I’m a public health professional. Here’s why I won’t vote for Republicans on Nov. 3

For over a century epidemiologists and other health professionals have been working behind the scenes to ensure low rates of acute and chronic diseases and improvements in quality of life.

Our success is reflected in infant mortality rates that have dropped by more than 90%, the eradication of smallpox, control of polio, reductions in rates of cancer-related deaths and life expectancies that have doubled over this period.

The beauty as well as the frustration of public health is that when it works, no one notices. So I’m here to remind us that whenever public health becomes a discussion point, there’s trouble in the air. That metaphor has become painfully apparent and poignantly appropriate during the COVID-19 pandemic.

Lessons learned

Among the many lessons that we have learned during this golden age of public health is the powerful link between the falling rates of diseases that once claimed the lives of more than 25% of children before they reached the age of 5, and:

▪ The prosperity in the general population.

▪ The availability of public education.

▪ The ready access to healthy food.

▪ Improved hygiene.

It was against the background of endemic poverty and limited economic opportunity that the health centers movement started in Zulu South Africa during the 1960s as a means for achieving economic prosperity and promoting community development.

That occurred right around the time that the civil rights movement was gaining ground in the United States, and the combination of these two historical forces resulted in the creation of the Federally Qualified Health Centers.

Indeed the Democratic Party’s support of both the Federally Qualified Health Centers. and the Affordable Care Act is duly noted and greatly appreciated because it has provided primary care to people who would otherwise not have access to it.

Look at other countries

During my career I have worked and lived for years in Africa and Asia, and I have visited about 60 countries; last year alone I published 75 papers with colleagues in more than 30 countries.

When I started in public health over 45 years ago the U.S. had one of the most equitable distributions of income in the world. We also had one of the lowest correlations between parents’ and children’s levels of education.

It was no accident that we also had among the best health indicators in the world.

Things have changed

How things have changed in these 45 years.

Today we have the most skewed distribution of wealth among developed countries.

We have the highest correlations between parents’ and children’s education.

And we have seen our relative ranking in public health indicators fall precipitously over this time.

Indeed, we are unique among the developed countries of the world.

A worrisome lesson

So the lesson is clear, and it is worrisome in light of this knowledge:

The tax giveaways to the very rich that have occurred under Republican control of the Senate — and with the help of the executive branch — will contribute to an accelerating downward spiral that we have observed in basic health indicators.

Empty complaints

We have all heard Republicans complain about “socialized” medicine.

Yet every country in the world that has better public health indicators than the U.S., and there are now 33 of them — all of them democracies — that have some version of socialized medicine.

The evidence is clear: these societies are both more equitable and more humane.

I am here to remind us that we also have socialized medicine in this country.

The obvious examples include Medicare, Medicaid and the Veterans Health Administration, all of which function much more effectively and efficiently than their profit-driven insurance industry counterparts.

However, our support of “socialized” medicine does not stop there; our tax structure forces taxpayers to subsidize employer-based health insurance.

As we all now know, the Affordable Care Act has provided insurance to over 20 million people.

Play the long game

In public health we must play the long game; this requires building and maintaining basic infrastructures that encompass strong public education and a commitment to social justice.

One of the hallmarks of authoritarian leadership is a dangerous disdain for truth, honor, decency, fairness and public education — all of which are necessary to ensure the long-term health of the population.

So when I reflect on the xenophobia, racism, hypocrisy, disrespect for civil rights and disdain for science and education evident among Republican leaders, I am reminded of conditions created by Third World dictators and their enablers around whom I worked back during the 1980s.

Failed leadership

Having grown up in a staunchly Republican household, I never thought that I would need to speak out in this way against leadership that has gone so badly astray in safeguarding the public health — and also the attributes of civil society on which it depends.

That’s why, as a public health professional, I will not be voting for Republicans this November.

James Hebert is an epidemiologist who lives in Columbia.