From Twinkies To Tofu: The Ten Best Public Health Initiatives Ever

I never ate yogurt, avocadoes, or tofu until I was in my twenties.  When I first went to the dentist as an eight year old, I had twelve cavities.  And the Connecticut River smelled like raw sewage when I was a kid – because it was filled with raw sewage.

This is Public Health Week; the theme is “return on investment.”  The good news – spending on public health  (as a percentage of all health spending) has doubled in the last fifty years.  The bad news, this is still less than 3 percent of our national health budget.

Despite that meager investment, the return has been big.  Here are my top ten public health initiatives ever – or at least in my lifetime.

10. From Twinkies to Tofu.  Nutrition education has come a long way in the last fifty years. Twinkies, snowballs, chocolate cupcakes, and sugary cereals “fortified” with vitamins were staples of my youth.  We knew so little about nutrition in those days.  I never ate yogurt.  I never even heard of tofu.  And an avocado never touched my lips.  We may be heavier today than we were then, but thanks to public health professionals at least we know why. (Perhaps it’s the 701 sodas we consume every year – a 26 year low!)

9. HIV/AIDS Prevention.  I lost too many friends and classmates to AIDS in the 1980s, and we had no idea how to treat it for several years after it was first identified.  But once we cut through the noise created by people who worried that it came from mosquito bites, Haitians, and kitchen utensils, public health pros found effective prevention strategies that saved millions of lives while we waited for effective treatments.

8. Water Fluoridation.  Cavities were inevitable when I was young, and lost teeth were the price we paid later – in spite of brushing.  Then we fluoridated our water and prevented tooth decay.  Not only did the public health pros save teeth; they saved lives as we reduced heart disease linked to poor oral health, too. 

7. Smoking Bans in Public Places.  Thirty years ago, I was eating in a popular Italian restaurant.  The cigarette smoke was so thick that I could barely see clearly across the room.  The owner came over to say hello.  I asked him where his “no smoking” section was.  “Wherever you’re sitting,” he replied.  He was the Chairperson of the Connecticut Legislature’s Public Health Committee.  We’ve come a long way, baby.

6. Sewer Separation.  When I was young, toilets in my home town flushed waste into storm sewers that flowed directly into the river.  No wonder the water was brown.

5. Oral Polio Vaccine.  I remember getting my dose in the school cafeteria.  Immunization came of age in my lifetime, and we now we take it for granted that our children will never get many formerly life-threatening diseases – such as polio, measles, mumps, rubella, and even influenza.

4. Air Pollution Control.  My mother used to repeat the rhyme “red sky in morning, sailors take warning.  Red sky at night; sailors delight.”  Then red skies at night just meant ozone pollution.  While we have a long way to go, we can’t say that public health pros weren’t on top of the climate change issue almost from the beginning.

3. Bike paths and running trails.  When I ran my first road race thirty years ago, there were fifty people entered.   But when I ran my first marathon ten years ago, there were over ten thousand.  Exercise has gone mainstream in the last fifty years.  Don’t believe me? Compare the lack of muscle tone on the bodies of movie stars of the 1960s to what you see today.

2. The Rise and Fall of Plastics.  My wife Pam was reminiscing recently about when we used to see pictures of garbage floating down our rivers.  Everything became disposable about the time plastics arrived.  But then we began to redeem, recycle, and re-use, saving valuable landfill (and river) space.  Now cities like Austin have banned plastic bags entirely.  Why not?  Live simpler, and we often live healthier.

1. Getting the Lead Out.  When I was young, my brothers and I used to peel the lead paint off the side of our grandfather's house for fun.  We didn’t stop until he replaced the shingles with asbestos siding.  Oh, how we long for the everyday toxins of our youth.

And if only we could see this big a return on all of our investments in the future!  

To reach Paul Gionfriddo via email: gionfriddopaul@gmail.com.  Twitter: @pgionfriddo.  Facebook: www.facebook.com/paul.gionfriddo.  LinkedIn:  www.linkedin.com/in/paulgionfriddo/