind them.
Part of the board’s work was to lobby the Iowa legislature on multiple issues. I spent most of my lobbying time working to make Iowa a tobacco-free state with clean air. We also wrote letters to the editor on timely topics. When the Smoke-Free Iowa Act was signed into law, banning tobacco smoke in most public places, through effective political lobbying, the gambling industry got an exemption for casinos. We had to compromise to get the bill passed. Oh, yeah! It’s political.
Our local boards of health have been charged with leading the effort to prevent disease and improve physical, mental, and environmental health in the community. Few members of the public attended our public meetings or offered comments. Citizens should be first in line to attend these meetings and offer solutions on how Iowa can improve its public health system. Until they do, volunteer members of boards of health do the best they can to promote health and prevent harm. We even had that printed on coffee mugs.
I don’t know if it’s political but there is one area that could improve: More licensed medical practitioner volunteers are needed to supplement the work of the public health system. In an era when government spending on public health can be expected to decrease, volunteers enable us to get more work done within the existing public health infrastructure. For the number of per capita medical practitioners in Johnson and Linn counties, our performance in this area has been disappointing.
So yes, of course, public health is political. It’s the nature of the beast, even if it is rooted in a time when there was a broad consensus about what government can do to further the public good. You know, back when we were Iowa nice. Sadly the sun set on that a long time ago.










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