December 12, 2017
Aedes aegypti Mosquito. Close up a Mosquito

The Greatest (Public Health) Stories Ever Told

by Berkeley Wellness  |  

Glow-in-the-dark watches, horseshoe crabs, fly swatters, spittoons, gin and tonics, bicycle helmets, American cheese, lab rats, bulldozers, birth certificates, and Joe Camel. You may not think these sundry objects have anything in common. But, along with 89 others, they make up the “100 Objects That Shaped Public Health,” an engaging and thought-provoking list recently compiled by the Johns Hopkins Bloomberg School of Public Health in honor of its 100-year anniversary. The chosen objects “tell some of the most compelling stories of public health over the last century and help us appreciate its vast reach,” according to the Hopkins website. Here, briefly, are just some of our favorites, for the wide-ranging impact they’ve had.

Objects that shaped public health

  • The mosquito net. Simple and inexpensive ($2.50 apiece), insecticide-treated nets effectively protect against malaria, dengue, and other viruses trans­­mitted by mosquitoes. Their use has saved countless lives in developing countries that lack costlier resources to combat insect-borne diseases. Other low-tech items on the list with similar bene­­fits include window screens and the ever-humble fly swatter.
  • The Pill. Since the 1960s, the revolutionary use of oral contraceptives has allowed women to plan their pregnancies and control the size of their families. This birth control method is credited with lowering birth rates and improving the health of infants and mothers around the world. Condoms, which became popular after World War I, also made the list for their crucial role in preventing many sexually transmitted infections, in addition to pregnancy.
  • The bifurcated needle. This small two-pronged steel needle played an oversized role in ending smallpox. Used during the World Health Organization’s Global Smallpox Eradication Program from 1966 to 1980, its special design (which, unlike a hypodermic needle, just lightly pricks the skin) allowed the vaccine against this dreaded disease to be delivered more effectively and efficiently. Of course, this object is just one key element in the broader public health achievement of vaccines, which over the past century have been responsible for eliminating polio in the U.S. (and most of the rest of the world) and for preventing misery and deaths from measles, whooping cough (pertussis), chickenpox, and other infectious diseases, as well as birth defects from rubella.
  • The tamper-resistant cap. Required since 1970, this innovative (though often frustrating) package design saved more than 900 children from accidental poisoning deaths from aspirin and oral prescription medications over the following two decades, according to calculations made by the U.S. Consumer Product Safety Commission. These hard-to-open caps are also found on bottles of bleach and other hazardous household substances. (Still, thousands of children get their hands on dangerous materials every day, with dire consequences for many of them.)
  • Fluoride toothpaste. The discovery in the mid-20th century that fluoride makes teeth resistant to decay is hailed as one of the greatest breakthroughs in dentistry, saving millions of children a year (and plenty of adults too) the ordeal of the dental drill. Besides its addition to community water supplies across the nation, fluoride is now the active ingredient in 95 percent of toothpastes in the U.S., beginning with Crest in 1955.
  • The refrigerator. By slowing growth of harmful bacteria in food, this now-ubiquitous household item (at least in industrialized nations) is credited, in large part, with significantly reducing foodborne infections in the U.S.
  • The speed limit sign. Excess vehicle speed is a major factor in road crashes. The speed sign, first introduced in 1901 in Connecticut (12 to 15 mph), is now re­­quired in nearly all states. They really help: As a 2009 study reported, there was a 3 percent increase in traffic deaths after Congress repealed the maximum federal speed limit (55 mph) in 1995, which led to higher speed limits nationwide. Other objects that have contributed to great advances in road safety include traffic lights, seat belts, airbags, children’s car seats, bike lanes and helmets, and even sidewalks (see next item).
  • The sidewalk. These walkways keep pedestrians safer (by re­­­­ducing the chance they will get hit by vehicles) and healthier (by making it easier for them to walk, rather than resort to driving everywhere). Studies suggest that more “walkable” neighborhoods encourage residents to be more physically active.
  • Warning labels on cigarettes. Cigarette packs have carried a “Caution: Cigarette Smoking May Be Hazardous to Your Health” warning since 1965. Bet­­ter for helping people quit, however, are the pictorial labels used in more than 100 countries and territories, which show stark images of diseased hearts and lungs, people with gangrene and on ventilators, premature babies, decaying teeth, tracheotomy holes, and more. Shamefully, a proposal by the FDA to require specific pictorial warnings on cigarette packs in the U.S. was stymied in 2013 when tobacco companies successfully challenged it. However, a federal lawsuit filed in October 2016 by pediatricians, anti-tobacco activists, and groups representing heart and cancer specialists has reignited the issue, challenging the FDA to issue a final rule requiring such labels.

Public (health) enemies

Not all of the objects on the Hopkins list have had a positive impact. Quite a few have made us sicker and less safe or have hurt the environment. Among them: Joe Camel (the cartoon camel that made smoking cool to kids), tanning beds (which increase the risk of skin cancer and are especially popular with teenage girls), the Big Gulp (which ushered in the age of super-sized sugar-laden drinks), and leaded gasoline (which contaminated our air, water, and soil, leaving traces that still linger). Some, like thalidomide, asbestos, and flame retardants, may have had good intentions when developed or first used but later turned out to deliver more harm than benefit.

Still, some good has come out of even the most controversial objects, by initiating cascades of events that ultimately led to policy changes. The indiscriminate use of the pesticide DDT, for instance, inspired the environmental movement, while the unsafe 1960 Chevrolet Corvair led to the creation of the National Highway Traffic Safety Administration.

CDC: The Top 10 Public Health Achievements in the 20th Century

The CDC's “Ten Great Public Health Achievements in the 20th Century" include immunizations, motor vehicle safety, family planning, and fluoridation of drinking water to prevent cavities. Read about them in more depth through these links.

From objects to actions

As the Hopkins website eloquently states, “Public health impacts all of us, in every corner of the globe, every day of our lives—not only our health and safety, but also how we live, what we wear, what we eat, what happens to our environment and the stewardship of our planet . . . It is because of public health that we have clean water to drink, safe food to eat and are protected from many deadly infectious diseases. This list, an important tool, also reminds us that we have a lot of work to do to address the many challenges that remain.”

As we here at the UC Berkeley School of Public Health approach our own milestone anniversary of 75 years, we share the vision of improving public health, especially for the most vulnerable people, through continuing research and education in such areas as disease control, aging, maternal and child health, mental health, injury prevention, environmental hazards, and to­­bacco control.

Which brings us to the last of the Hopkins objects to highlight here: The public health diploma—in recognition of the students at the 59 schools of public health and 109 public health programs around the country who will put what they’ve learned into practice around the world.

It’s well worth a visit to the Hopkins website to check out the full list of objects. Many will make you think twice about things in your everyday life that you may take for granted, such as the flush toilet, which has gone a long way in reducing the spread of disease. And some—like horseshoe crabs, glow-in-the-dark watches, and the Monroe calculator—may surprise you.