Map of life expectancy at birth from Global Education Project.

Monday, March 27, 2006

The desperate character writhes again . . .

I started this blog mostly as a form of self-discipline. I have often attempted to keep a journal of my professional interests - to write every day about the subjects I study and the work I do - but the project always seemed to lapse after a while. When web logging came along, it seemed to offer that essential psychological prop - the illusion, at least, that there was an interlocutor out there, somebody reading. As with cooking, that makes writing more satisfying, gives me an incentive to do it at least acceptably well, and gives me a kick in the pants to do it at all lest I let my reader down.

Well, it worked. I have indeed written every day now for about a year and a half, except for some Saturdays when, as long time readers know, I am out in Windham County Connecticut, building a house. Sundays I usually get off the explicit topic of public health and say something vaguely philosophical. With those indulgences, I've been able to keep it going. Even better, I actually have readers -- I presume the number is modest, but the commenters here are fabulous. I can hardly believe the knowledge, wisdom and good humor of the people who contribute. That makes it worthwhile. I've also been able to spin off some other activities in the blogosphere from this site, and it's all been very gratifying.

So, now, I feel some responsibility to meet expectations, to have a clear definition of what I'm doing here that is both potentially of interest to others and within my capabilities to do well, and to try to keep improving. My biggest challenge, it turns out, is limiting the terrain. Public health is about, well, everything. It provides some standard analytical tools, it adopts scientific theories of knowledge, and there are some topics that people in public health tend to focus on, such as disease entities and their causes and prevention (with treatment a less prominent concern), health disparities, concepts of well-being, measurement problems, etc. But really, if it has to do with Homo sapiens, it has to do with public health.

And right now, I'm mostly worried about subjects that don't get a lot of ink in the American Journal of Public Health. We aren't going to get any positive changes in public health or health care policy so long as the present gang remains in power, and ven if they collapse like Enron, we'll be digging out of the wreckage for decades. It seems feckless to write about social and economic disparities in health, the Millenium Development Goals, the obesity epidemic, the nefarious pharmaceutical industry, pathogen drug resistance, the marginalization of mental health, the Rule of Rescue and the perverted priorities of health care, environmental justice, and all those other subjects that have occupied us here, when the country is ruled by a gang of murderous thieves who are doing everything in their power to destroy any chance we have to make progress on these problems.

The public discourse in this country right now is utterly inane. A headline in my local birdcage liner today read "Two lawmakers call on the president to obey the law." Which means that 533 did not. $10 billion a week of money the U.S. government borrows from the Chinese and the Saudis goes down the rathole in Iraq, which just descends deeper into nightmare. Corporate CEOs are paid tens of millions of dollars a year while their employees don't have health insurance and their standard of living keeps going down. We keep spewing more and more CO2 into the atmosphere, climatic catastrophe approaches, while our political leadership claims the entire issue is nothing but a left-wing fabrication intended to destroy capitalism and the corporate media continue to portray it as a political dispute rather than a settled scientific question.

I'm could continue but I'm sure you can extend the list as well as I can. So we have a democracy, right? The people can put a stop to this, right? Elections in this country are contested over the issue of whether the earth is 10,000 years old and whether letting some people get married will destroy everybody else's family; whether people who say that we should pursue national security by trying to apprehend people who actually attacked us or plan to, rather than invading unrelated countries in order to control oil fields are traitors; and whether candidates drink beer or wine. All of this critical thinking is disseminated by means of television advertisements, which means the real fundamental issue is who can get people and corporations to fork over hundreds of millions of dollars to spew this dreck into people's living rooms.

Sometimes, in other words, I feel like I just can't go on. But, now that I've got that out of my system, I will. Thanks for your indulgence.

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