From COVID to guns and abortion, health care providers should step into advocacy

For me the most difficult period of the pandemic was the Winter of 2021.  Not only were the hospitals in which I work as an ICU physician massively overextended with COVID-19 patients, but there was an exhaustion throughout the hospital that was palpable as you walked the halls. There was physical weariness from the sheer number of patients and amount of clinical work there was to do.

But for me the emotional fatigue was far more severe. Because by the winter of 2021, the vast majority of those who would die in beds in our ICUs were there because they had made the choice not to be vaccinated against the virus. For most of us fighting this thing, it was hard to stomach.

This choice was not made in a vacuum. It was bolstered by the messaging of many elected leaders who either remained silent about what science told us was the best way to protect ourselves and society or just plain spouted untruths about what was going on.

This came to a head in December of 2021 as lawmakers at the Indiana Statehouse debated House Bill 1001. This bill would have prohibited private businesses from requiring vaccination of their employees. HB 1001, drafted and debated (and ultimately passed, although in a version that essentially had little impact) suggested that vaccines are not important.

Statehouse impact

I have reflected a lot on the way the pandemic has been handled and it has laid bare for me the fact that many bills written and enacted at the Indiana Statehouse are the biggest determinants of public health and safety in the state. Hoosiers literally live and die based upon the decisions of our lawmakers. And the messages sent by bills as of late ignore science and put Hoosiers at risk.

The message sent by HB 1001 and the silence of many of our elected officials about the importance of vaccines meant that far more Hoosiers died this past December and January than should have. The science demonstrates that states with the highest vaccination rates have the lowest per capita death rate from COVID-19. Lawmakers who see their mission as keeping their constituents safe and healthy should act on this.

The permitless carry bill that became law July 1 now makes it easier for Hoosiers to carry guns in public spaces than before — and this is occurring in a year in which Indiana has already seen more mass shootings in 2022 than we generally do in an entire year. States with stronger gun safety regulation have significantly lower rates of gun violence and gun deaths. Gun violence is now the leading cause of death in children. Lawmakers who see their mission as keeping their constituents safe and healthy should act on this.

Abortion up next

Now we come to abortion, on which lawmakers meet starting today to further curb access to via Senate Bill 1.

And most experts agree that limiting reproductive rights will lead to an increase in complicated and high risk pregnancies, further worsening a maternal mortality rate that ranks 47th in the country. Currently twice as many Hoosier mothers die around the time of childbirth than the national average. And a recent study demonstrated that states with more restrictive abortion policies had significantly higher maternal mortality. Lawmakers who see their mission as keeping their constituents safe and healthy should act on this.

These three issues — vaccines, gun safety, and reproductive rights — are ones in which decisions made by politicians at the Statehouse have a direct effect on exam rooms and ICUs around the state. And these are issues for which we have empiric data that can and should help guide lawmakers in their deliberations to keep Hoosiers safe and healthy.

To me this clearly points to the fact that those of us involved in healthcare and public health need to become far more involved in civic advocacy with an eye on the Statehouse. We need to work to elect lawmakers who understand science and want to use it to guide policy to make us all safer and more healthy. We need to interface more with our elected officials to help them understand our stories and experiences about how policies affect the lives of normal Hoosiers. 

And (gasp!) maybe some of us in healthcare and public health need to run for office and represent the ideals of sound public health policy and science in the General Assembly. (Note this is not a campaign announcement, but I think more of us should consider it). Because the flow of patients to our healthcare facilities at this point in history seems to be regulated at the statehouse.