Public health is political, but shouldn’t be partisan


Taxes, property assessments, crime and schools were top concerns for Long Island politicians in the Nov. 2 elections. Both Democrats and Republicans tried to persuade voters that they would do a better job of keeping us safe and financially secure.
In 2021, however, these standard suburban issues motivated more Republicans than Democrats to show up and vote, resulting in a change in party leadership in Nassau County’s executive branch and the Suffolk County Legislature. For suburban residents, the added expectation and understanding is that our high tax dollars show up to maintain our quality of life in the services that the government provides. We are paying for safety from crime, but also the safety of the air we breathe and the water we drink, and protection during a pandemic.
But in campaign materials, and apparently on most voters’ minds, one major issue seemed to be missing: the ongoing public health crisis that is the Covid-19 pandemic, which has killed more than 750,000 Americans. If Covid was mentioned by candidates during campaigning, it was with promises of what the government would not do — no mask mandates in schools, no employee-mandated vaccines.
While political parties focus on the topics that they believe will get people to the polls, some issues, like public health, need to be supported no matter who is in power.
Public health is by its nature political. It must be. In the earliest days of the United States, protecting citizens from infectious diseases like yellow fever fell to local municipalities, which enacted quarantine regulations for ships that arrived at coastal cities. The first public health agency was created in 1866 in New York City, and reduced deaths from a cholera epidemic that year through inspections, investigations and disinfection. Cities that did not have a public system to monitor and combat the epidemic experienced many more deaths.

Government action is necessary to carry out the work of public health. How else do you get sewers across jurisdictions? Who else would pay for the clean water and the pipes to bring it into your home? Would restaurants regulate themselves to keep food preparation safe? The work to ensure public health must be carried out no matter what ideology is popular or which party has been elected to lead. The needs of public health continue no matter who is in power.
Meanwhile, there are other pressing public health issues in Nassau and Suffolk counties that require political support: the increase in substance use and overdose deaths; the significant mental health strain of anxiety and depression among young people; and high rates of maternal and infant mortality.
Collective and coordinated political action worked on Long Island to manage the spread of Covid-19 by deploying wide-ranging techniques similar to those used more than 150 years ago to combat cholera.
Modern approaches to public health now also recognize that social factors play a key role in people’s health. We saw this when the coronavirus pandemic devastated communities of color in Nassau and Suffolk counties, and recognize that the people in these communities were not solely to blame. Rather, it was the underlying conditions that existed before the pandemic — food insecurity, crowded housing, lack of internet access — that made outcomes so much worse for some than for others. Political forces need to address these public health priorities as well.
At a time when party lines are dividing those who are vaccinated and those who are not, when mandating mask wearing to protect the health of everyone is framed as a matter of individual choice, we have lost the nonpartisan thread of public health.
Whoever is in power in Nassau and Suffolk needs to address the longstanding issues of public health by doing what works and acknowledging the vital role that government action has on health outcomes. Red and blue waves come and go on Long Island every few years, but political public health action must remain constant.

Dr. Martine Hackett is an associate professor in the Master of Public Health and Community Health Programs at Hofstra University.