Hate Is A Public Health Emergency

As I listen to the ongoing batshitery at the Republican Party convention where a liar and sociopath was just nominated as the party's presidential nominee, one message comes through loud and clear from today's GOP: hate and bigotry underscores almost every aspect of the party platform.  Given that the GOP is now controlled by hate-filled Christofascists, white supremacists and insane conspiracy theory devotees, it should not come as a surprise.  The irony is that as Republican rail about all of the supposed problems in America, there is one common thread that powers much of it: hate.  And no one nowadays - with the possible exception of ISIS - does more to fuel and generate hate than the GOP and the right wing factions that support it.  Two physicians have co-authored a piece at Huffington Post that looks at how hate is now a public health emergency.  Here are highlights:

The massacre of 49 people at a gay nightclub in Orlando on June 12 is the latest manifestation of violence as a public health emergency. A public health emergency, according to the World Health Organization (WHO), is “an occurrence or imminent threat of an illness or health condition, caused by ...an epidemic... or ... highly fatal infectious agent ... that poses a substantial risk of a significant number of human facilities....” Violence is the “epidemic” and the “health condition” is disability, death, and trauma to families and neighborhoods.

So then what is the infectious agent? It is hate. And in the wake of this man-made disaster, we are left in the debris and horror of incalculable hatred.  . . . .It manifests itself as racism, homophobia, religious discrimination, sexism, ageism, and a whole host of other injustices.

Hate is not a feeling without consequence. Hatred causes deadly harm, with or without a gun. Hate enables us to judge people on who they love, how they express their gender, or the color of their skin. This creates barriers to health and wellbeing that are as violent as the damage done by a gun, knife, or bomb. It can lead to a quick death such as from gun violence or a chronic, slow, festering death that seeps the health out of our communities.

Hate can be expressed through policy and can evolve into hard-to-see structural biases. We see it expressed in the ban on blood donation for gay and bisexual men and in barriers to equal restroom access to for transgender people. These policies are a reflection of oppressive systems, that regularly ignore, insult, and stigmatize LGBTQI, Black, and Latino communities.

What should we do as medical and public health professionals to respond to this emergency? Most in the public health community know that ensuring good health is about more than promoting good behaviors. It requires supporting policy and structural changes to an inequitable social, political and economic system that results in gun violence and persistent health inequities.  But how do we address hate?

As a start, with intention and without fear, we must acknowledge that these -isms and phobias are a public health threat, just as real as a gun, a virus, or a bomb. Systems cannot wait to change organically. They must be pushed to change.

Public health and common sense dictate that imminent threats are not nursed with the hope that they will extinguish by neglect. Public health emergencies—and hate is a public health emergency—require aggressive and decisive action. Orlando is a wake-up call, an opportunity to say “never again,” not only to obvious acts of violence like the Pulse Nightclub massacre, but to the more subtle but equally lethal acts of violence fueled by every day, systemic hate.