I spent most of this past spring and summer rolling my eyes every time I heard a news story about the swine flu. Almost every day local reporters got hysterical about 5 or 10 or 20 confirmed cases. Entire schools closed in response to a handful of kids with fevers, and as if there were no war in Afghanistan, no economic crisis, and no other epidemics claiming ten times as many lives, newscasters talked about H1N1 (the proper name for swine flu) for hours.
I have a degree in public health and my work focuses on preventing rape and other acts of violence and supporting survivors in healing from abuse. When I see all the attention swine flu is getting, I'm jealous. Other than intermittent news stories about sex offenders on the loose or why women who accuse professional athletes of rape are lying, sexual violence rarely gets any widespread coverage. Certainly no state of emergency declared by the President of the United States.
Now, I don't want to diminish the grief of those who have lost loved ones to H1N1. I don't even want to question the scientific validity of the Center for Disease Control's decision to declare it a pandemic. But the fact remains that the impact H1N1 has had on our country to date is far less than that of other public health crises that receive a fraction of the attention and resources. The CDC reported just over 43,000 cases of H1N1 between April and July of this year and estimates that it affected a million people in that time. Compare this to the 2.5% of women and 0.9% of men who reported being raped or sexually assaulted in the past year. That's more than 2.5 million sexual assaults in a three-month time period. The most recent statistics about rape available from the CDC are from last year. Swine flu? Last week. (Editor's note: A few sentences from the above paragraph have been updated to reflect statistical changes since this post was originally published.)
What would our media, our public discourse, and our institutional responses look like if people cared as much about rape as they do about H1N1?
I imagine the federal government urging colleges to stop the epidemic of rape by developing protocols for quarantining students who have tried to use drugs or alcohol to incapacitate women who would otherwise not consent to sex. Or university officials directing students to stay off campus or out of public areas until they are free of the belief that they are entitled to sex any time they want for a full 24 hours. Sounds pretty good, doesn't it?
I dream of public health departments so inundated with the demand for educational programs that teach kids about healthy relationships that they can't keep up. Of public outrage that there are not enough doses of self-defense training to inoculate everyone against rape, and of medical experts having to go on television to reassure people that more of these self-defense vaccines are on the way.
Then I wake up to a phone conversation with a principal who tells me there is no dating violence in his school and another with a teacher who desperately wants to offer rape prevention resources to her high school classes but can't because the entire budget for health education in her district was cut. So much for the dream.
But if I stop resenting H1N1 for getting so much attention for a moment, I realize that what I'm complaining about is actually public health at is best. It is probably true that the coordination of government urgency, media attention, medical system mobilization, and common sense precautions will succeed in thwarting a pandemic. We will probably not look back at 2009 and say it was the beginning of a swine flu crisis that devastated a generation.
What feels like hysteria or over-emphasis is actually the way prevention is supposed to look. It is supposed to be widespread and coordinated. Messages about the importance and seriousness of the public health threat are supposed to be so pervasive that they are almost impossible to ignore. I'm so used to caring about public health crises that don't get the attention and resources they deserve that I almost can't recognize what the public health system looks like when it does work.
This kind of focused attention is my wildest dream for our society's response to HIV, rape, domestic violence, drug addiction, racial health disparities, cancer-causing corporate pollution, food system injustice and every other area of public health that is marginalized.
So why is the public health infrastructure working so well? Because it's not being undermined by shame, stigma, and denial (you know, the way rape and sexual assault are). Even in the highest drama evening news stories there is almost a complete absence of victim blaming. Personal choices and individual behaviors spread the flu, but our government, our health workers, and our media understand that this crisis is too serious to waste time arguing over whether people who don't wash their hands or share cubicles with co-workers who fail to stay home from work the recommended 4 to 7 days deserve what they get.
It would be unthinkable for a person to avoid seeking treatment for swine flu because s/he's afraid that if s/he tells her/his doctor s/he'll be blamed for touching her/his eyes and nose or lose her/his housing because no parents want to raise their children in a neighborhood where people don't sneeze into their elbows
As if invoking the finale of High School Musical, when it comes to H1N1, we're all in this together. Swine flu is not concentrated in any population that people already hate or devalue, so raging debates about whose immoral lifestyle caused it don't get in the way of an effective public health response. (Even Fox News is posting stories that are sympathetic to people whose jobs don't have paid sick leave and the hardship they face in missing work as the authorities direct.) Wouldn't it be nice if other health crises were treated the same way?
In watching the rapid mobilization against this virus I know that the public health infrastructure works when our government, our media, and our medical leaders are motivated to mobilize it. H1N1 is not getting any attention it shouldn't – it's getting the attention all public health crises should.