Thursday, July 10, 2014
Riding in to work this morning, I heard an NPR story on raw milk, and it struck me once again that public health may be a victim of its own success.
I understand the appeal of knowing where your food is coming from. I remember how excited my nieces were to get ice cream at a local dairy and visit the cows that we assumed provided the milk for our treat. (They may not have.) But while most Americans could benefit from a better understanding of where of food comes from (including understanding it does not come in packages), there are reasons to be leery about returning to a day before pasteurization.
A 1943 article in the British Medical Journal estimates there were 65,000 deaths attributable to tuberculosis from raw milk in England and Wales between 1912 and 1937. This total does not include deaths from other causes associated with drinking raw milk. While there have been only two reported deaths from raw milk in the United States from 1998-2011, the Centers for Disease Control and Prevention reports that thousands have become ill as a result of drinking raw milk. Children, the elderly, pregnant women, and people with weakened immune systems are more susceptible to illness from raw milk.
Because in 2014 in the United States we infrequently see children die from infectious disease, it is easier to make a decision that risks infectious disease. In earlier generations, most people knew someone – a family member or a friend – who had been injured or died from infectious disease. Reports of polio would leave public swimming pools empty in the summer heat. Worldwide diarrhea still kills 760,000 children under the age of 5 each year, and measles remains one of the leading causes of death among young children. In the United States, access to antibiotics and vaccines have thankfully made such experiences a rarity. But as our collective memory of what those public health successes have achieved dims, we may ignore what public health has to tell us about our current risks.