Who hangs which political figure during training

Even collection of data bearing on these issues has been hotly contested at all levels of government. There is strong evidence that needle exchange programs are effective in preventing the spread of HIV, hepatitis, and other infectious diseases.

Federal funding for such programs is currently barred by conditions placed on appropriations bills. Corporate interests often engage in the political process to block public policies that are contrary to their business interests, or use campaign contributions to gain access to lawmakers. For example, the beverage industry mounted costly campaigns to defeat soda tax referenda in multiple jurisdictions, 3 and there was significant opposition to federal programs that tackled obesity and tobacco.

Climate change science continues to be challenged by both industry and political figures who oppose government interventions in markets. Despite these challenges, many of the top public health achievements of the last 50 years are the product of public health officials constructively engaging the political system at federal, state, and local levels.

Examples include:. Many deadly childhood diseases have been virtually eliminated, and race differentials eliminated, through vaccination requirements for school-age children set by states and school districts, and public funding of vaccines for uninsured and underinsured children the federal Vaccines for Children Program. Second-hand tobacco smoke exposure has been significantly reduced as a health threat through action at the federal level eg, banning cigarette machines in schools and banning smoking on commercial airplanes and local level smoke-free policies in bars, restaurants, and other indoor spaces , and more recently by public housing authorities and other entities.

Lead has been removed from paint and gasoline, resulting in a precipitous drop in blood lead levels in children. The recent crisis in the Flint, Michigan, water system is at once a reminder of how much work remains to be done in this area, and also the extent to which public health science must inform policy decision making. Public mandates for seat belts and other motor vehicle safety and highway construction standards, based on injury prevention research, have resulted in significant declines in deaths from motor vehicle collisions.

Federal clean air, clean water, and toxic substances legislation in the s and a subsequent generation of implementing regulations have reduced the burden of environmental toxins and their impact on human health.

Food safety standards, and federal standardized labeling of food content and menu offerings have protected the public from foodborne illness and allowed more informed consumer dietary choices.

These initiatives often follow a pattern of experimentation often at the local level, or through targeted research that leads to evidence, adaptation, and potentially adoption in other jurisdictions or nationwide. Political officials in these early adopting jurisdictions frequently take risks by pursuing interventions in the absence of clear evidence, but the accumulation of evidence of success and of favor with constituents contributes to broader consensus and adoption.

The political system is the vehicle through which public health officials can achieve population-wide and lasting systems change. And from a political perspective, the vitality and economic viability of any community is highly dependent on the health of the population and the effectiveness of its health systems. Health is a key determinant of economic vitality in cities and towns across the United States.

Sustaining economic development requires a workforce that is productive and has affordable health care costs. Employers cannot be expected to locate in communities that do not use all available public policy levers to create these conditions.

Elected officials have strong motivation to work constructively with public health officials to seek effective approaches that reduce costs and enhance health outcomes. Elected leaders are ultimately responsible for sustaining and improving the health of the governed, and to maximize success they need a strong partnership with public health officials. There is evidence that the public expects politicians to engage in such constructive pursuits: first, the public supports broader public investment in prevention and public health 9 ; second, polling indicates that the public expects elected officials to listen to science, and for scientists to engage with the public and policy makers.

Public health officials cannot simply ignore the political system because in reality nearly all governmental public health activity is based on authority and funding that is provided through a political decision-making process, usually through enactment of legislation.

The ability of federal, state, and local public health officials to regulate, implement programs, spend public money, or receive private funding through user fees or other means is derived through a political process. Furthermore, the aspiration of public health officials to influence policies that impact health—such as housing, transportation, and other social and economic determinants—will continue to rely on decision making by legislators and other elected officials, many of them who do not consider themselves connected to the health system.

It is past time for a rethinking of the ground rules of the tenuous relationship between public health and politics. Government is likely to remain divided along partisan, geographic, and philosophical lines; because we are essentially in a permanent election cycle, we need new approaches to foster a constructive dialog that respects the role of politics but enables effective evidence-based decision making.

These can start with a recognition of basic realities:. Public health officials and advocates need to recognize the role of political and ideological factors in public policy decisions, and adapt advocacy strategies so that these factors are leveraged or neutralized.

Policy makers and elected officials, meanwhile, ignore public health at their own peril: as with a breakdown of snow removal, a poorly handled health emergency undermines confidence in leadership, and a community in decline because of poor productivity and high health care costs undermines economic development and public budgets.

Both elected and public health officials can recognize that properly framed public health interventions are popular, can save money and lives, and create legacies for both elected and public health officials.

Both need to find new ways to engage in a constructive dialog that can lead to more sustainable public health policies and programs. For example, public health advocates who are predisposed to government action can benefit from also exploring how markets and the private sector can advance population health objectives, thereby gaining potential allies for important initiatives.

Elected officials can explore how more robust data and evidence can help them improve the performance of government, lower costs, and benefit constituents, and in the process, their electoral prospects. Understand nonscientific factors in public policy decision making. Present evidence and science-based recommendations while being sensitive to other factors that influence decision making including political ideology, religious beliefs, and the self-preservation instincts of elected officials.

Science can call attention to issues, frame a public debate, outline solutions, and stimulate action; public health officials should recognize that incorporating other perspectives can help craft more achievable outcomes, and strengthen arguments that advance public health positions. Avoid partisanship. Emphasize the long bipartisan tradition in addressing most public health issues, and recognize that bipartisan support has been key to advancing most significant public health policies of the past generation.

Present the evidence fairly. Produce unbiased, impartial data, research, and evidence—and avoid the reality or appearance of selectively highlighting evidence to support a predetermined position. Overstatement in pursuit of public health positions rests on the same flawed logic that ideologues use to deny the legitimacy of science. Advocates that stretch beyond the evidence surrender the moral high ground that gives them credibility. Be forthcoming about value judgments.

