In 1995, President Clinton proclaimed the first full week of April as National Public Health Week. Each year since then, the public health community has celebrated this observance by focusing on an issue that is important to improving the public's health. This year the theme is “A Healthier America Begins Today: Join the Movement.” Minnesota is also observing Public Health Week with a proclamation by Governor Dayton ( Gov. Dayton’s Public Health Week proclamation ) and several events occurring throughout the state during the week.
I’m not sure why the first week of April was chosen as Public Health Week in America, but I do know that on April 3, 1855, the index case for the “Golden Square” cholera epidemic of London was identified at 40 Broad Street by Reverend Henry Whitehead. This is the epidemic made famous by the removal by John Snow of the pump handle from the Broad Street pump. Because of his persistent efforts to determine how cholera was spread and for the statistical and mapping methods he used, Dr. Snow is now considered the father of epidemiology, one of the basic tools of public health.
John Snow’s accomplishments alone would be as good a reason as any to celebrate public health in early April. But, the broader story around the Broad Street Pump highlights even more about public health that warrants celebration and provides some guidance for today. It highlights the fact that bringing the disease under control required contributions from people from multiple disciplines, most of whom were not in the health field, sharing information and learning from each other. It required the data collected by Reverend Henry Whitehead from his church logs and his home visits. It couldn’t have happened without the spot maps made by Edmund Cooper, an engineer for the Metropolitan Commission of Sewers, in response to the public’s complaints about foul smells in their neighborhoods. And the eventual elimination of cholera would not have occurred without the creation of the central London sewer system by Joseph Bazalgette, chief engineer of the Metropolitan London Board of Works.
Beyond the science and the hard work, conquering cholera in London also required that people keep an open mind about the cause of a killer disease until definitive objective evidence could be obtained. It also took a great deal of courage to advance new ideas that contradicted popular opinion and that were far from popular. Think of all the public health problems today that could benefit from the approach that was taken to combat cholera in the 19th century.
While John Snow gets most of the accolades, he wouldn’t have been able to do his epidemiology without the contributions of many others. And while he also gets credit for curtailing the cholera outbreak in 1854-1855, cholera kept coming back for several years. It was only when Joseph Bazalgette was able to create the sewer system did cholera eventually disappear. In true public health form, few people have heard of the guy who saved the most lives.
Given that history and the fact that 25 of the 30 years that have been added to our lifespan over the last 100 years were the result of public health activities it’s evident that the Public Health Week theme of “A Healthier America Begins Today: Join the Movement” is not totally accurate. Creating a healthier America and a healthier world began a long time ago. Because of that, I think we should expand a bit on that theme. During this Public Health Week we should be sure to honor the work of all of the workers that has occurred before we came on the public health scene – work that has formed the platform for what we do today. We should also take the opportunity of this week to encourage each other to keep working to keep the public health “movement” strong and going forward.
The world is a much healthier place than it was 100 years ago. And most of that improvement is due to the efforts of public health.
Enjoy Public Health Week,