Char­lotte’s col­or­ful pub­lic health his­tory

The Charlotte Observer (Sunday) - - Opinion - BY WIL­LIAM BRAN­DON - SPE­CIAL TO THE OB­SERVER ED­I­TO­RIAL BOARD Bran­don is MMF Dis­tin­guished Pro­fes­sor of Health Pol­icy at UNC Char­lotte.

Pub­lic health is an im­por­tant func­tion of North Carolina and Meck­len­burg County gov­ern­ments. Last year was the hun­dredth an­niver­sary of the ap­point­ment of the first full-time pub­lic health of­fi­cer in Meck­len­burg County.

The re­cent Hepati­tis A scare (“Some think County should Re­think Worker Vac­ci­na­tions” June 29) jus­ti­fies re­flect­ing on this rich his­tory. The pos­i­tive les­son is that gov­ern­ment pub­lic health func­tions are much more trans­par­ent and re­spect­ful of in­di­vid­ual de­sires now than in the past.

Pub­lic health authorities used to be very mus­cu­lar. Lo­cal pub­lic health boards pro­mul­gated quar­an­tines and san­i­tary reg­u­la­tions much more quickly than the County Com­mis­sion can act nowa­days. Some­times “mus­cu­lar” had lit­eral not just metaphor­i­cal mean­ing. In Fe­bru­ary 1900, two physi­cians, six po­lice of­fi­cers and some le­gal func­tionary went to a lo­cal mill to vac­ci­nate em­ploy­ees against small­pox. Work­ers in the weav­ing room staged a largely suc­cess­ful mass break­out; some es­caped by jump­ing out win­dows.

Clearly, pub­lic dis­trust of vac­ci­na­tion was wide­spread long be­fore be­lief in the bo­gus link be­tween autism and child­hood vac­ci­na­tion arose. Dur­ing the day, sev­eral peo­ple were ar­rested un­til they con­sented to be vac­ci­nated. The pub­lic health and law of­fi­cers had more suc­cess in the evening when they raided the bars along Col­lege Street and vac­ci­nated the pa­trons.

Some­times trick­ing the pub­lic seemed to be the only path to progress. Cam­paigns to flu­o­ri­date pub­lic drink­ing wa­ter used to gen­er­ate great re­sis­tance in the U.S. In Char­lotte, the bat­tle raged for two years with crit­ics charg­ing that flu­o­ri­da­tion was “a com­mu­nist plot to doc­tor the wa­ter with rat poi­son” and “com­pul­sory mass med­i­ca­tion.” Lo­cal doc­tors and den­tists coun­tered with al­most unan­i­mous sup­port for flu­o­ri­da­tion, be­cause it pro­tects chil­dren against tooth de­cay at neg­li­gi­ble cost.

Char­lotte’s Pub­lic Health De­part­ment and City Council fi­nally in­au­gu­rated flu­o­ri­da­tion with great fan­fare on April Fools’ Day (ap­par­ently no­body no­ticed), 1949. All kinds of neg­a­tive re­views and re­ports of dire con­se­quences im­me­di­ately flooded into city of­fices, wrote the Ob­server. Some claimed that the wa­ter had be­gun to taste bad; oth­ers re­ported that lawns wilted and a range of do­mes­tic pets from gold­fish to cats and dogs sud­denly died. Other cit­i­zens claimed their teeth had fallen out.

The out­cry had reached a crescendo when city of­fi­cials an­nounced that flu­o­ri­da­tion could not have caused all those dire out­comes, be­cause they never started the flu­o­ri­da­tion ma­chin­ery. They had just wanted to ex­pose the fer­vid hype about flu­o­ri­da­tion.

The Health De­part­ment’s de­cep­tion suc­cess­fully de­flated what had been in­tense op­po­si­tion and flu­o­ri­da­tion be­gan for city res­i­dents in May 1949. Char­lotte was the first city in the south­east to add flu­o­ride to the wa­ter.

The last fifty years have seen great change in lo­cal gov­ern­ment. The County Com­mis­sion abol­ished the un­elected Meck­len­burg County Board of Health in 1973 and has ex­er­cised pub­lic health pol­icy-mak­ing power since, al­though the state has taken many of the pow­ers that lo­cal gov­ern­ment used to ex­er­cise. Thus the Ob­server (June 30) quoted Meck­len­burg County Health Di­rec­tor Gib­bie Har­ris as say­ing cur­rent state laws pro­hibit coun­ties from re­quir­ing vac­ci­na­tions.

Ob­server file photo

Meck­len­burg County of­fi­cials once ar­rested peo­ple who re­fused vac­ci­na­tions.

Wil­liam Bran­don

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