Interview transcript

Terry Gerton You’ve got a new book out called The Preventioneers, Diseases, Disasters, and the Discoveries that Changed Our World. I want to focus on that second word, preventioneers. That’s a new one? What do you mean by that?

Barry Davis Well, it’s an amalgam of prevention and pioneers, and I came up with that after I had researched the phrase, an ounce of prevention is worth a pound of cure, and realized that it was Benjamin Franklin and that he wasn’t talking about medicine, he was talking about fire. And Franklin had a lot of things go on in his life, he always lived or worked near major fires. And from an early age, he was interested in this and he wrote about it and he actually lived it because not only did he write about it in his Pennsylvania Gazette and editorial where he anonymously wrote this phrase but he gave advice as how to prevent fires but he also actually lived it in that he formed the Union Fire Company and he became a fireman himself.

Terry Gerton What is it about Franklin’s approach to preventing fires then that you extrapolated into sort of a broader lifestyle approach? What makes it so hard to act in a preventive way?

Barry Davis Well, his approach was that you need a system. And he thought that people needed to build institutions and habits and trust that would allow people to act before the disaster comes. It’s hard to do prevention because prevention is invisible. When it works, you don’t see it. When somebody has a, when there’s a disaster, you see it, when the disaster doesn’t happen, that’s okay. When a person has a heart attack or a stroke, or they develop cancer or something like that, you see it, but when they don’t, nobody says, well, it’s not known as it’s invisible.

Terry Gerton That’s a very medical-centric approach. I mean, we think a lot about health and preventive practices and those kinds of things, but it seems to me more difficult in the communal setting to agree on what preventive measures should be.

Barry Davis Well, that’s true, but there’s a lot of stuff that goes on that is involved in prevention. I mean, I know this is a government program, but think of all the things the government does. Besides the public health surveillance, infrastructure safety, make sure that the bridges don’t collapse. You have to build them right and maintain them. The food safety, you have to make sure the food distribution system is fine. There’s Aviation Safety, there’s  disaster preparedness, cybersecurity, there’s many things in government that is from a prevention point of view. You want to prevent bad things from happening.

Terry Gerton Do you think that might be one of the reasons why we’re having such a maybe a crisis of confidence in government is because our government has been so good at preventing bad things from happening that people wonder what the government really does?

Barry Davis Exactly. What happens is, as I said, prevention is invisible. So when nothing happens, you think, well, why do we need these services? Why do we this agency? Why do need that? Why do you need this? Well, exactly because you prevented these things from happening, and when they’re not in place, things will happen. As I said before, I keep on going back to the medical thing with a good example sometimes is measles. People think that measles has disappeared. Well, it hasn’t. The reason it did sort of disappear was because 95% of the population was immunized. But when that is less, things happen. The same thing with food safety or infrastructure maintenance. If things don’t occur and you cut programs, then bad things can happen.

Terry Gerton Dr. Barry Davis is Professor Emeritus of Public Health at the University of Texas School of Public health and author of the new book, The Preventioneers. Dr. Davis, one of the themes in the book is that warning signs are often visible before harm occurs and yet people tend to ignore them. In our current environment where there’s perhaps less agreement on warning signs in our fractured news environment, that seems to make that problem even bigger. How do you get people to have a common perspective of the dangers.

Barry Davis Well, that can be tough. You know, the book sort of highlights these people who did see this and told other people about it. Most of the people in the book had a platform of one or another, like Franklin had the Pennsylvania Gazette. There’s another person in the books, Sarah Josephine Baker. She was able to go to the New York Times and talk about things many times. But there were others where it was harder. You had to work through, let’s say, the medical literature or medical community in order to get the word out. But the warnings are there. We see this over and over again in many, many examples. I mean, one of the things I’ve picked on lately is artificial intelligence. The warnings are they’re about something needs to be done to prevent bad things from happening in the sense that it’s a great achievement of mankind. It can do many, many things, but like any new technology, there’s good and bad, and we have to prepare for the bad. And the way that needs to be done is to have guardrails in place to make sure things don’t go awry and we need to work harder.

Terry Gerton One of the points that comes through pretty clearly is that prevention rarely earns political rewards. So when you think about that, on top of even just some of the examples you just gave where the truth is there, but the fight is long, what separates people who really do take action in this prevention space from those who don’t?

Barry Davis Well, these are the people in the book, they’re the pioneers, the advocates, the champions. You have to realize that prevention, as I said at the beginning, is invisible. So it’s hard to convince others that they should set aside time, effort and money to do prevention when where’s the disaster, what’s happening right now? And you’re saying, well, we need to do this now before something bad happens, and we’ll save a lot of money if we do, we do this all the time. We invest in things. With the foresight that something bad could happen and they want to invest upfront.

Terry Gerton Let me give you a very current example. The Social Security trustees have just released a report that says the Social Security Trust Fund will be depleted by 2032. We’ve known for decades what that timeline was. We’ve know what will happen when the trust fund is depleted, and yet we do not seem to be able to mobilize to take collective action here. What would you recommend?

Barry Davis I would recommend that we need people to be at the forefront of that. I know there are a few groups that keep on telling us about the deficit and the debt and the Social Security Fund, but it’s up to the voters and the politicians to realize this is a looming disaster and that something needs to be done. I don’t have any magic words that will make this happen, but a lot of people need to be more informed. And it’s up to the media too. Media has a responsibility in presenting these issues as opposed to just going after the highlight of the day.

Terry Gerton You do tie this back to America 250 and talk about the lessons we should learn here for the securing of our next 250. Let’s close there.

Barry Davis Well, I mean, again, there are things that were built into the declaration and then into the constitution and sort of a prevention framework. These people had seen what it was to live under a king. And they decided that that was not going to happen again. And they built in all these things like voting, turning over the legislators or the electors, the elected people every few years. They built in checks and balances, separation of government, shared responsibility between the states and the federal system. There are many things that are built in the constitution, but one of the problems is, is like everything else in our society, is that you need people to stick to not only the laws, but the norms. And if people strain these things, again, bad things can happen.

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