Politics and public health

For most of the U.S. presidential campaign, public health hasn’t been front and center.

“Public health is not on the rhetorical agenda,” said Steffie Woolhandler, a panelist at this morning’s standing-room-only “Public Health on the U.S. Presidential Campaign Trail” session at the APHA Annual Meeting in Denver. “Nobody’s talking about public health very much. However, I think the election is very important to public health.”

Not many people would disagree with you there, Steffie.

“Health care was on the agenda, health care policy and the Affordable Care Act,” panelist John E. McDonough, of the Harvard T.H. Chan School of Public Health, said about the presidential campaign. “Public health, I would say, is not. And amazingly, astonishingly something that is not in any of the debates is climate change.”

The American Journal of Public Health has been publishing articles throughout the year on politics and public health, said session moderator and Editor-in-Chief Alfredo Morabia. He’s been particularly effective at keeping current events visible in the journal.

“This session is about public health in the presidential campaign,” he told the packed audience, who had plenty of questions for the panelists. “We thought a week away from the election would be a good opportunity for some of you to come and calm down some of your anxieties.”

He got a laugh for that, as well as when he quipped, “You have to imagine I’m Victor Blackwell or Anderson Cooper or Megyn Kelly.”

His questions, which he assured the audience he did not share with panelists in advance, included “What has been the role of the Obama administration in the opioid epidemic and its control?” and “How can we fix the Affordable Care Act?”

Panelist David Sundwell of the University of Utah proposed that instead of focusing on the health reform law, taking a chance on three “bold, new ideas” — federalize acute care Medicaid; block grant long-term care so states can design more home- and community-based services; and have a national initiative to reduce infant mortality.

When asked who supported a single-payer health system, a vast majority of the audience members raised their hands. It was fascinating to hear the three panelists’ perspective on Obamacare.

Woolhandler, who disclosed the she had been a health care advisor to Democratic presidential candidate Sen. Bernie Sanders, said: “Our big problem here is that we have not gotten to universal health care.” Then Sundwell said there’s been a “shameless misrepresentation” of the ACA by both parties. He told session attendees he’s been embarrassed at the bashing of the law by his fellow Republicans but thinks many Democrats have oversold the benefits. McDonough, who “was born and baptized a Democrat,” chimed in that “the ACA represents the greatest advancement in health justice and health equity since the establishment of Medicaid and Medicare, and I would argue that it is not nearly good enough and there is so much more work to do.”

Morabia, never one to shy away from hot topics, said he plans “to have a presence in the journal of a political discussion of what will happen with the new administration.” The January issue of AJPH will include pieces on the public health legacy of the Obama administration.

We all know the public health implications of this year’s presidential election are huge. As APHA Executive Director Georges Benjamin said in his Welcome to APHA 2016 post, “after the Annual Meeting, don’t forget to bring that re-energized public health passion to the ballot box! After all, exercising your right to civic participation is an undeniable social determinant of health.”

See you at the polls.