Georges C. Benjamin

Editorial independence at the journal.

The title of this editorial honors Richard Smith, the outgoing editor of BMJ, who recently published a spirited and honorable editorial of his own, “Editorial Independence at the BMJ.”1 That short piece helped crystallize for us a common underlying principle as we wrangled over issues of guest editorship, outside funding for Journal publications, and peer review of various categories of papers. We began writing this editorial in March 2004 at the annual spring meeting of the Journal’s editorial board and editors. Allocating 12 months for preparation and publication of this editorial allowed us to gain additional input from the American Public Health Association’s executive board in addition to the Journal editorial board and editorial team members during the 132nd Annual Meeting and Exposition of the Association in November 2004. Genuine collaboration takes time and many drafts to get it right. The motivation for writing this piece at this particular time came not from outright threats to continued editorial independence at the Journal, but rather from our collective desire to reaffirm the core value of editorial freedom. Together, we represent the editor-in-chief (M.E.N.), the outgoing editorial board chair (K.R.M.), the incoming editorial board chair (M.L.H.), the executive editor (N.J.J.), and the publisher (G.C.B.) of the Journal. This is not our first attempt at coauthorship,2 nor will it be our last. We honor the process and enjoy the struggle of working together to uphold the scientific integrity and ethical principles that form the common mission of the Journal and the Association, that is, to continue to strive to improve public health for everyone.3 Nonetheless, we wish to underscore the very real need for a clear separation between the Journal and the Association on editorial matters, as elaborated below. As representatives of both the Journal and the Association, we agree with Smith when he asserts, “Journals should be on the side of the powerless not the powerful, the governed not the governors. If readers once hear that important, relevant, and well argued articles are being suppressed or that articles are being published simply to fulfill hidden political agendas, then the credibility of the publication collapses—and everybody loses.”1(p0) Furthermore, we want to avoid even the appearance of threats to editorial independence vis-a-vis new Journal and Association initiatives and to reassure our readers and members that editorial freedom is alive and well. This is no small affirmation. We live in a time when there are increasing attempts to censor or restrict information provided to the public under the auspices of national security.4 Limitations on societal resources for health care have reduced funding from medical schools and hospitals for the infrastructure of continuing medical education (CME); commercial support now constitutes more than 50% of the total income of accredited CME providers.5 The cumulative influence of this support is increasingly biasing CME development, presentation, and participation toward topics that benefit commercial interests.5 Smith, unconventional editor and original thinker that he is, believes that “[u]ltimately . . . editorial independence is a space in editors’ heads, a complex function of their personality, courage, power, and the pressures they feel from owners, business people, and others.”1(p0) We appreciate this belief. But given how fundamentally important editorial independence is to safeguarding the public’s health and upholding the scientific integrity of the Journal, we have elected to go public with our plan to defend editorial independence now and in the future by making this statement of our collective position.

The Refugee Crisis in the Middle East and Public Health.

Unfortunately for public health, two months after this crucial moment in September 2015 in which the tragic death of three-year-old Aylan Kurdi brought the worlds attention on the crisis, confusion still predominates about what is at stake and what needs to be done for the many thousands of refugees from the Middle East.

Prepared to Serve Public Health

The idea for the first electronic-only supplement of the Journal devoted to public health preparedness was conceived on Saturday, December 10, 2005, in Room 102A of the Pennsylvania Convention Center in Philadelphia, Pa. The joint editors and editorial board meeting for the Journal was originally scheduled to be held on Saturday, November 5, 2005, in Hilton Grand Salon 10 of the Hilton New Orleans Riverside in New Orleans, La. But Hurricane Katrina changed the venue for the 133rd Annual Meeting and Exposition of the American Public Health Association, as well as public health practice priorities for the entire nation. In the wake of our grief over the lives lost and the damage wreaked on the Gulf Coast of the United States, we resolved to ensure that the Journal would be of service to those charged with preparing for and responding to future public health disasters. This necessitated a new approach to funding, editing, and publishing the Journal, which we approached with enthusiasm and integrity. As with any genuine collaboration, we encountered challenges as well as opportunities, detractors as well as supporters, and late as well as early adopters to this innovative undertaking.

