A classic warning in public health goes like this: “A society that spends so much on health care that it cannot or will not spend adequately on other health enhancing activities may actually be reducing the health of its population.”
No nation is as guilty of this practice as the United States, with its extremely high health expenditures alongside abysmal population-level health outcomes. But the medical field’s corrosion of public health doesn’t stop at budgets and policies. Through its stranglehold on resources and institutional power, the U.S. medical profession has also come to distort the very definition of public health and what is now widely believed to constitute relevant knowledge.
As I noted in a related essay in The Nation, lessons from labor history, social anthropology, political economy, epidemiology, communication, law, and various other nonmedical fields represent the bulk of the expertise that is most essential to formulating effective public health policy. Medical interventions constitute just 10% to 20% of modifiable factors that affect health, yet narrow biomedical expertise has been consistently prioritized in the selection of U.S. public health leaders from local to state and federal levels.