Leaning In To Public Health Policy: Public Health as Nation Builder.

Posted on | March 8, 2023 | Comments Off on Leaning In To Public Health Policy: Public Health as Nation Builder.

Mike Magee

As Stanford Professor of Law, Lawrence M. Friedman, wrote in A History of American Law, “One hundred and sixty-nine years went by between Jamestown and the Declaration of Independence. The same length of time separates 1776 and the end of World War II.”

During those very early years that preceded the formal declaration and formation of the United States as a nation, our various, then British colonies, fluidly and independent of each other, did their best first to survive, and then to organize into shared communities with codified laws and regulations.

For legal scholars, law (and lawyers) are often viewed as “rational instruments” and necessary evils. But for social historians, they are “a study of social development unfolding over time” impacted by emotions, politics and real-time economics. At the core of the struggle is a clash between the rights of the individual and those of the collective community.

This clash of values has been playing out in full view over the past three years of the Covid pandemic. It is also why Public Health veteran and Washington Post columnist, Dr. Leana Wen, has come to a conclusion that “Public health needs a reset.” In her column this week she asked, “Whose rights are paramount? The individual who must give up freedoms, or those around them who want to lower infection risk?”

This battle between “individual liberty and communal good” is ancient and current at the same time, and still a source of conflict wherever and whenever humans attempt some version of “nation building.” In our current case, as Dr. Wen described, “Some viewed mask and vaccine mandates as a direct encroachment on bodily autonomy. Others preferred them because they helped people feel safer as they resumed daily routines.”

Part of the reset that Dr. Wen is suggesting for our American society involves Public Health resisting the instinct to over-simplify, and rather lean into complexity by addressing decision making at the interface of science and values. This redirects fear and wasted energy to the community’s unmet needs – common ground initiatives like preventive steps such as better viral monitoring of wastewater on the one hand, and addressing the unintended consequences of our Covid response initiatives such as massive drops in routine childhood immunizations for diseases such as measles.

It is useful to recall that we humans on these shores have come a long way. From the beginning on the shores of Virginia in 1607, these early wild settlements were essentially lawless – that is without laws. They also were wildly different in their dates of entry and their range of issues. Consider that more than 100 years separated the beginnings of the Massachusetts Bay colony and the colony of Georgia. And as historian Lawrence Friedman noted, “The legal needs of a small settlement run by clergyman clinging precariously to the coast of an unknown continent were fundamentally different from the needs of a bustling commercial state.”

In these modern times, we still resist acknowledging our own history of enslavement and mass displacement and destruction of millions of individuals and their cultures. And yet, here we are together, doing our best to push back against the Governor DeSantis’s of the world who would halt our human progress.

in many ways, the struggle to act in a civil and wise manner, that mines common values, and finds a balance between individual freedom and wise collective rules and regulations, remains our hill to climb.

Public Health policy, debating it and formulating it, can help us get there. This is because it exists at the intersection of Law and Medicine. We should advantage this opportunity, and make the most of it.