Leading the Way Toward the Next 100 Years of Publishing

The authors opine regarding the journals continuing obligations in communicating public health information in the face of rising challenges such as climate change, population aging, and emerging infections. The authors discuss scientific quality, research integrity, and communication modes as 3 areas of focus. The authors emphasize the journals role in addressing public-health-related social justice and equitable health care.

The solution is injury prevention

I awoke this morning to the news that another American life was tragically lost because of a preventable injury, and I wondered why our nation has been so complacent about this problem. Then I remembered the retort I received from a policymaker the last time I sought funding for an injury program: “Injury is not a public health problem!” In 2000, injury was responsible for 10% of health care expenditures—more than

Building a Movement to Be the Healthiest Nation

117 billion. Injury is the leading cause of death for Americans younger than 35 years and is a leading cause of disability. In this issue of the Journal, Lynda Doll and Sue Binder of the National Center for Injury Prevention and Control lay out the case for injury as one our nation’s most preventable problems. They point to the incredible toll extracted by injury in human suffering as well as the staggering fiscal costs to society. Why, then, is it so difficult to convince policymakers that injury is a public health problem worth addressing? Maybe because they still believe in the accident paradigm. This line of thinking argues that injuries are an act of fate, and while it makes sense to be more careful, injuries will occur despite our best efforts. The evidence against the accident paradigm is exhaustive. Automobile-related injury has been dramatically reduced by a multifaceted effort to make cars safer. By redesigning automobile brakes, steering columns, sidewall protections, seat belts, air bags, and a host of other safety features, we have made the automobile a much safer machine. The addition of programs to reduce the incidence of impaired driving and promote driver training have addressed the human aspects of automobile safety. Pedestrian trauma from motor vehicles is on the rise and, once again, safety experts are intervening by developing novel ways to reduce the hazards of walking. On April 7, 2004, the World Health Organization is emphasizing the global scope of the problem by declaring road safety as the theme for World Health Day. In my days as an emergency physician, I was struck by the fact that most of the injuries I treated could have been prevented if only simple precautions had been taken. My colleagues and I would give individualized advice to patients on how to prevent future injuries while we provided medical care for their current injuries. Later, when I became active in public health, I recognized the need for population-based interventions as tools to reduce injuries, such as the interventions advanced in this issue of the Journal regarding motorcycle helmet laws, speed bumps, and programs to prevent dating violence. These interventions work. They reduce injuries, save lives, and prevent disabilities. They also save money—lots of money. These are marvelous accomplishments that are largely overlooked by most policymakers. At a time when economists predict double-digit increases in health care expenditures, I have a solution: injury prevention. At a time when we are looking for ways to address disparities in health care, I have a solution: injury prevention. At a time when we are looking to protect our children from harm, I have a solution: injury prevention. The next time someone challenges us on the propriety of addressing injury as a public health problem, point out that if something kills people or hurts people, it’s our responsibility as public health leaders to find a solution. Read More: http://ajph.aphapublications.org/doi/full/10.2105/AJPH.94.4.521 (term-accident-vs-injury)

Expanding Access to Spanish-Speaking Communities: A Critical Partnership

An introduction is presented in which the author discusses various reports within the journal on topics including the American Public Health Associations Healthiest Nation 2030 movement, the U.S. National Public Health Week celebration, and the social aspects of health care delivery.

The Clean Air Act Deserves Our Full Support

The article introduces the issue, which focuses on topics related to a partnership between the American Public Health Association and the Pan American Health Organization.

Preparing and Rebuilding After Natural Disasters: A New Public Health Normal!

In this article the author reflects on efforts which have been made to improve the air quality of the U.S. and on efforts which are being made in 2012 to reduce the power of the Environmental Protection Agency (EPA) and the U.S. Clean Air Act. In the article the author offers his opinions on the benefits that have been seen in public health as a result of the act and the efforts of the EPA, and on methods which could be used to increase the EPAs ability to enforce the statutes of the Clean Air Act.

2017 #NPHW and Beyond: Climate Changes Health

An introduction is presented in which the authors discuss various reports within the journal on topics including natural disaster-related preparations and rebuilding efforts, public health in the wake of Hurricanes Harvey, Irma, and Maria, and climate change.