The Ebola outbreak in West Africa, which has spilled out to other countries, including the United States, has sparked speculation, debate and panic. People want reassurance that effective plans to control disastrous outbreaks of disease are in place and enforced. In the US, the point person on such serious matters has been the Surgeon General.
Nominated by the President of the United States, and then confirmed by the Senate, the surgeon general’s stated job is to “protect, promote, and advance the health and safety of our Nation.” But we haven’t had one since July 2013, after the last permanent Surgeon General, Regina Benjamin, stepped down.
In November of that year, President Obama appointed Dr. Vivek H. Murthy to the position. His appointment has been stalled, however, by lobbyists in Washington. Some voices have suggested that it is Dr. Murthy’s position on gun control that has Republicans riled and swing-state Democrats nervous ahead of the upcoming midterm elections.
Yet just this week, John McCain called on the government to appoint an “Ebola czar,” a move that some have described as ironic given the Republican Party’s stalling in Congress of Murthy’s nomination.
Long before this recent Ebola outbreak, some questioned the need to have a Surgeon General at all. In 1997, Michael Tanner, in an article for the Cato Institute, likened the position to one of “national nanny.”
But it seems, perhaps, that we have needed that nanny through the years, and as McCain himself pointed out, we need one now. Here are 10 ways the Surgeon General has redefined the way we approach our health.
There’s still a lot of smoke out there but maybe fewer mirrors as public awareness has been raised about the risks of smoking. It was that warning on cigarette packs that helped get the ball rolling on the move to defeat big tobacco. In 1957, Surgeon General Leroy E. Burney declared it to be the official position of the US Public Health Service that a causal relationship exists between smoking and lung cancer. In 1964, Surgeon General Luther L. Terry issued his landmark report Smoking and Health, the first to receive widespread media and public attention. Congress introduced health warnings the following year.
Astounding as it may seem, people do still have sex without protection, but it was the Surgeon General’s department pushing for condom use that helped inspire a dialogue about safe sex and stressed the importance of educating people. According to the National Library of Medicine (NLM): “By educating Americans about the causes, transmission, consequences, and prevention of AIDS, the Surgeon General materially changed medical and public conceptions of the disease…[t]he Surgeon General helped redefine AIDS as a chronic, preventable disease, best countered with voluntary screening and drug treatment, and one that allowed the full integration of carriers into society.”
In 2001, the office published a new report about sexual health.
In 2004, the Surgeon General raised public awareness of this debilitating and “silent disease” of the bones which affects 44 million people, around 80% of them women. Strongwomen.com describes the report as a “milestone for combating this terrible disease. It outlines scientifically sound prevention and treatment strategies for improving bone health at any age.”
Dr. Miriam Nelson says that she is “thrilled that the U.S. government is taking a lead role in the fight against poor bone health [and is] confident that this report will stimulate people (individuals and medical professionals) to be proactive in fighting this devastating disease.”
The national hospital system, which the Surgeon General originally oversaw, began in 1870 and by the early 20th century the department was extending its reach to all areas of social welfare. One of its first advances was the establishment of the U.S. Children's Bureau in 1912. Since then, says the NLM, “the federal government has dispensed advice on infant care and breast-feeding as well as the care and rehabilitation of disabled children, subjects to which the Surgeons General have devoted several reports as well.” Today the Bureau deals with cases of child abuse as well as assisting with foster care and adoption.
One of the core principles of the Surgeon General’s office is to promote general health awareness. One of the landmarks of the dissemination of such information came in 1979 with Surgeon General Julius Richmond’s report Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention.
The NLM argues that this report “dramatically recast” emphasis on the prevention of disease in the general population. “The report,” it says, “established for the first time ambitious, quantifiable objectives for improving the nation's health, to be achieved by 1990.” The Healthy People report is updated every decade and encourages people to accept more personal responsibility for their own health.