At the recent Mises Institute Supporters Summit in Hilton Head, South Carolina, Tom Woods made commendable remarks regarding the work done by myself and James T. Bennett in our 2000 book, From Pathology to Politics: Public Health in America. Our book critically examined the public health establishment and its evolution over decades, highlighting how it has veered from its original mission of disease control to a focus primarily on left-wing political agendas. As Woods noted, we unearthed this shift nearly twenty-five years ago, emphasizing how the so-called "public health" movement manipulated its mandate to align with political trends rather than legitimate health concerns.
The establishment of public health in America can be traced back to the post-Civil War era when state and local health departments emerged to tackle sanitation, communicable diseases, and epidemic outbreaks. The American Public Health Association (APHA) was formed in 1872, reinforcing the role of scientifically trained experts like surgeons and chemists. In these early years, significant progress was made in combatting infectious diseases like yellow fever and in improving overall public health and mortality rates, aided by advancements in economic conditions and living standards that allowed Americans access to better nutrition and healthcare.
However, by the 1950s, the public health establishment faced a critical dilemma: having essentially achieved its primary goals, it needed to find new justifications for its existence and continued funding. This challenge was conveniently resolved by the explosion of welfare state policies under Lyndon Johnson’s "Great Society" programs. The 1968 Kerner Report explored the "root causes" of poverty, marking a pivotal shift in focus for the APHA. The organization gradually pivoted from traditional health concerns to advocating broader societal changes via welfare, which aligned with the interests of various social and political movements at that time.
As the APHA began to embrace socio-political themes and rhetoric, the nature of its leadership transformed. The organization’s conventions started featuring keynotes from labor leaders and social justice advocates rather than public health professionals. The APHA adopted radical proposals, suggesting comprehensive social programs as necessary remedies for societal maladies, and promoted ideas such as a guaranteed income, housing subsidies, and even endorsed nationalized healthcare. In this new paradigm, public health bureaucracies increasingly shaped their policies to fit the desires of political activists, often at the expense of tangible health outcomes for individuals.
The evolving narrative within public health saw a shift away from personal responsibility for health to an understanding that government should bear ultimate accountability for health outcomes. This marked an ideological shift wherein individuals became less accountable for their health decisions. Influential figures like Anthony Fauci epitomized this trend as many graduates from medical schools opted for careers in federal agencies rather than traditional medical practice. Fauci’s career in particular became emblematic of bureaucratic failings, where numerous purported health crises served more as mechanisms for enhancing his agency’s budget and authority than as genuine public health threats.
With the emergence of crises, perceived or otherwise, the public health establishment found fertile ground to expand its influence further. This became particularly evident during the COVID-19 pandemic, where fear-driven policies resulted in unprecedented government overreach and censorship of dissenting opinions. Allegations surfaced surrounding the prioritization of pharmaceutical profits over public welfare, culminating in widespread distrust toward public health directives. As the public became increasingly critical of the establishment, it became clear that the trajectory of "public health" had deviated significantly from its foundational aims, merely masquerading broader political agendas under the guise of health initiatives. The contemporary landscape reflects a growing skepticism towards the establishment that once commanded trust, with many Americans openly rejecting the legitimacy of its messaging and practices as a reaction to institutional failures.
