-By Jake T. Snake
You have gentle reader heard me lament these many months about the wisdom of investing in public health infrastructure and disease prevention now to save multiple dollars later and well...it appears that no one is listening. The latest crisis to prove that our public health infrastructure is woefully unprepared for the next unexpected event (which inevitably public health crises are. I haven't seen on announced yet.) is swine flu. Nicholas Kristof notes that those 47 million uninsured americans are going to screw the rest of us by going to work when they are sick with the flu and consequently spread it. Bastards. Don't they understand that they should stay home so that the rest of us don't become infected. Their families having to eat is not a good enough excuse dammit!
The history of humanity is sprinkled with outbreaks of diseases of various types that we were inevitably unprepared for. It is silly at this point in history that we cannot be reasonably ready when these predictable events come down the pike. While we may not know exactly what, when and where there are certain things we can do to cushion the blow when they happen. These things cost money and are not always used. Some years we are lucky and there isn't an outbreak of killer flu. But in the long run, your grandmother was right, an ounce of prevention is worth a pound of cure. The continued trimming of public health departments and our fascination with abstinence education has brought us to a place where the Center for Disease Control reports that 25% of young ladies between 13 and 19 have a sexually transmitted infection. That number approaches 50% among young ladies who are from comunities of color. While these may seem like unconnected issues they share many traits. To stay ahead of both you need a good prevention plan, backed by enough resources to do the job. I fear that nationally we may have neither.
Public health happens in the community, in people's homes, in prisons, at the senior center, the rotary meeting etc. We need to employ people who can actively seek out and prevent diseases at their source, wherever that might be. That is public health. Hospitals and clinics are great, but there are large segments of the population that cannot or will not go to these facilities. HIV and AIDS showed us this. No insurance, plus cultural incompetence on the part of health professionals = a spreading epidemic of whatever variety. I would suggest that the swine flu is spreading, because of these same shortcomings. The math is simple really. If I have no health insurance and it costs $500.00 to set foot inside an emergency room I might not. If no one at my local clinic speaks Spanish and I don't have health insurance my chances of a productive health care visit may not be optimal? Folks who work in emergency rooms are freaking out, because they know that when the shit hits the fan at times like these they are standing in front of said fan with eyes and mouths open praying for a reprieve.
We have been slashing public health funding since Reagan came into office. That is damn near 30 years now. I can tell you from first hand knowledge that public health systems have been doing more with less and cobbing things together for so long that the whole enterprise is constructed of Bondo and baling wire at this point. We are unprepared for another serious flu episode or AIDS epidemic if something doesn't change fast. The signs are there if anyone is paying attention. Look at rates of Obesity, Diabetes, Sexually Transmitted Infections, Hepatitis. Lice, Bedbugs and on and on. While much of the coverage is focusing on Mexico's lack of public health action. I think we could be in a similar situation.
The development of this particular strain of flu has been traced to some factory farming practices. This is another less publicized legacy of the Bush years, hobbling the food and drug administration's inspectors. The pro-business policies of this administration created disease at the farming end of the food production chain and slashed funding continuously to the public health entities that might have ameliorated the problems they created. Genius with a capital dollar sign and no regard for animal or human life.