Describe the values that underpin public health recommendations, particularly in cases where evidence is limited. For example, public health professionals often favor action where there is a plausible but unproven health risk, rather than waiting for certainty before taking steps to protect the population. Choose the right battles.

Make strategic choices on which battles to fight, at what time, and at what level of government. Political capital is as scarce as financial resources—and needs to be allocated carefully, as the political system can only focus on a few issues at a time. In many instances, an agenda is moved forward by staking out clear positions that can help generate political will, but there are also cases where selectivity and compromise will achieve goals and build momentum toward other goals.

Engaging allies with political sophistication should be an important element of any public health advocacy effort. Choose the right messengers. Recognize the unique roles of different messengers in presenting and advocating public health initiatives. Public health leaders working in government have both legal and practical constraints, and need to be mindful of the sustainability of the agencies they lead if they take provocative positions—so it is unproductive to place the full burden of communicating about the importance of public health on government officials.

Nongovernment officials nonprofits, academics, foundations have more freedom, but often less standing. Importantly, nontraditional messengers can be effective communicators—for example, leaders in the business community, or clinicians or health systems leaders in the community. Finding the right messenger contributes to advancing public health's agenda, but also allows others in the public health system to effectively consolidate gains and sustain programs for the long term.

Sharpen policy-relevant analytic skills. Develop and apply stronger analytic skills in the policy arena, to more fully evaluate alternative solutions to public health problems. In particular, exploring the role of incentives, market forces, partnerships, and other approaches as an alternative to direct government action may be key to advancing solutions in jurisdictions where limited government is a preeminent political value.

Make public health relevant to real-world decisions. Provide information relevant to real-world decision making by elected officials, including economic and other implications of proposed public health measures. Recognize science as relevant, even if not determinative. Acknowledge that scientific evidence is relevant to key public decisions, even if it is in conflict with deeply held views.

Elected officials do not need to embrace evidence as the only factor in decision making, but should not dismiss its relevance to the debate. Let science be science. Avoid the reality or appearance of undermining the development and release of evidence that is developed in an unbiased and impartial manner, particularly evidence that is developed with public funding. Free access to information that bears on a policy debate is a core principle of fair and open government, and facilitates both the policy and scientific process by allowing for refutation or replication of research results.

Be transparent about nonscientific influences. Disclose campaign contributions and other ties to individuals and corporations that may influence decisions. Engage public health officials in a search for solutions. Rather than waiting for public health advocates to bring proposals to them, elected officials can proactively engage public health officials for alternative ways to address problems that they identify.

In this way public health officials can be engaged in real-world problem solving for elected officials, bring evidence to bear on alternative solutions, and help inform decision making within parameters set by elected officials.

Advancing this dialog is also a responsibility shared by others. For example, the media and the public need to think past the latest outbreak scare and encourage both health officials and politicians to ensure that the infrastructure is there to be prepared for the next health event, as well as for improving community health. The media can help by focusing attention on key public policy decisions and the dynamics both scientific and political that drive them.

Similarly, educators can inject public health into core curricula at multiple levels of education. As an example, public health policy can be a critical component in civics curriculum—as it makes for more discerning voters, provides case examples on the roles of government, and illuminates intergovernmental issues inherent in our federalist system. Academic institutions can introduce practical considerations into science courses. For example, food safety is a practical application of biology, and regulation of environmental toxins is a practical application of chemistry.

And finally, philanthropy can aid the search for constructive policy solutions that bridge the gap between science and politics. Working together, public health officials and political actors can build confidence by seeking shared goals and inclusive processes to examine alternative policy solutions. Resurrecting the art of compromise, they can seek common ground on issues that are in the public interest.

Public health officials should not avoid the third rail—they can safely connect with it, and help empower communities to improve the public's health. National Center for Biotechnology Information , U. Journal of Public Health Management and Practice. J Public Health Manag Pract. She continued to work as a researcher in order to support herself, making her breakthrough as a chemist by helping develop emulsifiers for ice cream. Thatcher was one of the first world leaders to tackle the issue of global warming.

She, like the Queen, favoured geldings, though the Queen liked them on the racecourse, while Thatcher kept them in Cabinet. Carter graduated from the United States Naval Academy in with a bachelor of science, placing 60th out of midshipmen.

He served as an engineering officer on the USS Seawolf, America's second nuclear submarine, before pursing graduate studies in nuclear physics at New York's Union College. His father's death brought an end to his engineering career when he moved back to Plains, Georgia, to take over the family peanut farm.

Carter then went from peanuts to politics, but suffered the usual difficulty of someone so bright: he was overwhelmed by complexities and dithered. After leaving the presidency he achieved much by substituting decency for politicking. The German chancellor excelled academically in high school, but after failing her physics she decided to pursue the subject at the University of Leipzig to prove she could master the subject. Dr Merkel graduated with a degree in physics and physical chemistry before earning a PhD in quantum chemistry from the German Academy of Sciences.

She worked as a chemist at the academy until the fall of the Berlin Wall pushed her towards a career in politics. Dr Merkel has shown a sure touch in frightful circumstances: uniting East and West Germany, creating real wealth and showing humanity with immigrants.

According to the official biography on the Vatican's website, before Pope Francis entered the priesthood he had studied and "graduated as a chemical technician". We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work.

Margaret Thatcher, chemist The former British prime minister studied a bachelor of science at the University of Oxford, graduating with second-class honours. Jimmy Carter, nuclear engineer. Three unknown Australian scientists who changed the world.

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