Public health must treat cause, not just symptoms
December 15, 2014
The following letter was submitted to the Globe and Mail in November, 2014 in response to an opinion piece concerning the role of the public health community.
Peter Shawn Taylor’s opinion piece argues that public health should leave aside politics and economics, and stick to overseeing public health measures. He argues, “While there may be a link between poverty and health, there is no such connection to be found in the gap between rich and poor.” In fact we know that overall population health declines as that gap increases.
For Taylor it is enough to simply treat the disease’s symptoms and to leave the cause alone, but that is to misunderstand the very history of public health itself. To be effective public health must also point out the causes and conditions that create public health risks. As Rudolf Virchow, the renowned 19th century physician and public health activist, said more than 100 years ago: “Medicine is a social science, and politics is nothing else but medicine on a large scale.… If medicine is really to accomplish its great task, it must intervene in political and social life. It must point out the hindrances that impede the normal social functioning of vital processes, and effect their removal.”
To pretend that public health does not exist in a social, political and economic context is to deny the very basic epidemiology of disease. The Victorians understood that if you wanted society at large to be safe from diseases like typhus and the plague it required tackling the causes of those diseases and ameliorating the conditions that give rise to them. The same is true of TB, HIV, Ebola and a host of other diseases today.
Dr. Sylvia Abonyi, Saskatoon
Dr. Tom McIntosh, Regina
Saskatchewan Population Health and Evaluation Research Unit