2014 Shaping the Future of New York Fridays: 11:00-1:45 Boylan Hall, 2231

The reading for this week was focused on public health in a sociological perspective. Chapter 2 spoke of the developments of the past that were created with the concepts of public health in mind, such as the development of sanitation systems and pure water. The concepts presented of the poor being blamed for their diseases is still present in modern society though. The medical problems were caused by character of the poor and focused on their “sinful living” and in modern close-minded people will believe the same things.

Chapter 3 mentions that there needs to be changes in education to lead to awareness; that there needs to be changes in social structures for equality for all races, genders, and classes. While reading this it struck me. We talk about this in class constantly, that you must better the environment in which people live in, expand the options for food purchases, create areas where physical exercise is fostered and free healthcare is offered. In theory, this all seems so simple but there are obvious limitations. The way Obamacare was fought against within the country shows just how difficult it can be to instate welfare type programs. The reading particularly mentioned this corporate involvement in public policy as well by stating that “public health officials defined their mandate ever more narrowly and shrank from political engagement with powerful interests such as corporations and businesses that created unheahlthful environments.” Yet corporate influence and government turmoil are just a few limitations. There are also limitations in funding, problems in creating specialized programs based on individual neighborhoods (as not all neighborhoods will benefit in similar ways nor require equal amounts of attention), and public opinion to worry about. Yet, structural reform must happen to ease the inequity in public healthcare. Hopefully, James and I will be able to create an open discussion of all the issues surrounding this development of public health structures tomorrow.

Though I certainly enjoyed reading the last few chapters of The Ghost Map, I couldn’t help but come away with the impression that Steven Johnson’s work, while admittedly quite riveting, faded slightly down the stretch Johnson’s repeated rehashing of the miasma theory’s inexplicable hold on the otherwise educated and reasonable medical establishment grew quite tedious, and his subsequent, and slightly pretentious, bewilderment at the very notion of such stubborn and irrational thinking is almost certainly a beneficiary of excellent hindsight To prove my point, I quote: “How could so many intelligent people be so grievously wrong for such an extended period of time? How could they ignore so much overwhelming evidence that contradicted their most basic theories? These questions, too, deserve their own discipline: the sociology of error”

While he was concerned with belittling the intelligence of a long gone medical establishment, Johnson grievously forgot to mention the myriad of airborne diseases which were, in fact, adequately, at least at that time, explained by the miasma theory Some of the most destructive diseases of Victorian-era England can spread by airborne transmission, including the flu, measles, smallpox and tuberculosis At its peak in the 19th century, Tuberculosis was responsible for 25% of all deaths in Europe How can you fault physicians for being reluctant to shy away from a theory that so sufficiently accounted for the most dangerous disease of their time?

(Submitted on time, as a comment, moved to a post by Jennifer)

            Residents on Broad Street accepted the Miasma theory because it was the most readily used explanation, despite its dearth of supporting evidence. It is very easy however to blame the environment rather than human activity, just as we discussed in class, because human activity implies that we could change the outcomes of illness. The implementation of miasma theory had only exacerbated the spread of cholera. Believing all smell was disease, the Thames River became a sewage dump in efforts to rid homes of excretions and contaminated air. Although he held the unpopular opinion John Snow continued to build on his theory that contaminated water and not air was the vector for cholera.

            One week after the outbreak of cholera in Soho was when its turning point began with the removal of the Broad Street pump handle. It was the first time an informed intervention had been made based on a scientifically sound theory surrounding cholera. The removal of the pump managed to bring a decline to the outbreak as well as prevent a second outbreak. It is interesting to see that such a simple intervention can bring the end to such a lethal disease.