In the mid-19th century, New York streets were accumulating all kinds of filth. The land was swampy and lacked proper drainage. Unsanitary conditions exposed many of the city’s poorer areas to infectious diseases. In the summer of 1864, examinations carried out by a committee of concerned physicians produced a 17-volume report listing the symptoms. One inspector said his area was suffering from clogged gutters, clogged sewer pipes and “perennial seepage that breeds pests.” Another observed that certain streets looked more like “a dung heap than the thoroughfares of a civilized city.” In response to this report, the state legislature introduced legislation in 1866 that led to the establishment of the Metropolitan Board of Health, one of the nation’s first municipal public health authorities. Shortly after its inauguration, the Board faced the possibility of a cholera outbreak. It established quarantine measures and implemented new health ordinances to help stop the spread of the disease. Support for the new agency soared, and other cities began forming similar authorities. The modern public health movement in the United States was born.
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A key revelation from the 19th century’s “Great Hygiene Awakening” was that social and environmental factors can have a profound impact on people’s health. In the late 20th century, policymakers began to turn their attention to issues such as product and workplace safety as ways to save lives. In the mid-1950s, nearly 40,000 people died in car accidents each year. While most of the attention focused on driver responsibility, doctors and engineers pointed out that most of these fatal crashes could actually be prevented by changing car design. In 1965, Ralph Nader, a young lawyer who later became an activist and perennial presidential candidate, published a book called “Unsafe at Any Speed,” which examined how automakers failed to prioritize safety. The book became an unlikely nonfiction bestseller, along with Truman Capote’s In Cold Blood. Mr. Nader’s report prompted Congressional hearings and the creation of what is now known as the National Highway Traffic Safety Administration. Pioneering public health scientist William Haddon became the agency’s first administrator and oversaw the first safety requirements for new cars, including energy-absorbing steering columns, shoulder harnesses, and side door beams. The ratio of car crash deaths to the number of miles driven by U.S. drivers has plummeted.
The main goal of public health is prevention. This research is primarily scientifically inspired by epidemiology, which studies the spread of diseases and their determinants to develop control strategies. In the mid-1960s, public health professionals began incorporating these techniques into the nascent discipline known as injury science, tackling problems such as children falling out of windows, house fires, and child drug addiction. Gun violence in the 1990s. The premise is intriguingly simple. Leverage scientific data to identify risk factors and the most vulnerable populations, and employ multifaceted solutions to stop problems before they occur. For example, when it comes to gun deaths, public health interventions include pediatricians asking about safe storage at home, governments establishing waiting periods for gun purchases, and raising the legal age of gun ownership. This may include things like: The challenge lies in building consensus on the community-wide solutions that public health requires. This is where public health efforts often run into difficulties, including when it comes to guns.
In recent years, public health researchers have begun to consider whether an emerging social threat, political violence, deserves scrutiny. One of the researchers leading this effort is Galen Wintemute, director of the Violence Prevention Research Program at the University of California, Davis, who has studied firearm violence for more than 40 years. Wintemute is a thin, bespectacled emergency doctor. (He still works four or five weekends a month at the University of California, Davis Hospital.) He’s 72 years old, but when he talks about his research into violent death, he speaks with almost childlike curiosity. talk. Wintemute said he and researchers have tracked a surge in firearm purchases across the country, especially among first-time gun owners, during the coronavirus pandemic. They found that even as the coronavirus crisis began to subside in 2021, people were still buying guns at unusually high prices. Confused by the constant demand, he wondered, “What is this all about?” He spent a week immersing himself in the available data on the relationship between political polarization and violence. When he appeared, he concluded that the subject of political violence urgently needed to be studied because people were “armed” and the consequences “could reshape the future of the country.” . He ended up directing a third of his 30-person team to spend at least some of their time working on a new project investigating how likely people are to resort to violence to achieve political ends. .
