Public health is about the health of the public. So why do so many people feel they can take their blood to the Public Health lab and have it tested for free? There is a misunderstanding about how public health functions. Public health is about the people, not the person.
It's about research and control of public outbreaks of disease, protecting and improving the health of groups of people through promotion of healthy lifestyles. Overall, public health is concerned with the health of entire populations.
The public health lab is, I'm sorry to say, not concerned with your private blood test for Zika done by your private GP who nowadays is diagnosing any rash as Zika, taking blood and sending it to a private lab which is busily doing tests for Zika that are neither reliable nor accurate. Those are inconvenient truths.
The public health lab is concerned about whether or not there is an outbreak of Zika, how to diagnose the disease so as to inform the Ministry of Health that there is an outbreak and what can be done to protect the entire population from Zika as well as the next virus coming down which the population knows nothing about because it is not yet an immediate problem.
People don't think about public health until they come up against an immediate problem.
Yet public health has affected us in hundreds of ways over the last 100 years which was when the great public health programmes of sanitation, vaccination, nutrition etc, began to influence our lifestyles.
My alma mater, the Johns Hopkins Bloomberg School of Public Health has published a list of 100 objects that, for good or bad, have affected the public and our common health.
At the top of the list has to be the toilet. It's hard to think of a more basic or prosaic invention for promoting public health. Toilets channel human waste into sewer systems instead of into the water supply. Water contaminated with faeces carries potentially fatal diseases including gastro which still is the world's second-leading cause of death in children younger than five.
Hundreds of millions of people in the world do not have access to safe drinking water. In these places, bottled water is a lifesaver. However, notwithstanding the ads, the tap water quality in T&T is generally excellent, and readily available.
Despite this, many Trinbagonians believe that bottled water is safer to drink. And the ads are slick. "People easily consume simple marketing messages–the urban myths," Kay Dickersin, a professor of epidemiology at the Bloomberg School, says. Bottled water uses up scarce resources, plastic is environmentally a disaster and the water is not always safe. There have been outbreaks of vomiting and diarrhoea traced to bottled water. Apart from convenience, there is no need to drink water in bottles.
American cheese is a sterling example of processed foods. Bread, cheese, beer, pickles have been processed by human beings for thousands of years. Processing can keep food fresh longer and can make food safer by killing harmful bacteria. These days, however, most products like American cheese, are super processed, and make up a major part of our diet. These foods are packed with sugar and salt. Humans adore sugar and salt. The availability and cheapness of such foods has contributed significantly to obesity and obesity-related diseases, particularly in the poorer population.
Pavements. Such a simple thing. Pavements promote walking. Walking promotes weight loss. Walking on pavements promotes neighbourhood interaction, neighbourhood personality and economic enterprise. In neighbourhoods where there are no pavements or where pavements are near busy roads, walking can be dangerous and the car takes over. Cars isolate people. Pavements bring people together.
The chair is the opposite. Chairs promote obesity. The man in the chair is always superior. Chairs have been around for 5000 years but only came into general use in the 18th century. Before that chairs were reserved for Very Important People like Presidents and the like who enjoy sitting around and drinking wine. Ordinary people either squatted or knelt or sat cross legged on the ground or sat on whatever was around, a barrel, a bench.
We now spend more time sitting in chairs, in cars, watching television, in school or at work than we spend lying down or standing. Sitting down for more than 30 minutes at a stretch is bad for your back and circulation. It's associated with cardiovascular disease and diabetes, and it prevents children from learning.
Birth and death certificates are also such simple things. But counting births and counting deaths is the way we were able to start looking at the health of large groups of people. So we know what people are dying from and can set up programmes to combat those illnesses. Initially death records were kept by churches and it was not until the end of the 19th century that states began keeping centralised systems of recording.
Successive governments in T&T have basically destroyed our Central Statistical Office because we Trinidadians are so smart we instinctively know what is going on in the country.
Perhaps the best public health story though is gin and tonic. Gin and tonic! How could a gin and tonic have anything to do with health and public health at that?
It stems from the 18th century use of quinine powder as an anti-malarial. To ease the awful taste, British officers in India mixed it with soda and sugar, creating tonic water, which they then mixed with gin. Stave off malaria and feel good while doing it. Could anything be better?