[The following is a guest post by EmmaGold, who will be joining me as a regular contributor to this blog.]
President Obama has nominated Dr. Regina Benjamin for the post of Surgeon General. According to CNN, Dr. Benjamin “has spent most of her career tending to the needs of poor patients in a Gulf Coast clinic in Alabama.” If confirmed, she will be the third woman appointed Surgeon General.
Now, most of us only think about the Surgeon General when we see a cigarette ad, reminding us that smoking causes lung cancer, or that pregnant women shouldn’t smoke. But the position can have a pretty big effect on public health. Think about those cigarette warnings— the NIH cites two Gallup surveys saying that the percentage of Americans who believed smoking caused cancer rose from 44% to 78% from 1958-1968. The Surgeon General’s office came out with a report linking the two in 1964. The first warnings on cigarettes (in the US) appeared in 1966. And the link between cigarettes and cancer, not to mention other health issues, is well-established enough in 2009 that cities around the country have banned smoking from indoor public spaces.
But recent Surgeons General have struggled to promote public health over politics in recent decades.
Most of the power of the Surgeon General is the power of the “bully pulpit”— the power to draw the public’s attention to an issue. Dr. Jocelyn Elders, appointed by President Clinton, used her position to draw attention to STDs and sexual education. And though she got away with suggesting that schools give out contraception, Dr. Elders was fired for suggesting that they teach masturbation, as part of sex education. As the Arkansas director of public health, she was able to expand access to birth control, sex education, and HIV testing, but the federal office got in her way. Maybe if she had been allowed to continue as Surgeon General, we wouldn’t have the ridiculous system of abstinence-only sex ed that is so common today.
At least Dr. Elders got to express her opinions. In 2007, President George W. Bush’s Surgeon General, Dr. Richard Carmona, accused the Bush administration of preventing him from communicating accurate and scientific health information to the public.
“The reality is that the nation’s doctor has been marginalized and relegated to a position with no independent budget and with supervisors who are political appointees with partisan agendas,” Carmona said. Anything that doesn’t fit into the political appointees’ ideological, theological or political agenda is ignored, marginalized or simply buried.”
When he wanted to launch a public education campaign on the science of stem-cell research, he was told he couldn’t. I was blocked at every turn, told the decision had already been made. Stand down, don’t talk about it,” he said.
Now, the Obama administration seems pretty on board with science, so I don’t think they will try to play politics with public health like their predecessors. And Dr. Benjamin’s experiences caring for low-income and minority patients will undoubtedly fit well into the administration’s goal of universal health care.
Still, I hope that Dr. Benjamin will have the courage to take on more controversial topics—women’s reproductive health, immigrant health issues. And even more so, I hope that the politicians will not prevent the nation’s doctor from doing her job.