STEVE WING

Associate Professor, Department of Epidemiology, School of Public Health, University of North Carolina

Steve Wing teaches classes on history and philosophy of epidemiology and on environmental justice and community-driven epidemiology. He conducts research on health impacts of ionizing radiation, industrial animal production, and environmental injustice. He is a founding member of the North Carolina Environmental Justice Network.

Public Health Preparedness, Disease Control, and Social Justice

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Public health preparedness in the United States focuses on medical response to threats from terrorist attack and other disasters. Preparedness includes stockpiling of pharmaceuticals and specialized medical equipment, surveillance of sentinel diseases, and strengthening of emergency services for rapid response.

Although support for public health preparedness was enhanced after September 11, 2001, this approach is rooted in the historical integration of public health with the military and police functions of the state. Consequently, public health preparedness policies suffer from a misplaced emphasis on preparing for response to threats rather than on prevention. However, extensive evidence shows that health is primarily a matter of access to healthy foods, clean water, safe housing and jobs, quality education, and an unpolluted environment. Improvements in these conditions, often considered to be basic human rights, are responsible for most health gains in the US over the last century, and inequities in them are responsible for most of the disparities in health within and between countries.

The current approach to public health preparedness leaves much of the public, disproportionately low income people and people of color, with poor access to the basic conditions that create health. These populations are most vulnerable to terrorist attack, new infectious agents, and disruptions in increasingly centralized food and energy systems. Furthermore, a focus on preparing for disaster fails to address the injustices that foster despair, desperation, and a lack of peaceful options for social change. A more effective health policy would balance emergency preparedness with a preventive strategy that seeks health through social justice.