(Circulation. 1995;92:2785.)
© 1995 American Heart Association, Inc.
Articles |
Using Public Policy to Fight Heart Disease and Stroke
A 21st Century Approach
From the American Heart Association, Office of Public Affairs, Washington, DC.
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Introduction |
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 Top Introduction |
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With the 21st century almost upon us, we have to think innovatively about additional ways to fight heart disease and stroke, America's number one killer. Thinking innovatively means to consider our current resources and how we can use them in new ways to bring about greater progress toward our mission: to reduce disability and death from cardiovascular diseases and stroke. Part of that innovative approach will include strategically positioning the AHA's public policy priorities and advocacy activities to ensure continued progress toward our mission.
The AHA can use public policy to fight heart disease and stroke at the turn of the 21st century much as Samuel J. Crumbine, MD, did to fight disease at the turn of the 20th century. Crumbine was a physician in Dodge City, Kan, who thought that prevention was as important as treatment. He was appointed to the Kansas State Board of Health in 1899 and moved his family to Topeka.
Crumbine worked to educate the public and policy makers about how dangerous it was for cities and towns to pump their raw sewage into streams and rivers. He pushed for water and sewage laws that were eventually passed in 1907.
The "common drinking cup" was another disease carrier in those days. In schools, on trains, and in other public places, everyone used the same cup over and over. Crumbine took cups from several trains and analyzed them. He found many kinds of bacteria, including the tuberculosis bacterium. He started his campaign to abolish the public drinking cup. He met with heavy opposition from newspapers, railroads, and politicians. However, he never faltered in his one-man crusade. Because of his work, Kansas banned the public drinking cup in 1909. It was the first state to do so.
During the 19 years Crumbine devoted to public health work in Kansas, the state enjoyed constantly decreasing death rates, proof of the value of the public policy initiatives and health programs he advocated. This innovative approach to treating disease placed Kansas among the leading states in safeguarding the health of the people.
Public affairs is the term the AHA uses to describe activities related to the monitoring, advancing, and defeating of legislative or policy initiatives. To be successful in public affairs, we must infuse it into all areas and levels of the AHA and acclimate all volunteers and staff to public affairs activities. A common understanding must permeate the AHA of the importance of public policy and the impact it can have on our mission.
Public affairs naturally complements the already successful AHA enterprises of cardiovascular science, public education and community programs, and revenue generation. But we must think outside the box of these traditional enterprises and embrace public affairs as a new strategy pillar. However, public affairs is not a function unto itself, but requires the inclusive assimilation of volunteers and staff from all areas of the AHA.
This means that we must draw on those in science, medicine, and education to deliver expert testimony. It means that we must look to those in communications to craft messages and responses that rise above the media noise and connect to the general public. It means that we must look to those in community organization to assist in recruiting networks of individuals who will call, write, or visit their elected officials. We complete the public advocacy mix by having devoted public affairs volunteers and staff who are trained and experienced at cutting paths and inroads into government bureaucracies and public policy arenas.
Like Crumbine, the AHA has persevered with its public policy initiatives. As a result, the AHA has won several federal, state, and local public policy victories relating to federal funding for heart disease and stroke research, tobacco control, and nutrition labeling.
As in research, which is the AHA's number one priority issue, success in public policy requires perseverance, skill, and a vision and hope for progress. Whether our issues are before Congress, a state legislature, city council, or local school board, the AHA's public policy initiatives can greatly reduce disability and death from cardiovascular diseases and stroke, with the positive effects lasting well into the 21st century and beyond.
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