Public Health and the Obama Presidency

On the night of his inauguration, President Barack Obama attended the Youth Ball at the Washington Hilton in Washington, D.C. Emphasizing the theme of service, Obama said: “We know young people, everywhere, are in the process of imagining something different than what has come before … Where there is war, they imagine peace. Where there is hunger, they imagine people being able to feed themselves. Where there is disease they imagine a public health system that works.”

Earlier that day, during his inaugural speech, Obama promised: “We will restore science to its rightful place and wield technology’s wonders to raise health care’s quality and lower its cost.”

In the span of a few hours during a day that may set the tone for his presidency, did Obama’s comments signal a reinvigoration of public health in the U.S.?

Noted Robert Blendon, professor of health policy and political analysis at HSPH: “What he’s really reinvigorating is government’s role in protecting the people. There appears to be a greater emphasis on the government-directed role in improving the health of the population.”

The economic stimulus package is a visible sign of where Obama believes investments should be made, said Blendon. The package includes rebuilding facilities at the Centers for Disease Control and Prevention, improving preparedness for pandemic flu and bioterrorism, and spending on the prevention of chronic diseases.

He signed an executive order six days after becoming president on car fuel emissions, declaring: “Year after year, decade after decade, we’ve chosen delay over decisive action. Rigid ideology has overruled sound science.”

Obama has created new positions within the White House to help oversee health, energy, and environmental policy; appointed a new acting director of the CDC; and nominated neurosurgeon and CNN’s chief medical analyst Sanjay Gupta to be the next Surgeon General. He nominated long-time senator Tom Daschle, who authored a book about health care reform, as Secretary of Health and Human Services. Daschle withdrew the bid on February 3, 2009.

Blendon pointed out that Obama has made more appointments involving individuals with science backgrounds than any president in decades: “He places more weight on science in decision-making. This is very important to us at HSPH to know that we will have a receptive audience.”

Ashish Jha, assistant professor of health policy and management at HSPH, is optimistic about opportunities to improve the quality of health care and to reduce health disparities in the U.S. He is struck by Obama’s understanding of the need to focus on health information technology, for example.

“There is a sense that this is someone who understands that part of the role of government is to focus on public health,” said Jha. “And he talks about public health in its truest sense, improving the health of whole populations.”

There are serious flaws in the way our health care system is structured, said Jha, who asserted: “In the Bush administration there was a phobia about any government intervention. But there are places where the market fails and the government needs to act, and public health is a poster child for that.”

--Ellen Barlow.  Photography by Daniel Bersak.