A Passion for Public Health
Passion is what drives a lot of people in health care. A passion for helping children, for example, or for fighting cancer. But a passion for infrastructure? Yes, such a thing does exist, and Harold Cox, associate dean for public health practice in the School of Public Health, is living proof.
“Public health is a universal concern,” says Cox, meaning that it must cover all aspects of health—such as immunization, food safety, emergency preparedness, chronic disease, and primary care, to name just a few—and it must reach every member in a community. “You need to be thinking of everyone’s health, and you need to be thinking of all of their concerns, all of the time.” This universality includes vulnerable, and not immediately obvious, sections of the population, he adds, such as “people whose primary language is not English, people who may not have access to newspapers or the Internet, and the elderly, who may be isolated.”
Figuring out how to channel individual passions for specific causes or demographics into a functional, comprehensive, and sustainable health care system is no easy task. But it’s a challenge that Cox enjoys, and one he will continue pursuing as a newly reappointed member of the Massachusetts Public Health Council.
“Public health is not a frill. Public health is essential. Cut it out, and see what happens.” Harold Cox
“The council’s first responsibility is to advise Commissioner John Auerbach on all aspects of public health, and the second, statutory responsibility is to enact certain regulations for the betterment of public health across the state,” says Cox, who also serves on the Boston Public Health Commission, reporting to the mayor. High on the list of issues Cox would like to address and improve are health disparities, obesity, access to care, and emergency preparedness.
He also wants to use his nearness to elected officials to keep public health a priority in a time of deep budget cuts. “Public health is not a frill,” Cox says. “Public health is essential. Cut it out, and see what happens.”
His work with the council can be difficult, he says, “because I get to hear some really horrible things about people’s lives.” A recent ray of light came in the form of a community greenhouse in Roxbury, the opening of which Cox attended. Built on a blighted block once filled with toxins, it had been cleaned up and converted into a useful, profitable, healthy public space. There were tomatoes for sale, and plots had been set up for local residents to tend. “It was a chance to see people who were intimately involved in actively making their lives healthier.”
Cox is also eager to undertake an ambitious project of regionalization. “There are 351 cities and towns in Massachusetts, and right now there are 351 health departments,” he says. By combining some of the smaller health districts into regions, Cox hopes to leverage resources and deliver more services, particularly to smaller communities far removed from the myriad health care resources available in Boston.
“It’s not as sexy as being in the emergency ward of the hospital,” Cox admits, nor is his work as visible. When food and water are safe, and infections are contained, citizens don’t give a second thought to the efforts of public health officials. A job well done means keeping it that way. “That’ll be the sign of success,” he says, smiling, “to have no one know we’re there, and to never get in the newspaper.”