In 1918, Babe Ruth pitched the opening game of the World Series for the Boston Red Sox (they won the series) and a worldwide flu pandemic got under way, with over 500 million people stricken with the infection. A digital encyclopedia of that disaster — the flu, not the subsequent trade of Ruth to the Yankees — was launched last year by the University of Michigan Center for the History of Medicine.
Now, with a serious seasonal influenza outbreak in the United States, we can be grateful that since 1918 we’ve developed effective preventive vaccines and have new anti-viral drugs, as well as excellent flu tracking and public information campaigns such Elmo & Rosita on the right way to sneeze. A ton of information is online.
Unfortunately, one of the key measures recommended by the Centers for Disease Control and Prevention — staying home for at least 24 hours after your fever is gone, except to get medical care and for other necessities - is not an option for too large a number of Americans. Millions of people lack access to affordable medical care. And millions of workers lack paid sick days; they risk losing their jobs and their family income if they stay home, even when sick with a contagious and dangerous ailment.
Remedying this situation doesn’t require science. It requires legislation — mandating paid sick leave as in the proposed Healthy Families Act. This act was introduced in the 112th Congress and will be reintroduced shortly in the 113th. Passing and enacting the legislation will not only provide paid sick time for the 40 million workers who need it to care for themselves or for family members, it will improve workplace productivity and spare all of us — and our kids — the risk of being exposed to contagious ailments.
Another step needed to make us all healthier is making preventive medical care available to all residents of the United States regardless of their immigration status or income. During the 1918 influenza outbreak, African Americans suffered disproportionately and faced segregated and difficult-to-access care even though, as was noted then, “germs know no color line.”
Today, we ought to remember: “Viruses don’t know your citizenship status.” Unfortunately, the Affordable Care Act does not provide coverage to undocumented Americans. The law says that “unauthorized immigrants will not be allowed to purchase insurance from the exchanges, receive subsidies for exchange coverage, or enroll in full-scope Medicaid and thus will likely remain uninsured at very high rates. Their access to primary and other forms of outpatient care will depend on the ability and willingness of local safety net providers, such as community health centers, to serve them, which will likely vary from area to area.”
We need to amend the Affordable Care Act to provide preventive care for everyone; doing so will promote public health in the best possible way —through prevention. Until that is done, we need to make sure we have accessible local safety nets to serve those who are unable to enroll in government programs.
Paid sick days and expanded access to preventive medical care would be a World Series victory for all of us.
Janet Golden, a Rutgers University history professor, specializes in the histories of medicine, childhood and women.
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