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November
2001
The Winds of
Spore
At the same time the government was issuing statistics
last month showing that life expectancy for Americans is higher
than ever, a lot of Americans started acting as if they could expect
to die tomorrow.
The near-panic set off by the anthrax intrusion
at Rockefeller Center, West 57th Street and Capitol Hill illuminated
not only the role of public health officials but the role of the
consumer as well.
While people were storming pharmacies in search
of Cipro, there were anecdotal reports of otherwise rational Americans
throwing their diet and fitness regimens to the same winds they
feared bore deadly spores. After all, if you aren't sure you will
live to a newly designated ripe old average age of 76.9, why bother
to hit the gym or to pass up that box of Belgian chocolate?
The reason that life expectancy has increased is
that deaths from heart disease and cancer continue to go down, largely
because we, as a people, have learned new and healthy behaviors.
It wasn't so much improvements in medical care; it was that over
the past 20 years, consumers started heeding believable information
from public health authorities. We had easy access to solid scientific
information about the dangers of smoking and of cholesterol and
we acted upon it.
The same lesson holds true for fighting bioterrorism:
Public health doesn't work without the public.
Communicating clearly and truthfully with us has
to be the only option for government and medicine. The traditional
military model of secrecy and the medical model of paternalism dangerously
underestimate our intelligence and good judgment, obstruct appropriate
action and place way too much power in the hands of fragile public
health and medical infrastructures.
It is we, as individuals, who put into action what
a mountain of scientific evidence and years of clinical experience
have taught us. If we don't show up for screenings, if we can't
accurately assess our risk, if we can't identify symptoms, if we
take Cipro unnecessarily, then all that our medical and public health
systems know and do is for naught.
We are all
in this together - the government, the medical profession, the public
health system and people acting as informed consumers. Ours is a
system of trust; we need to trust the information public health
authorities give us and they need to trust us to act accordingly.
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