The Death of Public Health

H/T Dick Puddlecote for this article from Boston University school of public health:

Paternalistic measures are employed in public health because public health wants a compliant population, not an informed one. When accurate labeling does not “work,” advocates move on to more coercive measures. Cigarettes have been appropriately labeled with increasingly dire warnings. The warnings have evolved from informing smokers that cigarettes “may cause cancer” to current warnings that say “cigarettes kill” and cause a variety of serious diseases and conditions. If we wished to have an informed smoking population, we would measure what smokers know about the risks of smoking. But success in labeling is not measured by what smokers know about the risks. Success is determined by the number of people who stop, or do not start, smoking. The goal is to control behavior and have people do what we think is best for them.

When informed people make choices we do not like, we increase the pressure on them to be compliant. We move from written warnings on cigarette packs, which inform, to grotesque (and misleading) pictures on cigarette packs that are meant to disgust. Or we ban smoking in parks, although there is no health justification for doing so. Recognizing that it was not possible to make a supportable argument that secondhand smoke presents a risk to non-smokers in parks, Thomas Farley, the New York City commissioner of health at the time, said that children should not be allowed to see people smoking. This is an example of the extent to which public health advocates go to deny that their acts are paternalistic and to pretend that their actions are designed to protect others. Obviously the reason Farley wants smoking bans in parks is because it give smokers less opportunity to smoke—to protect them from their “foolish” choices.

The only loser in the end is going to be Public Health. If it currently still enjoys considerable public trust, it’s because the predecessors of its current practitioners slowly built up that trust over a long period of time. The current practitioners are now busily squandering that carefully accumulated trust. One day they’re going to find that they’ve lost the trust of the public, and they won’t know how to win it back.

It’s exactly like a family business which slowly accumulates a considerable fortune over several generations, only for a spendthrift son to inherit the fortune and blow the whole lot on horses.

Public Health seems to think that it enjoys public trust as some sort of natural right that comes automatically with the job. But there exists no such natural right. It has to be earned. And once earned it needs to be continually maintained. But no-one in Public Health seems to understand this right now. Although they all will in the end.

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About Frank Davis

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24 Responses to The Death of Public Health

  1. Harleyrider1978 says:

    The biggest loss in public health to the regular Joe on the street was finding out public health is no longer doing their real job. Prevention of disease vectors from bacterial and viral components. Cdc gave up that to become lifestyle policemen/ prohibitionists. Then the junk science and criminal laws against everything fat sugar alcohol etc etc

  2. Lepercolonist says:

    “However, for seniors 65 and older, this year’s flu shot was found to be only 9 percent effective against the more virulent H3N2 strain, the report showed.”

    “All of these experts in the room were looking at each other stunned,” he said.

    This was the 2012-2013 flu vaccine report. 91% failure rate from the CDC. Think the public trust was cracked ?

  3. John Watson says:

    Of the three I suspect Ebola will be the one people remember if only for the facts that the WHO were more interested in scoring political Brownie points on smoking than dealing with the more serious Ebola outbreaks!

  4. John Watson says:

    and the fact they said Ebola was under control, It clearly is not.

    • beobrigitte says:

      http://news.trust.org/item/20160319232244-ogqjg

      WHO warned, however, that Ebola could resurface at any time, since it can linger in the eyes, central nervous system and bodily fluids of some survivors.
      The WHO:
      “Houston, we’ve got a problem…. Best to distract the public with some well funded health scare. Perhaps Ebola can be linked to smoking….”

      I would not be surprised if the smoker haters would publish something like that. After all, they crossed almost EVERY border no-one else would.

  5. Clicky says:

  6. Cecily Collingridge says:

    Trust in Public Health was lost a long time ago but that hasn’t made a jot of difference.
    Earlier this month, the launch of Public Health England’s patronising ‘One You’ campaign prompted some in the national and regional press to run polls asking the public if they take notice of government health campaigns.

