Prevention is a powerful form of civic action: that's according to a new book that explores the “prevention gap” in society.
Find out why adopting a true prevention mindset is essential to protecting public health and building a more resilient future.
The Preventioneers: Diseases, Disasters, and the Discoveries that Changed Our World by Dr. Barry R. Davis chronicles the work of people who recognized the warning signs of disaster and intervened.
Hear from Dr. Davis about what we can learn from these prevention pioneers or “preventioneers” to make the world a better place in the future.
Guest:
- Dr. Barry Davis, author, The Preventioneers: Diseases, Disasters, and the Discoveries That Changed Our World
Transcript
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Amy Juravich: Welcome to All Sides with Amy Juravich. Prevention is more than just a strategy. It's a powerful act of civic duty. That's the central theme of Barry Davis' new book, "The Preventioneers." Diseases, disasters, and the discoveries that changed our world. Davis bridges the prevention gap by chronicling the unsung heroes who spotted the warning signs of catastrophe and acted. They tried to make things better.
What can we learn from these Prevention Pioneers. Or preventioneers to build a more resilient future. And to teach us a few history lessons that can be guides for the future, we have Dr. Barry R. Davis, a physician scientist and the author of the new book, "The Preventioneers." Welcome to All Sides, Dr. Davis.
Dr. Barry Davis: Thank you, Amy. It's a pleasure to be with you.
Juravich: So you start the book with a Ben Franklin quote, and the quote is, an ounce of prevention is worth a pound of cure. Now that's a quote that is probably familiar to many of our listeners, but what they may not know is that quote actually is related to fire prevention. So it's not about vaccines, it's about hand washing, it's a about being a firefighter basically. Tell me about how Ben Franklin is actually one of America's first firefighters. I wanted to start there.
Davis: Sure. Well, back in the 18th century, fire was a constant threat. The houses were close together. Many were made of wood. There was open flames everywhere. And firefighting was limited. Franklin's insight was that the best way to deal with fire was not simply to get better at putting out fires, but it meant to prevent fire from starting.
He lived through actually two great fires and sort of vicariously through one great fire. And he used all that experience that he learned especially when he lived in London about the the Great Fire of London in 1666 to come up with his ideas and then he put him into practice too. He wrote about it, he formed a fire company, he actually became a fireman, so he lived what he said.
Juravich: I think most people who know Ben Franklin will know him as a founding father, the person who maybe discovered electricity and lightning, he's on the $100 bill, he invented bifocal glasses. But I mean, playing a really big role in fire prevention, why is it that we don't know that?
Davis: Actually, it's amazing to me. There are so many fire museums across the United States. If you walk into any fire museum, there's always going to be an exhibit about Ben Franklin there.
Juravich: Oh, okay, well, I get maybe I haven't paid attention in any of our music.
Davis: Yeah He's a real hero to firefighters.
Juravich: All right, so tell me about that quote though. Like, an ounce of prevention is worth a pound of cure. Yeah, so what does he mean by that? Just a little bit does a lot?
Davis: Yeah, he lived in Philadelphia, and in 1730 there was a huge fire, and he lived and worked there, and it wasn't far from where he lived or worked, and ended up writing a letter to his. Newspaper, the Pennsylvania Gazette, which he published, but he wrote anonymously. He did that a lot. In that letter, he gave advice for how to prevent fires. And he started off saying, an ounce of prevention is worth a pound of cure. And then he went on to give several bits of advice on how to present a fire, and then go on to talk about even firefighting in the letter.
Juravich: So he, I mean, a lot of what you put in the book about what he said about fire prevention is obvious to us nowadays, you know, like don't make the houses so close together, maybe a little bit less wood, you, know, something like changing the way the wood stoves are, like a lot things that just make practical sense so that you don't have a big fire. But was he ahead of his time? Had no one really thought about, is this like an example of no one had thought about preventing the fire? They just kind of were putting out the fires.
Davis: Well, he was ahead of his time and he wasn't. He wasn't ahead of time in that many of the things that he recommended, that had always been recommended before were sort of put into place in different areas. And they said he lived in London for a period of time and they had suffered through the Great Fire of London and they put into practice many of those things.
He just sort of borrowed them but he expanded on them too. And I mean, he organized this fire company, invented the Franklin stove, he invented the lightning rod. So he did a lot of things on his own that added to this whole concept of fire prevention.
Juravich: Before we move on to more ways to prevent diseases and disasters, I wanted you to tell us a little bit about why you decided to write this book. What gave you an idea to write a book about pioneers of prevention, and then invent a word, I guess, the preventioneers? Tell me about the origin story of this book?
