Security and Public Health

Beginning of article

Introduction

Freedom from danger. Safety. Freedom from fear or anxiety. Freedom from the prospect of being laid off Measures taken to guard against espionage or sabotage, crime, attack, or escape. These are some components of the standard dictionary definition of "security" (Mish, 1994).

THE WORD "SECURITY" IS EASIER TO DEFINE BY ITS ABSENCE THAN BY ITS PRESENCE. For example, the expressions "Freedom from Fear" and "Freedom from Want," two of the Four Freedoms enunciated by Franklin Roosevelt during World War II, expressed the desire of people for security against fear and want even though the word "security" was not used. Such expression of desire for security, and the use of the word in descriptions of programs like "Social Security" in the United States, generally cast "security" as positive, something that people desire.

However, at times "security" may be viewed as negative. Shakespeare (1605) describes the false sense of security given by the three witches in the advice to Macbeth. Another witch, Hecate, warns that these false feelings of security,

...by the strength of their illusion

Shall draw him on to his confusion.

He shall spurn fate, scorn death, and bear

His hopes 'bove wisdom, grace and fear;

And you all know security

Is mortals' chiefest enemy.

"Security" is often used to mean prevention of or protection against violent attacks, as in "national security," "homeland security," or "personal security." The word "security," in this sense, is used by those advocating warning systems, alarms, guard dogs, armed guards, and other methods of preventing personal or property intrusion and by those advocating military responses to threats of war and terrorism. This concept of security has been interpreted as security of territory from external aggression, protection of national interests in foreign policy, or "deterrence" of attacks by weapons of mass destruction.

Public health has much to do with security. In fact, a standard definition of public health implies that public health and societal security are inextricably linked. Public health, as defined in the 1988 Institute of Medicine report entitled The Future of Public Health, is what we, as a society collectively, do to assure the conditions in which people can be healthy (Institute of Medicine, 1988). This article explores how public health and security are intertwined and highlights specific aspects of security as they pertain to public health.

In the United States, we have come to expect protection from certain dangers. We expect safe supplies of food and water, safe medical care and safe pharmaceuticals, relatively clean air, safe consumer products, safe neighborhoods, and protections to ensure opportunities to participate in the decisions that affect our lives and those of our families and communities. However, our expectations are not always met. And our whole concept of vulnerability was forever altered on September 11, 2001 (Levy and Sidel, 2002).

It is increasingly evident that the safety and security of people in the United States is closely tied to the safety and security of people elsewhere in the world. In the age of globalization, the failure of economies in Asia affects the economy here in the United States. The development of multiply resistant strains of microorganisms, such as multiple-resistant tubercle bacilli, has global ramifications. Inadequate public health measures to control a localized epidemic of viral hemorrhagic fever in Africa may lead to serious epidemics of fatal, untreatable diseases in the United States. Poverty and social injustice undermine the conditions in which people can be healthy and they reduce political, social, and economic security. Moreover, inadequate measures of security to control weapons of mass destruction - biological, chemical, and nuclear weapons - can have profound adverse consequences for us all.

The term "national security" is generally used to denote security based on military measures. These measures are usually termed "defensive capability," even if they clearly have the potential for "offensive" or "preemptive" use. Reliance on such measures usually includes convincing potential enemies and allies of a willingness to use military measures - to go to war - for protection of "national security." France's Maginot Line before World War II, the massive military buildup by the USSR and the U.S. during the Cold War, and the current reliance of the Republic of Korea and the United States on military force and landmines to protect the border between South Korea and the Democratic People's Republic of Korea (North Korea) are examples. Measures such as these often result in an arms race, since offensive measures can often overcome so-called defensive arms. National security is thereby diminished rather than …