    They all seemed to show a staggering result of over 90% voting No, e.g. the 92% here:
    http://www.expressandstar.com/news/2016/03/07/poll-do-you-think-people-take-notice-of-government-health-campaigns/

    • Oi you says:

      That article is really interesting! Particularly good are the comments…

      :o)

    • beobrigitte says:

      Trust in Public Health was lost a long time ago but that hasn’t made a jot of difference.
      Of course it hasn’t. People want to live their lives.

      Earlier this month, the launch of Public Health England’s patronising ‘One You’ campaign prompted some in the national and regional press to run polls asking the public if they take notice of government health campaigns.

      There is a new health scare almost every day – peddled happily by the BBC and ignored by everyone. Surprised?

  7. garyk30 says:

    ” “cigarettes kill” and cause a variety of serious diseases and conditions. ”

    However, their own data shows otherwise.

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5745a3.htm

    The chart lists the diseases ’caused’ by smoking, the total deaths, and the deaths ’caused’ by smoking(SAM) for those diseases.

    Note:
    1.There are a total of 1,300,000 deaths and only 393,094 SAM’s.
    Only 30% of the deaths were attributed to smoking.
    70% of the deaths from the diseases ’caused’ by smoking were NOT caused by smoking.

    2. 128,477/852,370, shows that 85% of the heart attack-stroke deaths were NOT attributed to smoking.

    3. 160,848/225,627, shows that 38% of the cancer deaths were NOT attributed to smoking.

    4. 103,338/181,889, shows that 43% of the respiratory deaths were NOT attributed to smoking.

    5. Heart attack-stroke deaths make up 66% of the total deaths and if someone dies from them there is an 85% probability that death was NOT caused by smoking.

    • Harleyrider1978 says:

      Gary sounds like the Sam reports show the smoking rate is 30% not the claimed 17% they claim

      • garyk30 says:

        Ah no, percentage of the population that smokes is not the same idea as the percentage of deaths from the diseases ’caused’ by smoking.

        • garyk30 says:

          Anyway, they include ex-smokers in the figures.

          “SAFs for each disease are calculated using the following equation: SAF = [(p1(RR1 — 1) + p2(RR2 — 1)] / [ p1(RR1 — 1) + p2(RR2 — 1) + 1] where p1 = percentage of current smokers (persons who have smoked >100 cigarettes and now smoke every day or some days), p2 = percentage of former smokers (persons who have smoked >100 cigarettes and do not currently smoke), RR1 = relative risk for current smokers relative to never smokers, and RR2 = relative risk for former smokers relative to never smokers.”

  8. garyk30 says:

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a2.html

    ‘Any smoking-related chronic disease’
    We see that never-smokers make up 37.1% of those people with ‘any smoking-related chronic disease and would be expected to have 37.1% of the deaths from those smoking related diseases.

    That 37.1% 1,300,000 total deaths = never-smokers having 482,300 deaths from the diseases ’caused’ by smoking.

    Smokers only have 393,094 smoking caused deaths.

    Never-smoker deaths are 23% higher than the deaths ’caused’ by smoking(SAM).

    Ever-smokers deaths that are NOT caused by smoking are 33% of the total and equal 428,426 of the deaths from the diseases ’caused’ by smoking.

    When we compare the SAM of 393,094 with the ever-smokers 428,426 deaths that are NOT caused by smoking, we see that ever-smokers deaths from the smoking ’caused’ diseases are more likely to NOT be caused by their ever having smoked.

    • garyk30 says:

      “Never-smoker deaths are 23% higher than the deaths ’caused’ by smoking(SAM).”

      So, when ‘Dreadful Deb’ says that there are 100,000 deaths ’caused’ by smoking, one can point-out that there are 123,000 never-smoker deaths from those diseases and let her find an answer for that ‘paradox’.

  9. Pingback: Weekly Foggy Recap – Week of 3/19 | The Voop Review

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