by Anthony Robbins, MD, MPA
Every year, the United Health Foundation (UHF) publishes America's Health Rankings. Today UHF released their 22nd annual report. Rankings are a useful gimmick for getting attention as everyone surely looks at his/her own state. I was particularly proud to find my state of Vermont at the top of the list. I also looked to see how the report, titled A Call to Action for Individuals & Their Communities, might reflect changing attitudes toward the health problems caused by workplace environments, a long-term concern of mine. What I found is discouraging.
Worker protection, unlike many public health objectives, is firmly and clearly embedded in federal law, the Occupational Safety and Health Act of 1970. Yet the two Federal public health officials who introduce the 2011 Edition, the head of CDC and the Surgeon General, never mention OSHA, a law and programs directly within their domains.
The Report does note that measures of workplace safety are often weak yet they rely on counts of workplace fatalities, correcting for the industry mix. One might think that they understand the problem, except they proudly report improvements in workplace fatality rates. To do so requires that they ignore an economy that stopped growing in 2008, and more importantly, that dangerous manufacturing jobs have been moving abroad for many years. What workers know is that very few if any particular jobs are safer today than a few years ago.
Something is surely wrong with public health when we have a strong statute, OSHA, and our leaders shy away from asking that the law be enforced. Apparently, enforcing the law to protect workers "takes health professionals outside their comfort zone." [Report, p. 118]
Anthony Robbins, MD, MPA is a Professor of Public Health at Tufts University School of Medicine and co-editor of the Journal of Public Health Policy. He directed the Vermont, then the Colorado, state health departments and the National Institute for Occupational Safety and Health before serving as professional staff to the House Energy and Commerce Committee.
Tony, thank you for bringing this to our attention. I recently attended the annual meeting of the Massachusetts Public Health Association where, as most years, worker health and safety is not a matter important enough to be mentioned. When those of us for whom this is important do bring it up, the response is always, "Oh, of course occupational health and safety is an important concern" - but always as an afterthought.
In a forthcoming issue of New Solutions: A Journal of Environmental and Occupational Health Policy (of which I am an editor - full disclosure), Charles Levenstein has an editorial where he notes that a recent issue of the American Journal of Public Health that focused on "peak oil and public health" failed to address the workers in these industries. He states, "The articles address issues in medical care, urban planning, food systems, and international affairsâbut nowhere are oil and chemical workers to be found." And he reminds us of Tony Mazzocchi's call for a "Superfund for Workers" and "Just Transition." I encourage everyone to read this editorial when it comes out in January.
How can we build a successful public health movement if we fail to work to improve the lives of the working class - most of the 99%? The modern public health movement began in the 19th century with concerns for the abhorrent living and working conditions forced upon the working class. I encourage everyone in public health to read "The Conditions of the Working Class in England" by Friedrich Engels - a text that is as valid and meaningful today in our era neoliberal globalization as it was then early in the era of liberal globalization.
And rather than reaching out to the most exciting sociopolitical movement in quite sometime - the Occupy movement - public health is being used as the club to shut it down. We make a grave error when we let health and safety be used to squash a call for equality and working class power. We could instead be telling mayors that port-a-potties, trash collection, and other sanitary measures can be provided to the encampments if their health and safety is an issue.
We deceive ourselves if we believe that the modern public health profession could exist today without the political and economic victories won by the labor movement throughout the twentieth century. We have been reminded of this by Milt Terris, Vincente Navarro, and Linda Rae Murray to name a few. When working class students protest and say that they want higher education to be as free as the air we breath and the water we drink, we in public health need to support them and educate them to know that we are the ones who work so hard to make that air and water safe to breath and drink.
In solidarity - Craig Slatin
Why does the headline for Tony's comment not include "health"? Too often these days, "safety" is used as a substitute for "health" and it's not. Otherwise, this is greatly appreciated.