Joyce C. Lashof, M.D., APHA President, 1992

Supporting Health Promotion and Prevention

When I went to school, we talked about primary, secondary, and tertiary prevention. I think we have made a new advance when we now talk about preventive services, clinical services, and community-based prevention, as well as policy for public health prevention and health promotion. I would like to put the emphasis on the policy aspects, because we have tremendous policy tools and we have been learning to use them in legislation and regulatory measures. We have done nutrition labeling. In tobacco, we have used litigation as an important tool. And we have used a great deal of local initiative and regulatory policy to move us along.

During my presidential year, Healthy People 2000 was high on the agenda and we tried to look at the objectives and tried to ask, “Will we meet those objectives for the year 2000?” It was clear that the overriding factor that was present then is even more present now. What keeps us from moving ahead are poverty and social inequality. As long as there are poverty and social inequality we are not going to meet those objectives. When we challenge the U.S. Public Health Service for why it did not list the abolition of poverty as an important factor in reaching the healthy goals, it said, “We knew poverty was the major factor, but the Public Health Service can’t do anything about that, so we didn’t want to put that as a goal.” I submit that’s a cop-out. We need to fight that issue. Good luck to all of you. Carry on the good fight. We’ll be with you.

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