Facebook’s CEO Mark Zuckerberg announced today that he’s donating 99% of his Facebook shares to his new charity focused on public health. The news is expertly timed with the birth of his baby, wrapping the effort in a warm fuzzy blanket of creating a healthier world for the next generation.
Public health is the science of keeping whole populations healthy, often through environmental and policy changes. It includes controlling infectious diseases, building wellness into lifestyles to prevent chronic diseases, and working on root causes of illness like inequity and poverty. Zuckerberg calls it "advancing human potential", which isn't a bad reframe for a new generation.
Microsoft CEO Bill Gates paved the way for this type of investment with his historic leadership in public health in 1997. The Bill & Melinda Gates Foundation’s work, especially with vaccinations, has already paid off. And this year they’re doubling down too. Like Zuckerberg, they think the pace of health improvement is actually quickening.
As everyone celebrates these achievements, someone’s public health efforts are being completely forgotten: yours.
It’s time for you to take some credit. You have been one of the biggest investors in public health. American taxpayers fund institutions like the National Institute of Health, the Centers for Disease Control, and state and local health departments. Your investments have improved life expectancy and quality of life in America and abroad. You’ve helped drop infant mortality, cut the smoking rate in half, irradicated smallpox, decreased heart attack deaths, and decreased childhood cavities. That’s a lot to be proud of.
Public health achievements are an American win funded by you, your families, your grandparents. And they create a healthier world for us all.
Yet, while Gates and Zuckerberg increase their investments, as a taxpayer you’ve begun to cut your investment in public health. While chronic diseases like obesity and diabetes grow and disparities scourge populations most vulnerable to poor health, you’re opting out. Maybe you don’t yet see what the professional investors see — population health’s growing potential for dramatic return on investment. And you’re going to miss out.
You’ve cut the National Institutes of Health (NIH), the world-renowned Federally agency responsible for leading biomedical research, ever since 2010. Congress’ sequester applied austerity to your investment and resulted in a funding cut of 12.1% by 2013. Even the Obama administration support of science hasn’t been able to secure funds to meet inflation.
Your funding for the Centers for Disease Control (CDC), our premier disease prevention and wellness promotion agency, has not kept up with inflation either. It’s slight decrease (and lack of proactive investment) can afford to provide only barebone support for America’s public health infrastructure. The ACA’s landmark Prevention & Public Health Trust Fund — which was intended to provide new public health investment — is now only filling our budget gaps instead of propelling us forward.
And at the levels that most impact your daily life, you’re probably decreasing your public health investment too. State health departments have experienced $1.3 billion in cuts. Across the country, 22 state legislatures have decreased funding for public health…. many for the second or third year in a row.
So what’s the deal? Why are you decreasing your public health investment?
American investment in public health clearly lacks the leadership and vision of Zuckerberg and Gate’s private investments. Zuckerberg expressed a confident and optimistic growth vision for shaping the health of the next generation. Yet most Americans don’t understand what public health is… let alone embrace it’s potential for extending their quality of life and lifespan.
The apathy is apparent in the presidential debates. Despite health affecting every single American, no candidate has aggressively positioned public health issues as the cornerstone of their agenda.
Somehow we’re stuck in a pro/con Obamacare conversation, instead of a bipartisan agenda to advance public health. The mainstream vision for public health is based on fear instead of optimism, and even then isn’t taken seriously. The dramatic Ebola fervor, though finally a national recognition of the importance of a public health system, was never matched with a significant investment in public health preparedness.
Where’s our generation’s public health vision? There are glimpses: Vice President Biden has rightly brought back Nixon’s 1971 war on cancer by recommending a cancer cure “moonshot”, Mike Huckabee has emphasized Alzheimers research, our embattled Surgeon General is focused on the uncontroversial topic of walking, Michelle Obama’s obesity prevention campaigns have fizzled short of policy change, and Obama is stuck defending health insurance for millions of Americans. All the while Congress has decreased healthy investments in all of the above.
Where’s our letter to our daughters? Our smart rationale for return on investment? Our bold bet for health of the future? Voluntary investments from Facebook and Microsoft are great models, but it’s time for some new American leadership on public health. We deserve a lifespan extension like the last generations.
I’m a taxpayer who believes public health is the most crucial, effective, sustainable, and exciting effort in the world. And I selfishly want clean water, air, a healthy food system, a walkable neighborhood and a significant lifespan increase.
It’s time for more young Americans to understand and take credit for their public health investment. Let’s double down.
It will pay off in a longer, healthier life for all of us.