Government's Role in Protecting Health and Safety (New Eng Jour Med)

[pinto]

Government's Role in Protecting Health and Safety

Thomas R. Frieden, M.D., M.P.H.
April 17, 2013

What is the appropriate role of governmental public health action? Law and public opinion recognize protection of health and safety as a core government function, but public health actions are sometimes characterized as inappropriately intrusive. Such criticism has a long history, but today we accept many public health measures that were once considered misguided, intrusive, or controversial. Public health initiatives include efforts to promote free and open information to facilitate informed decision making, protect individuals from being harmed by other individuals and groups, and facilitate societal action to promote and protect health (see table - Potential Public Health Actions of a Responsive Government.).

Free and open information empowers people to make informed choices and reduces the likelihood that misinformation or hidden information will endanger health. Laws may require disclosure of factual information (e.g., product content), provide for government transparency (freedom of information), or prevent dissemination of inaccurate or misleading information. Newer applications of this principle include calorie labeling in restaurants, which appears to encourage some companies to offer and some people to choose more healthful food options.1 The initial costs to restaurants to perform nutritional analyses and reprint menus and menu boards are the focus of most objections, but these costs may be counterbalanced by lower health care costs and increased productivity. Some people value the transparency that such laws require, regardless of the health effects.

Another example of the power of information is the graphic warnings on tobacco packages and antitobacco advertising to encourage smoking cessation.2 Pack warnings convey clear information about the health effects of tobacco use, creating a visual and visceral counter to the aggressive and often misleading information spread by tobacco companies, which have been convicted of deliberately deceiving the public about the health effects of tobacco. Antitobacco advertising helps counteract the industry's efforts to undermine science and its massive marketing expenditures. Opposition to such government efforts may have financial as well as philosophical or legal bases.

A second key role of government is to protect individuals from preventable harm caused by other individuals or groups. An individual's right to engage in particular conduct may affect others (“your right to swing your fist ends at my nose”). Government has a responsibility to protect individuals from unhealthy environments, whether the sources of health risks are natural (e.g., mosquito infestation) or created by people or organizations. Few Americans now question government's role in preventing sales of contaminated food, water, and medications; reducing alcohol-impaired driving; or protecting workers and communities from industrial toxins.

<snip>

Source Information

Dr. Frieden is the director of the Centers for Disease Control and Prevention, Atlanta.

Copyright © 2013 Massachusetts Medical Society. All rights reserved.

<full article at> http://www.nejm.org/doi/full/10.1056/NEJMp1303819?query=TOC