Davis: Sure, so, I mean, the prevention ears just came from. Prevention pioneers and I decided that I was just going to stick them together.
Speaker 4: Mm-hmm.
Davis: But they're not only prevention pioneers, they're prevention crusaders, prevention champions, prevention advocates. And why now? Because several things. We're living in a time of warnings. There's a lot of things going on. I mean, one of the big things that inspired me was the COVID epidemic.
But there are so many other things. Climate change, social media, now artificial intelligence. And there's a lotta things going on where there are all these warnings about what to do and somehow we don't act on them. Is this thing I call the prevention gap, is the difference between what we know and what we do.
Juravich: And do you feel like, because I mean, we can talk about, you know, what we know and what we do when it came to the COVID pandemic because we've all lived through it, but something we haven't quite lived through yet is this burst of AI. I mean you just mentioned. So what do you think, I mean can't predict the future, but what warning signs are you worried about when it comes to AI that you think that a preventioneer is gonna have to tackle?
Davis: Oh, sure. Well, in AI, there's many things. First of all, there is a problem of deep fakes. There's a problem with how good is the advice, because sometimes there's hallucinations. And then there's the problem of just no safeguards around it. There's no regulations as yet.
I mean, other countries are trying to do that. But it's increasing at a rapid pace. It's increasing at a rapid pace. It's one of the most fastest moving technologies we've ever seen, considering where we were two, three years ago and where we are today. Somebody and authorities need to be aware of what could happen, and they need to able to regulate this stuff. We need to have some guardrails.
Juravich: This is All Sides on 89.7 NPR News. I'm your host, Amy Juravich. We're talking this hour about prevention and we're talking with the author of a new book. The book is called "The Preventioneers," Diseases, Disasters, and the Discoveries that Changed Our World. It's written by our guest today, Barry R. Davis, a professor emeritus in the public health department at the University of Texas School of Public Health.
So, you write in the book that there is both an art and a science to persuading a skeptical public. So I wanted to use that idea to pivot to the next prevention area you feature in the book. This is Ignaz Semmelwels. I didn't have to say it out loud until now. Am I close?
Davis: Similize. Ignis, Similise.
Juravich: Ignis Semmelweis, a doctor who figured out how to save the lives of new mothers and prevent childbed fever. He basically figured out that health care providers need to wash their hands, and I mean it's so simple and it's obvious now, but can you tell us about the skeptical people who did not realize they were contaminating, their contaminated hands were killing young mothers?
Davis: Sure. Well, it's so obvious now, but back in his day, there wasn't a germ theory. And people didn't understand that at all. They believed that the disease came from the air. It was called the miasma theory. And he was presented with an interesting set of data when he looked.
He was an obstetrician and he was in a Vienna General hospital, which was one of the premier hospitals in the world. And they kept great records. They also had two different clinics for pregnant women. One was manned by or staffed by. Physicians and medical students, and then the other was staffed by women who were taking care of the other women.
And there was a marked difference in the mortality rates between the two clinics. In fact, women, when they came into the hospital, cried out that they didn't want to be assigned to the clinic where the doctors were because they knew of their reputation. And do careful consideration and a little bit of luck.
Stemilites figured out that the cause was that when doctors were in the autopsy rooms, they would come back to the clinics and examine the women, and somehow they were carrying disease with them, even though there was no germ theory at that day. And he realized that maybe if they washed their hands and washed their hand in chlorinated water to get rid of the smell from the autopcy room, that would help. And it did. It made a dramatic difference.
Speaker 4: Mm.
Davis: This is one of the tragic stories of the book, I'm sorry, in that he met resistance, incredible resistance.
Juravich: Yeah, so people didn't really believe him or did they think he was crazy to say that by touching, basically they were doing autopsies on cadavers and then bringing whatever disease was in the cadaver to these mothers who had just given birth. Why didn't they believe him?
Davis: Well, okay, so first of all, again, we've got to remember that this was back in 1850s, and there was no germ theory. So people had no idea that you could transmit disease this way. But they didn't believe him for two main reasons. One was this thing I called about before, the miasma theory.
It just was not evidence for germ theory in those days, and so they believed in that, that it was in the air. And the other was, you're basically accusing doctors of being the carriers of disease. That their hands are literally dirty. And he was a junior person, and he was also a foreigner who was Hungarian. So, you know, how dare you tell them this? So they resisted tremendously. And it's a very tragic story because he was like 30 years ahead of his time.
