This week Boston laid to rest it’s longest serving mayor, Thomas Menino. He served as mayor in Boston for 20 years. Yes. That’s right. Twenty years.
To his admirers he was known as the “Urban Mechanic,” as the Boston Globe describes, ”leaving to others the lofty rhetoric of Boston as the Athens of America, he took a decidedly ground-level view of the city on a hill, earning himself a nickname for his intense focus on the nuts and bolts of everyday life.” To some of his detractors (and even his supporters) he was referred to as “Mumbles,” for his less than soaring rhetorical skills.
This humble man from the Hyde Park neighborhood of Boston rose to national prominence, with former President Bill Clinton paying his respects before the funeral procession and Vice President Joe Biden attending the ceremony. Impressive for a politician recognized to have no political ambition beyond running his city.
What does this have to do with homeland security? For some time I’ve heard from various colleagues that preparedness, particularly health-related preparedness, had an unusual amount of political support in Boston. Public health and EMS were not simply the minor leagues to law enforcement and fire service major league players. But it became vivid when I read the following description from a food-orientated homage to Mayor Menino from The Atlantic food critic Corby Kummer:
But aside from the coddling and special treatment any mayor who shows up gets, Menino cared about food for exactly the reasons today’s food-movement activists do, and long before it was fashionable to embrace what food can and should mean: access to fresh produce for everyone of every income level; gardens as ways to unite and repair communities; and, most importantly, fresh food as a route to better health. The mayor told everyone, including his biographer, longtime Atlantic senior editor Jack Beatty, that he wanted to be remembered as “the public-health mayor.” That made him work particularly closely with my spouse, John Auerbach, who served 10 years as Boston’s health commissioner.
So….apparently I missed this self-appointment. After the fact it was easy to find further evidence of Menino’s interest in public health. See the videos I’ve posted below.
Again, how is this related to homeland security? Two points that at least I think of are interest.
A lot, if not the majority, of public health work does not seem to fall into the category of homeland security. Expanding access to fresh produce in low income communities, anti-smoking efforts, childhood vaccination campaigns, etc. It’s not always about responding to the next Ebola outbreak. Yet when taken as a whole, improving the health of the community in general improves overall resilience. Healthy people fare better during and following disasters than unhealthy ones. People with access to health insurance are more likely to visit a primary care doctor than the emergency room for common maladies, thereby not taking up vital resources during events like the Boston Marathon bombing. A healthier community is a more resilient community.
Menino’s attention to public health underscores the importance of political leaders in homeland security. I have often heard professionals complain about meddling politicians (along with the annoying press) and how events can be run more smoothly when they are absent. Yet not only do they play an important role in communicating with the public during and following disasters, they make or influence the choices made in a community before there is a bad day. Menino’s focus on public health not only improved the overall health of Bostonians, but contributed to the competence exhibited during the response to the Marathon bombing, from the existence of a Medical Intelligence Center to the cooperation between city agencies such as Boston EMS and Public Health with the private hospital systems.
It is comparing apples and oranges, but in thinking about this I could not help but contrast Boston’s situation with that of New York City. Size and resource issues aside, NYC has spent the most energy on security instead of general preparedness since 9/11. I am not arguing that there has not been a lot of resources directed towards preparedness and response activities and organizations, only that it is lacking when compared with the radical changes enacted in the NYPD and other agencies charged with preventing a terrorist attack. I think I could make the case that Boston, under Menino’s leadership, took a more all hazards approach while NYC, under Mayors Giuliani and Bloomberg, remained primarily focused on terrorism. That is not a value judgement, but simply an observation.
If you are interested, the following video highlights many of Mayor Menino’s accomplishments in public health. From the Boston Public Health Commission (which Menino created in 1996):
If you have a little more time, here is a longer discussion held at Harvard’s School of Public Health with Menino shortly after he left the Mayor’s office. For those more security minded, at the beginning of the discussion he is asked and replies with a lengthy description of his point of view about the events surrounding the Boston Marathon bombing.