Public Health Is a Public Good

by Debra Walker, State Committeewoman for Monroe County and Upper Keys Co-Chair.

Any basic economic theory text considers the contrast between a public good and a private good.  In general, a public good is defined as something that benefits society overall, while a private good benefits the individual.  By definition, private goods are marketable and can be bought and sold, but public goods are sponsored by the community at large, generally through taxes, and all benefit from the service.

The grand outline for what constitutes the public or “common good” is itemized in the Preamble to the US Constitution:

We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.

The current pandemic has brought into clear focus that our public health system promotes the general welfare, and is essential to the common good.  Fragile and underfunded in the U.S., public health agencies generally operate below the radar, ensuring the basic tenets of a healthy society are maintained without too much visibility.

As individual citizens, we only rarely engage with the system, for example, when vaccinating infants or registering children for school.  Some balk at even that low level of interaction with the public good, as the recent spate of measles outbreaks demonstrate (Recent Measles Outbreak 2019).  Antivaxxers assert, against reason, that they have a right to not vaccinate their children, and that they have no duty to help protect society as a whole from certain diseases.  One could argue that this view is unconstitutional because it fails the Constitution’s Preamble test.  But I digress.

The real point here is that the viruses that carry measles or COVID-19 don’t care about your individual rights or whether you “believe” in the scientific method applied to epidemiology.  All members of society are equal in the “eyes” of a viral agent, and all are equally likely targets.  We ignore our public health officials at our own peril.

In Monroe County, we are lucky to have insightful, rational public leadership during this difficult time.  Monroe County’s FDOH Administrator Bob Eadie, an experienced professional, keeps us calm and informed on a regular basis (Keys Weekly 20MAR20).  County Mayor Heather Carruthers (Mayor Carruthers Q & A ) and Key West Mayor Teri Johnston (Mayor Johnston Facebook Live) have used Facebook live events to tamp down rumors, keep residents up to date, and answer questions in real time.  Key West physician Dr. Norris does daily informative video posts about COVID cases and how to stay healthy in the Florida Keys.  These links to relevant, rational information minimize rumors passed through the coconut telegraph.

Good public health policy informed leadership early on to close the Keys to tourism, shut down US 1, and, more recently, to require customers and staff of essential businesses to wear masks.  All these measures reduced the rate of new infections, and it shows in the data—our rate of new cases per day is very low throughout the county.

Good public health policy also informs average citizens, many of whom have taken to supplying homemade masks to their communities.  Precinct #29 Co-captain Susie Anderson of Key Largo, for example, has made dozens of masks, soliciting fabric from other community members.  Food banks remain open with modifications, thanks to volunteers and donors throughout the Keys, as at Burton Memorial UMC.  Others are offering free takeout meals at specific times.

Although we are living through an unprecedented event, with good local leadership, good public health policy, and good local involvement promoting the common good, we will make it through this.  Keep your distance, keep calm, carry on, and thank a medical professional for their efforts!

#KeysStrong #CrushTheCurve #Masks4All

For further reading on public health as a public good try this blog post by Sandro Galea, MD, DrPH Dean and Professor, Boston University School of Public Health.