Dr. Bob: Benefits of boards of health

September 16, 2018

The United States faces enormous challenges in its efforts to protect the health of the American public. Monitoring and researching health issues must be ongoing.

In 1900, the leading causes of death were primarily infectious in nature. Today, they are more lifestyle-related. However, worldwide exposure to infectious pandemic conditions are just a plane landing away.

Just last week, several passengers and crew of an Emirates airplane caused a public health emergency when it landed in the U.S. with an unknown, potentially infectious condition. Just this week, many schools in Utah County and beyond find themselves battling Norovirus, a highly infectious condition causing vomiting and diarrhea. Sanitation of entire school buildings, busses and other common environments are currently being performed. Potentially, Norovirus can close schools, churches, movie theatres and every other place where large numbers of people come together.

Community public health efforts aimed at disease control, as well as chronic diseases, are the responsibility of a wide spectrum of public health agencies, not the least of which are state and local boards of health.

These boards, virtually unknown to most of the general public, are some of the most powerful bodies in the country. Much of their influence is derived by millions of deaths occurring as a result of disease outbreaks of hundreds of years ago. Often they were given unlimited authority by a weary public to end epidemics before everybody was infected or dead. Today, boards of health continue to perform a vital service at both the state and local level.

In 1861, the famous writer Henry Wadsworth Longfellow wrote a poem that immortalized a famous American and Boston Board of Health member 40 years after his death. In fact, his name and service would not even be remembered were it not for the poem. As you may have guessed, this now famous person was Paul Revere. “Listen my children and you will hear the midnight ride of Paul Revere.” Or maybe you have heard, “one if by land, two if by sea.”

Paul Revere’s Ride was actually written at the outbreak of the Civil War, when many writers were trying to rally Northerners to fight against the South. Longfellow succeeded in stirring up the spirit of many Northerners by causing them to rally around the idea that one person could take a bold stand for his country and make a difference. Revere was only a regionally known name before the poem and a beloved national hero after its publishing. In addition, the poem was never meant to tell a historically correct story.

The facts seem to be that Dr. Joseph Warren, a Harvard educated doctor and long forgotten Revolutionary War hero, actually sent not only Revere, but also William Dawes. Each were assigned different routes, however. Their job, consistent with board of health responsibilities, was to warn that the British were on the move. Today, boards of health have similar duties, maybe not to warn of an impending military invasion, but certainly of other forms of imminent danger.

In general, health departments’ duties include collecting and keeping track of vital statistics, births, deaths, weddings, divorces, and outbreaks of communicable and chronic diseases. In addition, they operate various clinics such as those for identifying sexually transmitted infections, maternal and child health services, WIC (women, infants and children), water, air and food safety monitoring, including restaurant and convince store inspections, and perhaps the most familiar: immunization services, especially those targeted at preventing childhood diseases, just to name a few.

It is important to remember that medicine saves lives one at a time. If it is your life, that is very important. Public health and their controlling boards save lives thousands, often even millions at a time, and that is important as well.

In 1900, according to the National Vital Statistics System, the average life expectancy was 48 years. Thanks to public health, the average life expectancy is now close to 80. Thanks for the additional 32 years of life.

I am totally biased.

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