Juravich: Yeah, and the sad part is that he was right, obviously, but he ended up dying in a mental institution, humiliated and broken, which is so sad. But then all these years later, his work is rediscovered, re-recognized. One OBGYN that you quote in your book calls him one of the greatest minds in the history of medicine, who was far ahead of his time. So did you feel the need to include him when you were picking out your prevention ears? Did you include him because you wanted to give his memory some recognition?
Davis: Yes, that. But also because of just the story. It's just such a dramatic story. I mean, one of the reasons why I wrote this book, I have a background in statistics and in data analysis and in scientific investigation. And I could have wrote a book that had lots of statistics, lots of charts, but I figured A, wouldn't reach the more general public, and B, it'd be a little bit boring.
Juravich: Well, good for an academic, but maybe not for the general public, yeah.
Davis: Right. But I wanted people to be interested in this. And to me, the best way to do this was storytelling. The book is just chock-full of stories about different people. And if you think about prevention, just washing your hands, that is one of the most dramatic stories of prevention.
Juravich: Yeah, and the fact that Simmelweis discovered this and tried to tell people, especially the idea of washing your hands with chlorinated water, so like a little bit of extra washing. But the fact I barely knew how to say his name, I mean, his name should be the name that we use for hand washing or something like that, right, like he should be famous.
Davis: Yes, well in certain quarters he is. I mean the other day I was in a class that I was teaching and I asked about it and some people immediately knew who he was and others didn't.
Juravich: So I did want to give a little note, like we should note that maternal mortality is still a problem in this country. But this case study, it just shows that in this case, women were dying because of poor hygiene of their caregivers, you know? But like, do you have any ties whenever you think about that, where like we still have struggles with maternal mortality, but at least he figured out one reason Or one way to stop it.
Davis: Yes, yes. I mean, the rate of maternal mortality dropped dramatically once it was instituted to do this. But there are, you know, other reasons for maternal mortality today and some of them are being investigated and some of them need to be investigated. And it'd be great if we could figure out ways to just prevent it.
Juravich: Yeah, well, and that gets to the crux of your book. So we tend to treat the women as they come rather than trying to prevent the crisis during whenever they're nine months pregnant or during childbirth, right?
Davis: Up to a point, yes. I mean, there is some preventive care and prenatal care. Right. If more women receive that, that would be better.
Juravich: Well, and there's that prevention again. This is All Sides on 89.7 NPR News. We're talking about pioneers in the area of prevention, the people who figured out how to prevent disease and disasters and change the world. Dr. Davis is staying with us, and coming up, we're going to talk about prevention being a cure because, the quote, healthy people don't die. That is when All Sids continues on 89,7 NPR News.
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Juravich: You're listening to All Sides. I'm your host, Amy Juravich. Prevention is a powerful form of civic action. That's according to a new book that explores the prevention gap in society. Adopting a true prevention mindset is essential to protecting public health and building a more resilient future.
And learning about people who were true pioneers in the area of prevention is the focus of a new book called "The Preventioneers." Diseases, disasters, and the discoveries that changed our world. Dr. Barry R. Davis is a physician scientist and the author of this new book, and he joins us today. Thanks again for being here today, Dr. Davis.
Davis: Thank you so much, Amy.
Juravich: So the quote you used to open chapter three of the book really struck me. It's a doctor who worked in Hell's Kitchen in New York City. Her name was Sarah Josephine Baker. And she said, the way to keep people from dying from disease, it struck me suddenly, was to keep them from falling ill. Healthy people don't die. And I mean, this quote is amazing and also obvious, as we said earlier. Tell me. What did you learn about Dr. Baker's approach to helping these dying children who were living in poverty that she was seeing?
Davis: Dr. Baker was an amazing individual. She, well first of all, she was a woman doctor in the time when there weren't many women doctors. And she decided to do something about it when she, after that quote that I gave, and she entered the public health sphere in New York City, the Department of Health.
She went on to become the first head of the Bureau of Child Hygiene. But she realized that there were so many things that could be done to prevent the kids from dying from getting ill, and she instituted a number of achievements. One was these things called milk stations, where they provided pasteurized milk.
Another was getting nurses out into the community to see what was going on and to help these mothers raise their children. Another was just to practice good hygiene. And she was able to do all this because she also had a knack for using the media. Just like Ben Franklin had that platform where he owned the newspaper, she knew how to use the media, if I went back in the records and I saw how many times she was interviewed by the New York Times, and she was to use that platform to help get her message out, and she talking to women. So it was another woman talking to woman and it really came across.
