NBICS and Public Health2009submitted.doc

NBICS and Public Health

The Choice is Yours

Column by Gregor Wolbring

May 15^th 2009

http://politicsofhealth.org/wol/2009-05-15.htm

What is covered under the term public health?

Various definitions of public health exist.

"The science and art of preventing disease, prolonging life and promoting health through the organised efforts of society." (Sir Donald Acheson 1988) Different organisations have different definitions of public health. At the UKPHA we believe that public health:

is an approach that focuses on the health and well being of a society and the most effective means of protecting and improving it
encompasses the science, art and politics of preventing illness and disease and promoting health and well being
addresses the root causes of illness and disease, including the interacting social, environmental, biological and psychological dimensions, as well as the provision of effective health services
addresses inequalities, injustices and denials of human rights, which frequently explain large variations in health locally, nationally and globally.
works effectively through partnerships that cut across professional and organisational boundaries, and seeks to eliminate avoidable distinctions.
relies upon evidence, judgement and skills and promotes the participation of the populations who are themselves the subject of policy and action.”

The public health agency of Canada describes public health as follows:

“Having the medical services we need when we are sick are vital, but public health focuses on what we need to do as a society to help everyone stay healthy. Public health is part of every aspect of our lives, from our homes to our workplaces, and our schools to our communities. It encompasses everything we do, from the food we eat to the safety of our environment, and from access to safe walking/biking trails to preventing the outbreak of disease. Public health is about the way we live.“

The American Public Health Association

“Public Health is Prevention. Public health is the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries.”

If we compare these definitions, the UK and Canadian definition seems to be incorporating much more the social and the well-being aspect of health into the mandate of public health than the American definition.

However if one searches the webpage of the American public health association further one finds that the American Public Health Association supports Article 25 of the Universal Declaration of Human Rights, which is about health and well-being of oneself and one’s family, and that the APHA follows the values and beliefs inherent to the Public Health Code of Ethics. In these documents it is affirmed that a) humans have a right to the resources necessary for health; b) humans are inherently social and interdependent; c) the effectiveness of institutions depends heavily on the public’s trust; d) collaboration is a key element to public health; e) people and their physical environment are interdependent; f) each person in a community should have an opportunity to contribute to public discourse; g) identifying and promoting the fundamental requirements for health in a community are of primary concern to public health.

Given this additional information, it would appear that public health goes beyond a narrow medical definition of health and includes general well-being.

Nanotechnology and public health

If one searches nanotechnology applications for public health, one finds information primarily about how its impact on the environment might effect medical health and safety. One does not find much on how applications of nanotechnology might effect well-being.

MATSUDA MASAMI (Univ. Shizuoka, Shizuoka, Jpn) HUNT GEOFFREY (Univ. Surrey) HUNT GEOFFREY (Univ. Surrey) suggested in 2005 in the Japanese Journal of Public Health that nanotechnology raises many questions about public health which are not addressed. They were concerned about nanoparticles interaction with the human skin and organs, and with the toxicology of Nanoparticles released from various products, such as in car tires and vehicle plastic mouldings, into the soil groundwater, food-chain, and other places in the environment.

The 4th Nano Café in 2007 with the theme of Nanotechnology and Public Health dealt with the question "is the widespread use of nano-antimicrobials beneficial for public health?"

The APHA issued in 2006 a policy statement on nanotechnology called ‘Addressing Potential Environmental and Occupational Health and Safety Risks of Nanotechnology’. It talks about “numerous societal benefits” that “potentially arise” if it is ensured that the nanoproducts are safe. It does not mention any possibilities of negative societal well-being impacts.

The webpage search of the Public Health Agency of Canada and the UK public health agency do not gain any hit with nanotechnology. Health Canada covers it, but deals only with medical safety issues, not social well-being issues.

Robert F. Service wrote in ScienceNOW Daily News on 20 May 2008 a piece with the title “Nanotechnology's Public Health Hazard?”, which also focuses on medical and environmental health not social well-being.

And I could go on.

The Choice is Yours:

It appears that, as of today, the debate around nanotechnology mostly if not only covers the medical and safety side of public health . Little can be found about the potential impact of nanotechnology on the broader aspects of community and social well-being which is another aspect of public health. One wonders why there is not a more extensive discussion about the impact of nanoscale sciences and technologies (positive and negative) on the social well-being aspect of public health.

All of the "The Choice is Yours" articles can be found here.

Gregor Wolbring is an Assistant Professor at the University of Calgary. He is Affiliated Scholar, Center for Nanotechnology in Society at Arizona State University, USA; Part Time Professor, Faculty of Law, University of Ottawa Canada; Adjunct Faculty Critical Disability Studies, York University, Canada. He is a science and technology governance scholar, a disability/vari-ability/ability studies scholar, and a health policy and science and technology studies researcher. He is a member of the Center for Nanotechnology and Society at Arizona State University. He is the Chair of the Bioethics Taskforce of Disabled People's International. He publishes the Bioethics, Culture and Disability website, authors a weblog on NBICS and its social implications and on Ableism and Ability Ethics and Governance and contributes to the What Sorts of People blog.