As with any public health issue, the first challenge was collecting reliable data. Wintemute’s team conducted the first large-scale survey in 2022, finding that nearly a third of the population believes that violence is usually or always justified to advance at least one of 17 political goals. It turns out that The list includes curbing voter fraud, stopping illegal immigration, and restoring Donald Trump to the presidency. Nearly one in five people strongly or very strongly agreed that having strong leadership is more important to America than having democracy. The willingness to justify violence was greater among people who identified as “strong Republicans” than among those who identified as “strong Democrats.” Another study by the Wintemute team found that nearly half of the cohort they classified as “MAGA Republicans” (self-described Republicans who voted for Trump in 2020 and believe the election was stolen) said, found that they strongly or very strongly agreed with the statement “How to do things.” Lives are being lost so quickly that force may have to be used to save them. ” Wintemute has also been labeled by right-wing extremists who espouse racist beliefs and the use of violence to bring about social change, and who express support for certain militia groups such as the Proud Boys and the Oath Keepers. The threats posed were also investigated. Among this small group (which Wintemute estimates to be less than 2 percent of the population), they found a strong association between support for political violence and willingness to participate in such violence. did.
But certain findings gave Wintemute reason to be optimistic. A survey released last month found that only 6.5% of the population strongly or very strongly believes a civil war is imminent, and just 3.6 say the United States needs a civil war to correct the situation. It was %. Both numbers are broadly similar to the previous year’s findings, an unexpected result given that 2024 is a presidential election year and political tensions are gradually escalating. Wintemute also found that of the 3.7 percent of respondents who said they believed it was very likely or very likely that they would participate as combatants in a major conflict, more than 44 percent said they were “unlikely” to participate as a combatant in a major conflict. ” was also revealed as the answer. Participate if your family tells you not to. More than 30% said they would be deterred if a respected religious leader advised them not to participate. And just under a quarter said they might be deterred by respected news and social media sources. What that means, according to Wintemute, is that “most people are saying, ‘You can talk me out of it.'” This points the way to possible public health interventions that could include consistent messages from the media, religious leaders, and others about rejecting political violence.
The threat of violence hovers like a halo cloud during this election period. While the specter of the Jan. 6 riot at the Capitol remains omnipresent, two of the most visible acts of violence during the 2024 campaign were directed at Mr. Trump. On July 13, during a Trump campaign rally in Butler, Pennsylvania, a man on the roof of a warehouse fired eight shots at the former president. A bullet grazed Trump’s ear. One rally participant, a former volunteer fire chief, was killed. Two others were injured. Then, on September 15, while the former president was playing golf at a club in West Palm Beach, Secret Service agents patrolling the grounds spotted the muzzle of a rifle protruding from shrubbery along a chain-link fence. did. Investigators opened fire and the gunman fled. After authorities arrested him, it was discovered that he had staked out the course for hours. Democrats are also being targeted. In Tempe, Arizona, state party officials recently closed a campaign field office after being shot three times in three weeks.
Threats and harassment of local government officials skyrocketed in July, according to a tracked study by Princeton University’s Dismantling the Divide Initiative. Nevertheless, as another agency, Armed Conflict Location and Event Data, reports, violence by extremist groups has actually declined this year, likely due to law enforcement’s lack of support for the Capitol riots. This appears to be due to the arrest of dozens of members of these groups for participating in the attack. This results in a complicated picture. Is political violence an imminent threat to Americans? Political scientists apply theoretical frameworks to understand how the nation’s deepest rifts around race, ethnicity, religion, geography, and culture are currently shaping people’s politics. For years, they have laid out reasons for concern, including how they are embedded. The weakening of democratic guardrails in the Trump era. and spreading misinformation.
The promise of public health is to provide practical solutions based on scientific data. Treating political violence like an epidemic may help protect the future of American democracy. But the same rifts that can spark political violence can also jeopardize the cooperation needed to address public health crises. It can also cause helplessness, which is the most dangerous symptom. However, if you simply wait for the disease to develop, it may already be too late. ♦