Juravich: So yeah, so to give people a time frame here, Dr. Baker opened up her own practice in New York in 1899. And then a few years later, she moved to working in public health. She said that a third of the babies born in slums died before their fifth birthday. And she wanted to prevent that rather than spend all of her time treating sick babies. She wanted to to prevent it from happening. So you mentioned the milk stations.
So she basically figured out that if you give the moms pasteurized milk, that was stored properly and safely. It saved many babies' lives. So is this just the moms didn't know that they were using bad milk?
Davis: Essentially. It also wasn't available to them that easily. She was not the, she did not institute milk stations and the idea for that did not come from her. She just capitalized on it. In fact, the biggest person that did the milk stations is a person named Nathan Strauss who was involved with Macy Strauss. But she had them built all over the city that really helps things out.
Juravich: Yeah. And so in her, you also called, what did you call her department? The Department of Child Hygiene? Is that right?
Davis: You're a child hygiene, yes.
Juravich: Yeah, that is such an interesting name. So is that just what they called it back then? Did every state have one of those?
Davis: No, no. New York City was one of the first places to have that and she was also one of the first heads of that. So it was something that was quite useful. They decided to do it based upon her advocacy.
Juravich: And by this time, so we're talking like maybe like 1902, 1905-ish, had they figured out that like doctors needed to wash their hands, where were we at with germ theory then?
Davis: Oh yeah, they knew that by then. They knew the germ theory. In fact, she was involved in this, the New York City Department of Health had some real giants in terms of infectious disease. So she was trained with them. She knew all about that.
Juravich: So during this chapter, this is where you transition in the book from the Ben Franklin quote, an ounce of prevention is worth a pound of cure, to just basically saying, prevention is the cure. So tell me more about that phrase. What do you mean when you say, prevention is the cured?
Davis: Well, that came from one of the, what I call the auto safety doctors. Uh, these are, there were many doctors involved and actually many other people who realized early on that there's a problem with, uh, autos, cars. Uh, people were blaming all the injuries from cars and the deaths from cars on the drivers, they're just bad driving. Um, and they realized early that yes, of course that bad driving has an effect.
But there's something more that can be done in terms of saving lives and preventing injuries. And that was to change the design of the cars. People don't realize that cars didn't have safety glass until the about 1930s. The original cars had no safety glass whatsoever, so that's just incredible.
But these, and the reason the doctors came to this conclusion in this advocacy was because They throw it in their practice. One was a plastic surgeon who obviously would see patients, a neurosurgeon, a ear, nose, and throat doctor who's happened to also be a dentist. And these were the kind of things they would see.
And they started advocating that. Some of them even sort of redesigned their own cars. They created a padded dashboard. Yeah, it took a long time for this to take effect. But the one who wrote that was Sheldon Hunter. The prevention is the cure. He's a neurosurgeon. He advocated that you don't look for a cure afterwards when these people have these accidents and they have all these head injuries. You try and prevent it from happening.
Juravich: Yeah. Yeah. So basically you found that that sometimes and even often the times back a long time ago that it wasn't the car accident itself that killed people. It was the inside of the car that led to all the injuries. Right.
Davis: Exactly. Yeah, exactly.
Juravich: So in talking about the inside of that car, because what you were saying about cars didn't have safety glass, so that would mean that the glass, there was a windshield, but the glass in the windshield would just shatter and cut them everywhere, is that what you mean?
Davis: Exactly.
Juravich: Yeah, so because immediately you kind of think without seatbelts people are getting thrown from the car. But one of the interesting quotes in your book you said was actually if the person got thrown from the car back in the day, they had a better chance of surviving than staying in the car and getting attacked by all the things in the car
Davis: Exactly. That's true. Yes, that's what it was.
Juravich: All right, so you basically spent some time and you found five different people who helped with car safety. So there's, I mean, there's different ways, but this is, they all just discussed, you highlighted five people who wanted to make cars safer and there's obvious things like seat belts, right?
But then also things like a softer dashboard and having less sharp stuff inside the car, like make the ashtray round instead of having corners on it, like things like even simple things like that, right?
Davis: Correct. Yeah, they used to have these buttons in cars. People might remember them, at least older people, and they would just stand out and, you know, if you had a car accident, you would immediately hit those buttons without the seatbelt.
Juravich: This is All Sides on 89.7 NPR News. I'm your host, Amy Juravich. We're talking this hour about prevention, and we're talking with the author of a new book, "The Preventioneers." Diseases, disasters, and the discoveries that changed our world. It's written by our guest today, Barry R. Davis, a professor emeritus in public health at the University of Texas School of Public Health.
So in this chapter where you're highlighting how we should, how we have worked over the years to make cars safer, it made me think of, I recently talked to the host of a podcast called "The War on Cars." And they wrote this book called "Life After Cars." They're dreaming of a world with fewer cars. That's beside the point here.
