The very idea of public health is an interesting, although murky, concept. Public health includes the recognition, stimulated early in the 20th century, that we must pay attention to the patterns that link our lives and shape our health. It is not just our individual health that is important, but the patterns, often ignored or poorly understood, that connect our lives. The launching of public health as a field and a public agenda in the US and other countries was a call to all of us, not just to reimbursed practitioners and pedigreed providers. It was an urgent call to learn to think about and act on the patterns around us. In some cases these patterns are visible and obvious, but in others they are much more difficult to see.
At the turn of the last century, the Triangle Shirtwaist Fire in New York City jolted public attention and focused awareness on the conditions in which workers labor, the buildings they inhabit, and the engines of production (in that case clothing) that can lead to high risk or certain death. On March 25, 1911 over 100 young immigrant workers, mostly women, some no older than 15, died in that fire, on the ninth floor of a building with locked exit doors. Twenty years later, hundreds of mostly African-American workers who were building the Hawk’s Nest Tunnel through Gauley Mountain in West Virginia were killed, not by fire, but by breathing in the silica made airborne by drilling and digging. The workers were not given any masks or equipment to protect themselves from the deadly dust. Jolting crises like these rivet our attention, but unfortunately not for long. We need to learn to pay steady attention to what is happening in our communities, while building institutions that persistently work to prevent not only catastrophes like the Triangle Fire and Hawks Nest Tunnel, but the slow erosion of health and environment.
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Photograph of Triangle Shirtwaist Fire used by permission of the Kheel Center, Cornell University