Eric Garner died on July 17, 2014 while being arrested for selling cigarettes illegally.[1] The now infamous video shows Mr. Garner stating, “Every time you see me, you want to harass me, you want to stop me . . . please just leave me alone.” But by this time the police were already obligated to arrest Mr. Garner for selling loose cigarettes bought outside of the state. And that obligation was placed upon them by Public Health.
Public
Health interventions are almost universally designed to create better health
outcomes for those who bear the greatest burden on disease. These consist of the most economically,
socially, and culturally disadvantaged in our society. The ban proposed by former New York City
mayor Michael Bloomberg on sweetened drinks in sizes larger than 16 ounces, for
example, was specifically designed to address economic availability of
beverages containing large amounts of high fructose corn syrup.[2]
But
these interventions don’t just have result in a disproportionate health benefit
for the poor, they also result in a disproportionate burden on the poor. Sales taxes, one of the primary policy tools
for improving public health, work as regressive taxes. This means that the cost as a share of total income
is actually higher for those who are in the lowest income bracket. We accept this because we believe that the
net benefit of a healthier life ethically justifies the higher economic burden
that we are placing on them.
And
besides the economic financial cost, there is also a heavy social and cultural burden
born by minorities and the otherwise disadvantaged. Public Health policies result in increased
regulation, government oversight, and police presence in the lives of those who
often already see these forces as designed to oppress, isolate, and humiliate
them. In an effort to free these
individuals from negative health outcomes, history has shown us that our interventions
can have negative externalities on those of lower socioeconomic status.
The
fundamental causes behind cigarette addiction are powerful enough to create an
illicit industry that caters towards avoiding these economic, social, and cultural
penalties. Eric Garner was a part of
this industry. His tragic death must be
viewed as an externality of what has historically been viewed as a wildly
successful Public Health intervention.
We
in Public Health must be aware of the high social and economic costs our
interventions may place on the very people we are trying to help. And we must be sure that when we are acting
to create a better health outcome, that the benefit justifies the cost of
increased intrusion into the people’s lives.
Otherwise the system of Public Health, designed to promote human rights,
merely becomes another instrument of oppression.
References:
- Goldstein and Schweber. “Man’s Death After Chokehold Raises Old Issue for the Police” The New York Times. July 18, 2014. http://www.nytimes.com/2014/07/19/nyregion/staten-island-man-dies-after-he-is-put-in-chokehold-during-arrest.html. Retrieved: December 12, 2014 2:46pm.
- Wang YC, Vine SM. Caloric effect of a 16-ounce (473-mL) portion-size cap on sugar-sweetened beverages served in restaurants. American Journal of Clinical Nutrition. 2013.
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