Where Public Health Stops and the Nanny State Begins

Last week I had the pleasure of hearing Dr. Talbot speak.  If you don’t know who he is but you have heard of the current measles outbreak or past-pandemics, then you know of his and his office’s work. In addition, if you get a chance to hear him speak (and hopefully not telling you that there is a quarantine on your house), be sure that you hear what he has to say.

Firstly he is an engaging and down to earth speaker who has a knack of being able to explain the complex via the simple metaphor.  Secondly he has excellent perspectives on how public health can be cheap yet effective.  Finally he has an excellent sense of the history of public health and a sense of humor.  He can tell you about the cholera outbreaks of yester-year to the current measles blip with a wry context.

So while I would encourage you to hear Dr. Talbot speak, listen as a private-citizen looking to protect your own right of choice in a free society.  Hear what he has to say on public health but ask where the public good stops and the Nanny State begins.  Here are some examples, one past and some future.  The past example is the public health battle against public smoking.  I will admit that I have had the very occasional good cigar but otherwise have never caught the smoking bug.  Thus, over the past ten years, I was ambivalent and ultimately thankful when smoking was banned in places like bars and restaurants.  In my view,assuming you have read the warnings on a cigarette package, and you are not polluting my space or kids – it was your choice to start, continue or stop smoking.  In other words, banning smoking in public places is a reasonable public health compromise of personal choice versus public good.

Fast forward now into a time when sugary drinks are perhaps the new smoking campaign.  Not only will we not be able to super-size our mega-drinks while ordering a big Muck, they pop is banned outright as a public health measure.  Because I am not a big pop drinker, perhaps I will continue to watch this change with more ambivalence.

But what about the next step beyond smokes and a glass of pop.  What happens when public health measures become so intrusive that there is a backlash against them – and good is thrown out with the bad.  Perhaps we are seeing this already with the local measles outbreak.  A virtually preventable disease making  a come back because some parents have chosen not to vaccinate their children.

In other words, public health measures which effectively reduce our choice or make decisions for us (smoking, sugary drinks) may lead to public health challenges because people are tired of having choice taken away from them.

This situation can be described in the question of where exactly does public health stop and an intrusive nanny state in the guise of public health kick in?  I don’t have an answer but it is an excellent question that I will ask Dr. Talbot the next time I hear him speak.