LETTERS FROM THE GLOBAL PROVINCE

GP 29 March 2006: Lost Treasures

The End of the Hispanic Society.  The Hispanic Society, as we know it, is coming to an end.  Up at Audubon Terrace, around 155th Street, it was one of those hidden treasures in New York to which you could sneak away, while you took a turn at the American Academy of Arts and Letters, the American Numismatic Society, the American Geographical Society, and the Museum of the American Indian-Heye Foundation.  We used to take it in after looking at Indian artifacts: it was such a gracious and wonderful place.  With its departure, the area will become a wasteland, essentially because municipal government has not attended to balanced conservation and development throughout the city, concerned as it is with building big stadiums.  The others, too, have cleared out. 

George Moore, its chairman, “said that the society might need to raise as much as $300 million, citing the costs of buying land and constructing a building and a need to double the museum’s endowment of about $65 million….”  See the New York Times, March 23, 2006, p. B3.  The thought is to move downtown in Manhattan, where everything else is clustered.  It probably will be just fine, but one should visit the old Beaux Arts treasure soon, since it will soon be just a memory. 

Peabody Essex.  We have just been to the Peabody Essex Museum in Salem, Massachusetts.  It’s first class.  But it bears absolutely no relation to the now departed, very charming Peabody Essex we visited in years past.  As the English would say, it has become very grand, every grand, indeed.  We will be commenting on the new museum sometime in April. 

Hail, American Absinthe.  One Ted Breaux of Louisiana, an environmental chemist, has several very compelling hobbies at the moment.  One takes him to France, where he is trying to bring back reincarnations of several lost 19th-century absinthes.  This plays to his strength, since, in his day job, he works at restoring aspects of nature to their original condition after industrial plants have made a hash of things.  Take a look at his Jade Liquers, where he offers his potions for sale.  In April, too, we will have more to say about absinthe; lately we have dealt with the best gins and ryes on Best of Wine, Tea, Coffee, etc.  Absinthe, as it turns out, was banned in the U.S. and France because of alarmist, wrongheaded bureaucracies in both countries.   In a similar manner, we notice, Eurocrats are stamping out some very fine foods on the European continent. 

Creaky Public Health.  The public health establishment has gone into severe decline worldwide, not just in the United States.  The old Soviet Union, incidentally, promulgated some worthy health measures: now Russia stumbles along.  A decent public health system in these United States would do more to buck up our health and button down our health bill than anything else on the drawing boards.  But right now, at every level of government, public health is but a lost treasure, a dream gone.  If you want to read about this deterioration, you can find Laurie Garrett’s Betrayal of Trust: The Decline of Global Public Health in our Infinite Bookstore.  For this reason, the public health sector offers private enterprise unbelievable opportunities. 

But certainly part of the decline must be laid at the door of university educators.  First off, we are amazed at the number of renowned universities with huge endowments that do not have schools of public health.  In fact, we may baldly claim that any university that lacks such a school simply has opted out of the 21st century: such education is a crying need everywhere.  Arguably, the trustees of such incomplete universities do not understand their responsibilities to society and to the growth of critical knowledge.  You can find a pretty good, but not definitive, list of schools at the Association of Schools of Public Health. 

No Trickle Down.  It’s far from certain, however, that schools of public health are doing the right stuff.  In general, it’s sort of assumed that if they have lots of resources and carry on lots of activities they must be doing the right thing.  The assumption is that something healthy must come out of it.  But just as trickle- down economics doesn’t work (i.e., dribs and drabs from the well-off don’t trickle down to our underclasses), trickle-down education doesn’t work either.  Communities don’t get wiser because you spend a lot on universities: in practice, some towns and states have even gotten dumber with outlandish higher-education outlays.  Likewise, lots of public health education does not necessarily lead to better health. 

Rankings.  U.S. News & World Report constantly does rankings of higher education which are widely discredited.  In 2003, it looked at public health and put John Hopkins, Harvard, and the University of North Carolina at the head of its list.  In fact, John Hopkins would claim that it simply is the biggest and the best: 

The oldest and largest school of its kind, the School has been consistently ranked number one by U.S. News & World Report.  It receives 27 percent of research funds awarded to U.S. schools of public health; its faculty pursue research in 40 countries; and it awards one-sixth of all public health doctoral degrees worldwide.  Through education, research, and service, the Johns Hopkins Bloomberg School of Public Health offers innovative approaches to restoring health, preventing disease and injury, and saving medical dollars. 

Hopkins gets oodles of government money, does volumes of research, and cranks out students galore.  That makes it the best.  Well, perhaps not, when you look into it further. 

Our challenge is not to confuse inputs with outputs.  What are the results?  We think one way of getting at this is to look at the health of the citizens of the state where the public health institution is headquartered.  Then we will know if we are talking about an ivory tower institution, or educators who care about public health on the streets. 

United Health Foundation.  For a look at the health of Americans on a state-by-state basis, you can take a peek at an excellent report of the United Health Foundation, the child of an innovative health plan company in Minnesota called United Health Group.  Minnesota is number one, and, by that measure, the school at the University of Minnesota would rank number one.  And, by the way, that state has a deep, long public health tradition. Yale would rank 7, and Harvard 9.  Maryland is 34, and North Carolina comes in 36. One acid test of an institution is whether it is having a good effect in its own backyard.  

Of course, there are many other meritorious things Schools of Public Health are undertaking which must be taken into account when working up a scorecard.  UNC, for instance, is getting deeply into nutrition matters, which might have a titanic impact on the whole of the South.  We will be talking about some of these accomplishments at a later date. 

There is a real question as to where the public health establishment is helping, and where it is hurting.  It seems very clear that the very nature of government funding—and sometimes the lack of it—has actually hampered public health efficacy.  Just as the government put the blocks to absinthe for a century, it has also managed to use all its might to sap U.S. public health of its relevance.  By the way, if you want to look at a nation which has got it right, visit Finland. 

Many of the key tenets of public health improvement were born in this country, notably at Minnesota, but they have become lost treasures, remnants of which show up in other lands.  In “My Favorite Year,” we discuss Minnesota’s Ancel Keys who directed the very definitive Seven Countries Study—the implications of which were only understood and applied abroad. 

P.S.  The disappearance of the association complex at Audubon Terrace also symbolizes the declining role New York City is playing in America.  This is one of the many reasons why cities should get the “museum thing” right.  It does not behoove them to build big mausoleums, but rather to create a network of dispersed, differentiated locales.  Likewise, Schools of Public Health must think harder about a dispersed schema of activities that are intertwined with the communities in which they are located.  Nelson Rockefeller, the colorful governor of New York State, was often accused during his reign of suffering from an “edifice complex.”  His spiritual progeny, with the same compulsion, are many. 

P.P.S.  We had a wisp of Mr. Breaux’s absinthe on Mardi Gras.  It reminds us that someday we want to have a Sazerac made the truly old fashioned way—with absinthe and cognac. 

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