30 reasons to be thankful for public health

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A loving family, loyal friends, supportive coworkers. These are common threads in the status updates I've been seeing on my friends' Facebook profiles since the beginning of the month. Many of them have been participating in a "thankfulness" meme: The idea is to post one thing you are thankful for every day during November as a reminder that Thanksgiving isn't the only day we should strive not to take the blessings in our lives for granted.

Most of the posts I've seen reveal details about people's interpersonal lives, capturing the bonds between a parent and child, brother and sister, or lifelong best friends. What, though, about all the other ways that people relate to one another, beyond our immediate circle of friends and family? What about the difficult but often invisible work that people do to protect the health and well being of others, including people they've never met?

I haven't seen many posts that speak to these questions, so I've made my own list. Many of the items here are easy to overlook amid hectic schedules and daily stress. And even when we are reminded of them, we may forget that they weren't always the norm. They represent years -- sometimes decades -- of struggle. To me, they also represent social progress and the best of public health.

Over the last century and a half, public health has greatly expanded its reach, going from a field that once dealt primarily with water, sanitation and infectious disease to one that recognizes health as something embedded in nearly every aspect of our lives. Public health advocates and professionals are increasingly working across sectors to show that everything from the design of our roads to the quality of our education affects how likely we are to be healthy or get sick.

In reflecting on public health's many advances, I am thankful that:

  • I can drink water from the tap in my own home without fear of getting sick. Though securing clean water for the masses was one of public health's earliest accomplishments, just a few hours south of me, there are people in California's Central Valley who, to this day, are not so fortunate.  
  • I can set my garbage out at the curb each week and not think twice about whether it will get picked up. I don't have to carry perfume or walk with a handkerchief over my face to mask the stench from waste lining the streets -- a scene not uncommon little more than a century ago.  
  • I can fly on any U.S. airline and travel domestically or internationally without worry of secondhand cigarette smoke. That wasn't the case until 2000.  
  • I can also enjoy a smoke-free experience in restaurants and many other public places in California.  
  • I can get a low-cost flu shot and other immunizations to prevent serious and potentially fatal illnesses. That other people get these same shots protects me too.  
  • During times when I didn't have health insurance, I still had access to primary care services from a free public health clinic.  
  • I have no cavities, thanks in large part to the fluoridated water where I grew up.  
  • I can find out how many calories, how much saturated fat, and how much sugar is in my food just by looking at a label. As someone with many dietary restrictions, I rely on these labels to help me make better decisions about nutrition and to avoid getting sick.  
  • The food purchases I do make carry little risk of making me ill. On rare occasions when produce or other food is contaminated, governmental organizations mobilize immediately to do something about it.  
  • I can go into many restaurants and see from the labels recently added to their menus which meals and drinks are loaded with calories.  
  • Public health advocates have made me aware of the link between sugary drinks and diabetes, heart disease and other chronic conditions. This knowledge gives me greater freedom and control over my health.  
  • Schools in California have strong nutrition standards, so the kids in my community are more likely to establish good eating habits at an early age. A healthy diet not only lays the foundation for good health, it can also help children learn better in the classroom.  
  • I was able to witness the birth of my niece Sylvia. Thanks to advances in public health, my sister is able to have children with fewer risks than women in previous generations. Because of a difficult childbirth, my father grew up without his mom.  
  • I can buy birthday presents for Sylvia (as well as other nieces and nephews) with the expectation that they will be safe. Strict regulations on household products mean that children can't easily choke on small parts from toys or put their heads through -- and be strangled by -- the bars on their cribs. And when product safety issues do arise, organizations take quick action to get the product recalled and advocate for regulations to prevent future hazards.  
  • I can take the children in my family outside to play without concern that their playgrounds have soaked up the lead from gasoline exhaust.  
  • I am able to breathe clean air. In the Bay Area, where I live, people work tirelessly to ensure low levels of air pollution. In Oakland, for example, a coalition of environmental, health, labor and community groups have fought to reduce diesel pollution coming from the area's port.  
  • Sidewalks and crosswalks allow me to take walks without fear of getting hit by a car. Curb cuts in those sidewalks mean that people in wheelchairs can also be out and about and independent.  
  • I can follow those sidewalks to get to any of three local parks. Many communities do not have as much green space -- something public health advocates continue to push for.  
  • Strong building codes mean that my office space -- a recently renovated building in earthquake-prone California -- has a good chance of surviving the next Big One. And so do I.  
  • Policies at my workplace keep me safe in other ways too. For example, ergonomic assessments ensure that I don't suffer repetitive stress injuries. This safety standard reflects the progress that government agencies, unions and others have made in reducing injuries and deaths in all workplaces over the last century.  
  • My co-workers, some of whom are new mothers, have a place to pump and store milk at work so that they can continue to breastfeed -- an important factor in ensuring children's health.  
  • When I get into my car, I have a seat belt and airbags to keep me safe.  
  • In the terrible event of a car crash, anti-lock brakes will help prevent me from skidding, road design will make it harder for me to hit oncoming traffic or telephone poles, and I won't get stabbed by shards of glass from my windshield.  
  • With tougher alcohol laws and drunk driving on the decline, I have much less chance of being hit by a drunk driver. Deaths from drunk driving have gone down by 52% since the year I was born.  
  • In California, we have some of the toughest gun laws in the nation, and Saturday night specials have been banned, so I have a much lower chance of dying from a gunshot wound.  
  • I can now buy cosmetics from companies that have taken a pledge not to sell products that contain carcinogens. And advocates continue to work to make cosmetic safety the norm rather than the exception.  
  • I came of age during a time when being a woman no longer meant relinquishing power in the doctor's office.  
  • Because of sexual education and access to birth control, I did not become a mother at a young age. This would have been incredibly risky, as I later found out that a medical condition of mine makes pregnancy a serious health threat.  
  • I am likely to see my mom live to an old age. Because she has access to mammograms, her doctor was able to detect her breast cancer early. Five years later, she is cancer-free.  
  • I, too, have a reasonable hope of living a long life. And thanks to public health achievements that have increased life expectancies, my mom and I aren't the only ones.  

Of course, the struggle to improve health is far from over. In some parts of the United States -- not to mention the world -- many people are not fortunate enough to be able to give thanks for all of these things. Even in areas where public health has made the greatest advances, we still have a ways to go: Tobacco remains the leading cause of preventable death, millions of children still get exposed to unhealthy levels of lead, and chronic diseases like cancer and heart disease remain major killers. Issues of this magnitude take time to change.

Still, history shows us that we have every reason to be hopeful. For every issue that threatens the public's health, there are countless advocates working to end it. And for that, I am deeply grateful.


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