Creating a National Dialogue Around Public Health Issues
by Jay E. Maddock, PhD
The Dean’s Perspective focuses on issues pertinent to the relationship between academic public health and the practice community.

Jay E. Maddock, PhD, FAAHB
As our national election season comes to a close, it is time to reflect on the way that public health issues have been portrayed and how we can move forward as a nation, building on common ground where most Americans agree. Recently, I attended a dialogue on gun violence at the Boston University School of Public Health. The moderator began the session by pointing out the credentials and backgrounds of the seventy plus people in the room and mentioned that one person was from Texas, yours truly.
There are over 30,000 people who die in the US annually from firearms and countless more who are injured, roughly equivalent to the number of people who die in motor vehicle accidents. This is certainly a public health issue and one that requires a sane, rational, non-political dialogue between gun owners and non-gun owners.
Texas is a very different place from Boston or my former home in Hawaii. Since becoming dean at Texas A&M, I have visited faculty members’ houses where trophy heads cover the walls, taken tours through their walk-in gun safes, and eaten delicious venison sausage shot by a co-worker’s 12-year-old son. During my tenure in Hawaii –more than 15 years– I never saw a faculty member with a gun. But guns are a way of life in Texas and much of America, and they are not going away.
We need to talk about how we can reduce death and injury from guns while allowing law abiding Americans to use them for hunting, self-defense, and recreation.
There is a lot of common ground. The vast majority of Americans agree that guns should meet minimum safety standards to avoid hurting users; that mass shootings, especially in schools, are a national tragedy; and that people suffering from severe mental illness or felons should not have easy access to guns. No one wants their children harming another child with a gun. No one wants their guns stolen to be used in future crimes. Let’s start there. There are solutions that can create a safer nation without taking away what is important to so many people.
Health care has also become highly politicized. We will surely see the Affordable Care Act (or Obamacare) repealed or changed dramatically during this Administration. Even the strongest supporters of the ACA have to admit that the legislation is not perfect, costs too much, and could be substantially improved. Although there is a lot of disagreement on what health insurance should look like in this country, there are areas where most Americans agree: children should be allowed to remain on their parents’ policies until they turn 26; no one should be denied insurance for pre-existing conditions; and low-income Americans, especially children, should be provided access to affordable health insurance. We pay too much for too little. This needs to change.
There are many areas where Americans agree. Often, the media magnifies our differences to generate interest. For instance, in 2014 two-thirds of Supreme Court decisions were unanimous, but we spent a lot more time hearing about the ones that were split decisions.
In our post-election hangover, let’s look to where Americans can agree, protecting and improving the health of families and communities throughout our nation. It’s time to start the dialogue.
For further reading, consider these related articles from the Journal of Public Health Management & Practice*:
- Violence Is a Public Health Issue
- Assessing the Impact of Federal and State Preemption in Public Health: A Framework for Decision Makers
- The Intersection of Public Health and the Affordable Care Act: The Changing Role of Public Health
*Articles may require a subscription to JPHMP or purchase.
Jay E. Maddock, PhD is the Dean of the School of Public Health at Texas A&M University. He is internationally recognized for his research in social ecological approaches to increasing physical activity. He has served as principal investigator on over $18 million in extramural funding and authored over 100 scientific articles. [Full Bio]
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