But they talk about in their book about how in the United States, we accept car accidents that just happen, and they're a part of life, and we accept them too readily. So I feel like your book is saying something similar. It talks about the work done over the years to make the car safer inside and out. Can you talk about, I mean, how just the important doctors talking about the need to make cars safer really did it.
Davis: Yes, I don't know whether that's still true, I hope it is, but there are so many things that could be done to make the cars even safer. We've had a lot of things done in the last, let's say, 10-15 years, all the new cars have all these things on them with automatic devices, they sort of keep you in your lane, make the car slow down, beep when there's somebody coming on your side, things like that and so on.
And the cameras, the rear view camera, these have made differences, but still... There are things that could be done to improve things a lot more, be it also cars and road safety. There's this organization called Vision Zero, where they want to have zero deaths from cars. They want to redesign the highways, roads, and such to make sure that the accidents go down, down, down.
And we have all this wonderful science and technology. And people can think of all the things that cause car accidents nowadays and all the things that caused injuries once you have an accident. And I'm sure come up with ways to prevent them.
Juravich: So something like wearing a seatbelt. I mean, now that seems like common sense, but still, I mean I'm sure there's still people out there who don't wear them. If prevention is common sense like you write in your book, why is it resisted? Like why did people resist seatbelts for such a long time?
Davis: They resisted it because it wasn't a status quo. It was something different. People don't like to be told things, either. But it was amazing when seatbelts were first mandated in cars, people didn't use them. And think about all the things that have happened since then. OK, now when you get in the car, if you don't put your seatbelt on, it beeps.
You can still get around that by actually moving the seatbelt around. But also, if you get stopped for any reason... You can get a ticket. So there are people who are trying to find ways to make sure that you wear seatbelts. But it does happen. I was talking to a pediatric emergency doctor the other day, and he said one of the main things he sees in the emergency room is kids from car accidents, and the kids weren't wearing seat belts.
Juravich: So maybe the parent was, but the kid in the backseat wasn't.
Davis: And the other thing is maybe we need to do more public service announcements. We used to have those all the time. I don't know if people remember the crash dummies. But we have all these things on TV that announce, you know, this is a new medicine. This is such and such. And the number of public service announcements has gone down a lot. We used to have a lot more of them.
Juravich: Yeah, you're right, I haven't really thought about that, but there are fewer public service announcements now. Your five preventioneers who advocated for car safety that you feature in this chapter, what do you think they would think of all of our fancy cars now? All those blinking lights, all of those warning systems, they tell us when a car's in our blind spot, we have airbags. Do you think that they would be happy with all of that, or do you there could be even more?
Davis: No, I think they'd be very happy with it, but they would say there's more to do.
Juravich: So yeah, the idea of all of these, I hadn't really thought much about the public safety announcements and the crash test dummies. Why do you think we as a society got away from public service announcements so much?
Davis: Well, a number of reasons, but one of the things that's overarching in the entire book and that people who are, well, speaking, prevention knows, prevention is invisible. You don't notice prevention because prevention works. So the example, the many examples you can give, but you know, it's very dramatic when somebody rescues somebody from a burning fire, takes them out of the house and so on.
There's no drama when the house doesn't catch on fire because it was well prevented. And you remember many, many years ago there was a little girl that fell down a well.
Speaker 6: Baby Jessica, yeah.
Davis: Yeah, the nation was captivated for three days so they got her out, but think of all the wells that were plugged and nobody went down. There's no drama to that. People get used to it, even in the case of those cases like our infections, something like measles, you know, is well controlled. We solved it. Yeah. And then people say, well, I don't need to take a vaccine because there's no measles anymore.
Juravich: And now, what are we?
Davis: It's a victim, prevention is a victim of its own success.
Juravich: Are there, what comes to mind if you had the power to create some public service announcements? What would be the very first one you would make?
Davis: Probably about cars, because that would be an easy thing to do. The other one is smoking, and then another one about high blood pressure.
Juravich: One about high blood pressure. Yeah, tell me, yeah, we didn't get to the chapter on high blood pressur, yeah. Yeah, yeah tell me what you would say to people in a public service announcement about high blood pressure, that they need to get it checked or that they needed to pay attention.
Davis: All of those things, they need to get it checked, they need be aware, they needs to know whether they're in control and they need get it under control. And it should be made clear to people that if you have high blood pressure and it's under control, you reduce your risk dramatically. But if you had high blood and you don't know it, that's bad. If you have higher blood pressure and it not controlled, that's also bad.
