The Individual vs. Public Health

by Mindy Clegg

By now over 100,000,000 Americans have received the Covid-19 vaccine and we seem on track to double that by the end of President Biden’s hundredth day. Efforts to reach herd immunity continue apace with many states opening up access to more groups in recent weeks. It’s a hopeful feeling, seeing more people receiving this promise of a return to normality. But some dark clouds are obscuring this (global) goal of herd immunity. We might see yet another surge before we’re done, both here and in other countries. Many of the states struggling to get their populations vaccinated have begun to roll back various mandates for distancing, masking, and capacity limits in businesses. There is still a vocal minority who continue to insist that masking and distancing are useless “health theater”, a direct threat to our civil liberties, that Covid-19 is no worse than the flu, and will refuse getting the vaccine as it’s “their body” (ignoring how their actions impact others in their communities).

This vaccine hesitancy—which despite the media narrative that it’s prevalent among Black Americans is really now a problem among white Republicans—can easily disrupt our goal of herd immunity and draw out the liminal state many of us have been living through. This hesitancy stems from a longer history of initially pro-health, anti-corporate movements that have been twisted and weaponized. As a result, the people who have been historically hurt the most by our government and other institutions are now suffering the most. Their pro-life rhetoric only extends to theoretical life, not to actual humans already alive and in need of support and protection via widespread vaccinations. Here I argue that skepticism of government and even corporations has become weaponized to a dangerous degree, even when it comes to settled science such as vaccinations.

Some skepticism of large-scale institutions in our modern world is warranted. The American government has historically caused pain and suffering throughout history. Enslavement was written into our founding documents and the enslaved were constructed as less than fully human in our Constitution in order to give the people enslaving them a political edge. The expansion of the footprint of the United States came at the expense of Native American people, often in the form of violent wars peppered with acts of genocide. Women of all races were denied basic voting rights and continue to struggle to be treated as equals in the workplace, with women of color suffering greater levels of discrimination than white women. This historical discrimination means that non-whites suffer far worse health outcomes from our profit-driven, byzantine health care system. The history of building the modern health care system is instructive in just how Black Americans were denied equal standing. In our current conversation, most focus on the notorious Tuskegee experiment where from the 1930s to the 1970s, Black men diagnosed with syphilis were lied to and denied care in order to understand how the illness progressed. This study enrolled 600 men, with 128 men dying directly from the disease or from complications. By the 1940s, penicillin was a common and effective treatment for the STD but the men were denied access to treatment. Such racist policies carry over into unequal access for Black Americans today, such as the gap between Black and white women with regards to maternity care. However, much of the current vocal refusniks are not the people historically disenfranchised, but a not insignificant portion of white Republicans, especially those who identify as white Evangelical.

Other aspects of public health seem under threat, specifically health issues related to the environment. The gains made since the founding of the Environmental Protection Agency and various environmental laws passed in the 1960s and 1970s seem to be unraveling. The United States passed the Rivers and Harbours Acts of 1899, which regulated how the public could use navigable waterways. Some provisions of that were later superseded by the Clean Water Act of 1972, which revised several laws in order to better preserve the environment and our waterways. One particular incident in Santa Barbara California really galvinized public opinion about government regulation of the environment. In January 1969, a blown out pipeline began to pump out nearly 210,000 gallons of oil a day, which coated the beaches of the picturesque coast, coating local wildlife. Newly elected President Nixon saw an opportunity to reach out to the growing environmental movement to pass some incredibly consequential regulations. This regulatory regime instituted in a bipartisan manner has been successful in has been successful in cleaning up the environment, so much so that some believe we should stop enforcing these regulations. Recently, conservative, pro-business think-tanks have sought to undermine the public good of clean environment. Conservative attacks on environmental regulations at the local and national level have contributed to several public health emergencies in working class communities like in Flint Michigan and in many other communities across the country. Much of the attacks on environmental regulation seem driven by skepticism of government, and to a lesser extent, corporations. However, corporations have become the primary beneficiaries of lax regulation, allowing them to cut corners on public health and on worker safety which contributed to a decline in life expectancy. We have gone backwards on protecting the environment (and by extension, public health), in part due to corporate insistence on deregulation and the view that corporations are not powerful institutions, but instead individuals with the same rights as any American citizen. Far too many politicians since the 1990s—Democratic or Republican—have argued that the progress made on these issues means we can begin to roll back regulations. The situation we’re in today with regards to environmental degradation and public health are outcome of these (often bipartisan) decisions to deregulate corporations at the expense of the American people.

The Right puts emphasis for these failures squarely on regulation. They argue that binding the hands of corporations has only contributed to their “inability” to fix the very real problems we face as a society. Corporations, they argue, will act in their own and the public’s best interest in ensuring safe working conditions and protecting the environment. Government overreach is the real problem and they demand even more deregulation—despite the failures caused by deregulation since the Reagan administration. There is no historical evidence to back this up and in fact, the preponderance of evidence is on the other side of the argument. Regulation and strong unions were key elements in growing the economy in the second half of the twentieth century. Workers and the American economy prospered when corporate tax rates were high and workers enjoyed better protections thanks to nearly half the private sector being unionized. The economy in the wake of the second world war expanded dramatically in the United States (and elsewhere, too), though it should be noted that the type of economy built during that era contributed much to the environmental crisis of the 1960s and 1970s. The American public had gotten used to government regulation and intervention into the economy, and after Civil Rights, into social issues as well. The far Right revolt against that has recently been more visible in parts of the Republican coalition, to the point of dominating the GOP. Nixon, despite his willingness to use the power of the state to protect the environment, laid the first brick in what would become the culture wars with his Southern Strategy to try and win over the white working classes. A decade later, Ronald Reagan aligned his anti-regulation, anti-tax politics with the Moral Majority, a cultural movement hellbent on rolling back gains made by Black Americans, the LBGQT+ movement, and feminists. They positioned discrimination as a personal freedom since the end of Jim Crow (ignoring the new Jim Crow), a position many anti-maskers and anti-vaxxers regularly make. They refuse to see how their actions have a direct impact on other people. The reality is that government intervention on behalf of the American people, especially with regards to corporate malfeasance worked fantastically in expanding actual individual rights. While it’s entirely true that governments can be guilty of corruption and supporting oppression, a government that’s receptive to the public can provide an effective and necessary counterweight to the massive, globe-spanning power of corporations.

This brings us back to the problem of those who refuse to act in the best interest of their communities, primarily by denying that such communities exist. Even now, as more people are putting greater levels of trust in our government in the wake of the capitol insurrection on January 6th, many of us are skeptical of enforced vaccinations or even mask mandates. For states, counties, and cities that did adopt mandates, cases were far lower than in places without them. As vaccination rates increased, some states completely did away mask mandates altogether. Some worry that the lifting of mandates prior to reaching full herd immunity will derail our efforts to keep us all safe, at a time when more than 570,000 Americans have already died from this disease. However, many Americans don’t see this as a public health issue, but a personal freedom issue. As long as a minority of Americans buy into the Thatcherite lie that there is no society, there is only the individual and their family, the longer this crisis will drag out, and the further we are from being able to have public life again in any real, meaningful way. It’s hard to trust in our fellow citizens who refuse to do something as basic as think about the impact their actions will have on others in their communities. Ironically, few things illustrate our communal interconnectedness more than a small percentage of Americans refusing to do the right thing, as they see it as a personal issue as opposed to a communal one. The reality is that what you do on issues like this has impacts and reverberations, even far outside your own social circle. It’s perhaps time we acknowledge that reality and act as if someone other than ourselves matter.