Government and Public Health Policy – A Comparison Between Joseph Goldberger and Michael Bloomberg

Dr. Joseph Goldberger was a physician employed by the government in the early 20^th century that worked tirelessly to study the disease of pellagra in the South. Goldberger was born in Hungary and emigrated to the United States at the age of nine where his family settled in the Lower East Side. Goldberger started his college education at City College, where he planned on becoming an engineer. However, in 1892, he transferred to Bellevue Hospital Medical College where he earned his M.D.

I found it interesting to note the relationship between government and public health in Kraut’s chapter about Joseph Goldberger. During the early 20^th century, the American South faced a huge public health problem: pellagra. According to the chapter, pellagra rates in Mississippi were huge: “in 1914, 10.954 cases of pellagra were reported to the Mississippi State Board of Health, compared with 6.991 for the preceding year. The number of deaths reported for 1914 was 1,192, compared with 795 for 1913. Officials could only guess at the number of cases that had not been reported.” (Kraut) Because of the huge numbers of pellagra in the South, the Surgeon General at the time assigned Joseph Goldberger to study and find a treatment for the disease.

The governor of Mississippi at the time, Earl Brewer, took a big political risk in helping Goldberger. There was a lot of political turmoil going on at the time because of an earlier incident where Governer John Slaton of Georgia provoked his state’s anger towards him for commuting a convicted murderer’s sentence. Brewer, despite the potential for backlash, did the same thing to help Goldberger. Brewer decided to commute the prison sentences of eleven Mississippi criminals so they could become human subjects in Goldberger’s pellagra study. Brewer rationalized this by having the benefits outweigh the possible problems. Brewer knew that having a treatment for pellagra would cause a huge increase in the workforce’s productivity and therefore would attract much more investment money into the South.

I found Brewer’s situation to be very interesting and drew many parallels to Mayor Michael Bloomberg and his public health initiatives. In terms of government and public health policy, lawmakers always have to choose between two things: the potential that there can be legal and political problems from passing public health policy and the potential benefits that can be gained when public health policy is effective. For Earl Brewer, on the one hand, he was knowingly and consciously releasing criminals back into society where they had the opportunity to return to a life of crime and cause problems for local law enforcement. Furthermore, he was also risking public denouncement by Mississippi citizens due to the current anti-government feeling in the South. However, Brewer found that these potential limitations were eclipsed by the potential health benefit. If Goldberger found the reason for pellagra and found a cure, thousands of people that were missing work and were taking up healthcare money could go back to work. This was mainly an economic move but had huge social ramifications as well.

Mayor Bloomberg’s situation is also quite similar despite there being an almost 100 year gap between Brewer and Bloomberg. In terms of the anti-smoking ban that I will be working on for the final paper, Bloomberg recognizes that banning public smoking in restaurants, bars and public parks can be considered an infringement on civil liberties. Who is he, as part of the government, to say that a person can and cannot smoke in certain places? Although these places are public, some may still consider these places not to be under the Mayor’s jurisdiction to ban smoking. However, on the other hand, smoking is a huge health problem for both those who smoke and those who do not. Smoking and tobacco use in general accounts for one in five deaths in the United States. A huge amount of health care money is also spent on treating those harmed by cigarettes (both smokers and non-smokers). After considering both the benefits and potential problems, Bloomberg has decided that he would rather risk public disapproval and enact the smoking ban than not. Something that I think opponents of Bloomberg and the smoking ban should keep in mind is that although the law can seem imposing and restricting for smokers, the potential health benefits are huge for not only smokers but also for secondhand smokers as well.