Juravich: Are you saying that people don't go to the doctor often enough don't check and pay attention to these things?
Davis: No, I wouldn't say that. It's just that the whole system is such that there's these gaps along the way. And it turns out that there have been several studies done that of all the people who know they have high blood pressure and are trying to get it under control, only about maybe a fifth or a quarter of the people are actually under control. It's a huge number of people that are not under control
Juravich: So we have people walking around like a ticking time bomb with high blood pressure.
Davis: Well, close to a ticking, I wouldn't say it's ticking time bomb, but it's a slow ticking time bump. Yeah. And yeah, you end up having heart attacks or strokes or heart failure or kidney disease from this.
Juravich: You're listening to All Sides on 89.7 NPR News. We're talking about the pioneers in the area of prevention, the people who figured out how to prevent diseases and disasters and change the world. Dr. Davis is staying with us, and coming up, we're gonna talk about cancer prevention. And we'll discuss why people still smoke, even though we know it can kill you. That is when All Sids continues on 89, 7 NPR news.
You're listening to All Sides. I'm your host, Amy Juravich. In medicine, the most powerful interventions often happen before disease even appears. Yet across US healthcare systems, prevention consistently takes a backseat to treatment, leaving avoidable illnesses, outbreaks, and chronic disease to escalate before action is taken.
We're talking this hour with prevention medicine physician and public health researcher, Dr. Barry R. Davis. He calls this a disconnect, he calls this disconnect the prevention gap, the distance between what science already knows can prevent disease and what society actually implements. And Dr. Davis's new book is called "The Preventioneers," Diseases, Disasters, and the Discoveries that Changed Our World. Thank you again for your time today, Dr. David.
Davis: Well, thank you so much, Amy.
Juravich: So in the book, you say that this persistent gap between knowledge and action exists. And I think a really good illustration of that is your chapter on smoking. So lung cancer in many cases is preventable. Basically you say, that it is a manmade disease that can be prevented simply by never picking up a cigarette. So why do people still smoke despite everything that we have learned?
Davis: There's a whole host of reasons, but one of the main reasons is that it's still on the market. And it's still being advertised in various ways. It's not, we've got it off the air, but it's being advertised and it still in some ways being a little bit glamorized. I thought that it was gonna be off the movies, but it still there and people still smoke.
Young people for some reason keep on taking it up again, not in great numbers like they used to, but there's still a. A percentage of that too. You know, I recently wrote an editorial about this because the United Kingdom passed a law to try and prevent the younger generation from ever getting their hands on cigarettes.
Juravich: What does that law say?
Davis: I don't remember the exact dates, but I think people who were born after 2008 would not be allowed to buy cigarettes at all. Forever.
Juravich: Okay. Interesting. Yeah. So you write that we still smoke today because of addiction, obviously tobacco is addicting, because of defiance and then the influence of the tobacco industry. Which one of those do you think is the most powerful? I mean, the defiance.
Davis: The last one.
Juravich: Oh, okay. Yeah. Okay. Why? So the tobacco industry still has an influence over us, whether we like it or not.
Davis: Yes, they have an enormous influence. They fought back against the initial data, they fought back every step of the way, and unfortunately they're still fighting back.
Juravich: Interesting. I mean, I know someone who's listening right now is going to write to me and say that they know someone who never smoked a day in their life and got lung cancer. But I just wanted to clarify, we're not saying that all lung cancer is caused by smoking, but just a lot of it, right?
Davis: No, no, not all 90% but not all yeah. Yeah So I mean I've heard that argument too You know I can talk about people who cross the street without looking both ways and never got hit by a car Okay, it's not the thing to do
Juravich: Well, in this chapter about smoking, you quote a doctor who says that we take our cars in for more regular checkups than our bodies. So can you talk a little bit more about that? So like, why is it that we do oil changes on our car more than we do an oil change on ourselves?
Davis: It's a great quote. It's from Ernst Winder, who is one of the original discoverers of the link between smoking and lung cancer, along with Richard Dahl and Bradford Hill. Because it's just, well first of all, we get all these nudges about taking care of your car, and then we quickly notice that something doesn't happen to your car.
And there are all these reminders around to change your oil, Uh, all these companies get involved in this, uh, your dealership tells you to do this, do that, do this. Uh, it would be nice if we had these kinds of reminders. Now some of the, some doctors and some, uh health services do provide these timely reminders, but somehow people want to take better care of their cars necessarily than themselves. Sometimes he's thinking that your body is, uh self-healing and it'll take care of itself. Or a way that something goes wrong, but you don't do that about your car.
Juravich: So it's not just smoking, though. There's a lot that can be done related to prevention. Rather than just treating illnesses that we have, you write that we can do a better job of preventing them. And this made me think of the recent surge in GLP-1 medications, because we recently did a show about them. And it's being found that these drugs do work. People lose weight. They're helping with obesity.
But for the most part, insurance companies won't cover them unless you have severe diabetes. Losing weight, you know, it cuts down on lots of health problems for people. It improves heart health, reduce cholesterol, lower blood pressure. It can help with back pain and knee pain if you lose weight. So what's your assessment there? Do insurance companies, they don't want to help people prevent some of these problems?
Davis: I'm not sure, but it would be in their benefit to do that. To pay upfront a little bit more instead of paying on the back end to treat all these things. I mean, that's a great thing. I mean one of the things that I guess we haven't touched on was prevention. Is it a personal problem or something else?
People should try and do the right thing in terms of diet and exercise and everything else. But it's very hard to do that. And it'd be much more helpful if the things were designed to the system. Such, I mean, a great example is the seat belts. Tell the person to put on their seat belt, okay, fine, but you add in the beep, but you added in the law enforcement and so on. It makes it harder to do. Something needs to be built into systems to make it easier for people to do things rather than just depending upon your personal lifestyle. Although that is important.
Juravich: Yeah, so does the government or someone, I don't know if the government's the right word, but does someone need to make insurance companies cover these GLP-1 medications, make them cheaper so that we can prevent a whole slew of obesity-related illnesses?
Davis: Well, I would think that somebody needs to be involved, whether it's the government or other health agencies, but it should be, there's plenty of studies out there that should show that it would be very cost-effective. Now, I'm all for these new medications, and I guess there's two downsides. One is we don't know the long-term effects, but we won't for a while, but they seem to have incredibly dramatic effects. And then the other thing is, do we want... Just to be the way for everybody that we want our children to do this, we want them to get on this. We have to think of better ways to prevent all this from happening in the first place.
Juravich: Yeah, and that gets back to access to healthy food and making food more accessible and cheaper and being able to help people afford healthy foods, right? Exactly. I mean, that's a giant rabbit hole we can open. That's probably a different show, right, Dr. Davis?
Davis: Oh, right. Oh, yeah.
Juravich: All right. This is All Sides on 89.7 WOSU NPR News. I'm your host, Amy Juravich. We're talking this hour about prevention, and we are talking with the author of a new book called "The Preventioneers," Diseases, Disasters, and the Discoveries that Changed our world. It's written by our guest today, Barry R. Davis, a professor emeritus in public health at the University of Texas School of Public Health.
We don't have time to talk about every chapter in your book because we're running low on time in the show, but you do talk about suicide prevention, preventing cardiovascular disease and hypertension, and you also mention climate change. But in the conclusion of your book, you mention a universal truth. If you haven't got your health, you haven't got anything. So prevention is the cure. I wanted to talk a little bit about that. Like you decided to include that. What do you wanna say about the idea of like if you haven got your heath, you havent got anything?
Davis: People think that their lives are such that health is like a separate part of it, but do you realize that almost everything you do affects your health? Your day-to-day work, whether it's your physical or your mental health, and there are a lot of things that affect our mental health.
So there are things happening all around us that affect their health, a great example is like climate change. If we don't try and do a better job of dealing with it, it's going to affect your health in one way or another, whether it be physical health or mental health. I mean, the physical health is the obvious little things that go on in terms of heat and cold, but the mental health, I mean if something happens to your property or your town or your job, that's a big strain on your mental health. Health is all around us and we may not be aware of it but there are so many things that affect our physical and mental health in many ways.
Juravich: Yeah, your chapter on climate change was interesting to me because, I don't know, I feel like I could wrap my hands around or wrap my head around, whatever the phrase is, around the chapter about smoking and hand washing because we figured those things out. We have to wash our hands. We shouldn't smoke cigarettes. They're bad for us. Ben Franklin invented the fire department. All good.
But climate change, we haven't figured out. And so I feel like. Talk to me a little bit about the the the prevention aspects there if you're going to write this book again in ten years Well, we have more figured out.
Davis: I hope so. Actually, it's kind of too late to prevent climate change.
Juravich: That's true. Okay, yeah.
Davis: So we're basically at the stage where we want to mitigate it. We want to lessen its effects. Because all that carbon dioxide is all over the place now. So it would be nice if not only did we find out ways to lessening the output of carbon dioxide, but also find out way to deal with disasters that we know are coming.
And there are so many ways. I'm not a climate scientist or a climate expert. There are so many ways and so many things that people have suggested. There are actually hundreds of books about the climate change problem. I mean, just things like designing houses to resist the climate, not building in climate disaster areas, and so on and so on. People need to be very aware. And we have so many wildfires now. People need be aware of where things should be built, How they should be built There's a lot that's going on that we could do more.
Juravich: Yeah, you just said something interesting there. So your book right now is called "The Preventioneers." But when it deals with climate change, so is your next book going to be called The Mitigationeers? Because we have to mitigate it instead of prevent it.
Davis: That's a good, that's a a good choice Amy. I'll have to think about that. Okay, alright.
Juravich: Okay. All right. You write me eight chapters of people who are mitigating and make it sound great. Sure. Okay. Well, I asked you earlier about a magic wand to make people listen. So I'm going to ask you again, if you could, if can wave a magic wands and make people listen to one thing right now in the world of prevention, what would that be?
Davis: I would ask people to take a look at their lives and see what sort of preventable harm there is and whether something could be done about it. Now it could be all the diseases we talked about, smoking and blood pressure, but it could be things about climate change, it could things about artificial intelligence or it could more personal things in their own lives, things that they know like a bad habit at the creating that. What can they do about it? Because a bad habit might end up being very bad for their health. Are there ways they could try and prevent that? I want people to have a prevention mindset to think of, is this a harm and is there a way to prevent it?
Juravich: Um, and I wanted, I did want to touch on before we run out of time, that line between individual responsibility and the collective responsibility, cause that kind of comes up in your book too. I mean, you know, the individual needs to put the seatbelt on, but we, we as a society mandated it, you there's laws, there's the beeping in the car. So basically you have to do something with the seat belt. So what, what parts of prevention are the individual responsibility and when does society need to take over? Is there a line there?
Davis: It's not an exact line. People should be responsible for their own lives. But we live in a civilization. We all do things together. I mean, can you imagine if there were no traffic laws? I mean that is something that we deal with. There's red lights and stop signs and so on.
So they're to help us along, helps us navigate life. There should be things along the way that help us not just in the right direction. I mean, people can refuse to do things, but they have to realize that they're part of society. You can refuse pay your taxes, fine, but there are consequences. You know, the example I always remember is the thing with motorcycle helmets. Yeah, people didn't want to wear helmets, but if they get in an accident, who pays for all the medical care that happens to them, including what happens to their own family having to deal with it.
Juravich: Yeah, so whenever, so there's the idea of like society needing to take over. And that made me think of something you said at the very beginning where, because Ben Franklin borrowed all of his ideas about fire safety and fire prevention. A lot of them came from England and living in London and they were just like doing it over there. So then he brought it here. Are there other, are there countries that you look to that are doing a better job of prevention than we are?
Davis: Yes, there are a lot of countries across the world in Europe and Asia that are doing better jobs in terms of providing health care for their populations and if you can provide health care earlier, get preventable measures in place, you can help prevent a lot of disasters in the youth.
Juravich: Yeah. So do you feel like the United States health care system is a part of the prevention problem?
Davis: In a way, it is. There's a lot of things that could be done to do that. I mean, just being able to provide people basic health care is one way to prevent a lot disease.
Juravich: Yeah, all right. Well, we're down to about a minute left in the show. So if you want to just leave people with the bottom line from the preventioneers, tell me a little bit more about what you would say to them about what they can do for themselves. If society is not going to take over any time soon, tell me about what the individual needs to do.
Davis: Again, they need to think about what they do in their lives that could cause harm in some ways, whether it's eating, exercise, or even just habits, how they drive, what they do, and think about ways that they might be able to prevent it. Because if something bad happens, you can go back and say you can have a lot of
Juravich: We have been talking about the new book, "The Preventioneers," Diseases, Disasters, and the Discoveries that Changed Our World. It's written by our guest today, Barry R. Davis. Dr. Davis, thank you so much for your time today.
Davis: Thank you so much, Amy. I greatly appreciate it.
Juravich: And you've been listening to All Sides on 89.7 WOSU NPR News. I wanna say thanks to the All Side staff, producers Marcus Charleston and Erin Esmont Rabinowitz. Our student producers are Iza Huck, Colin Simpson, and Brianna Fortunat. And video production is by the Ohio Channel.
Board operation is by Chris Johnston. And if you missed any part of today's show, you can listen back at our website, www.WOSU.org slash All Sides. Subscribe to our podcast. Every episode is available for free in our mobile app. This is All Sides on 89.7 WOSU NPR News. I'm Amy Juravich. Thanks for joining us.