Wednesday, September 10, 2014

The 1850 Compromise

The Annual Meeting and Policy Summit of the Association of State and Territorial Health Officials (ASTHO) began today in the Santa Ana Pueblo just outside Albuquerque, New Mexico. By circumstance, the meeting began on the anniversary of New Mexico becoming a United States territory. The “1850 Compromise” drafted by Henry Clay of Kentucky and brokered by Stephen Douglas of Illinois was a policy that changed the course of U. S. history. Not only did it make New Mexico and Utah U.S. territories but it created the present day borders of Texas and California.

The “Compromise” convinced Texas to give up claims of a large portion of the Southwest in return for the U.S. Government assuming responsibility for the debts it had acquired. But that wasn't the biggest compromise. The true “compromise” was around the issue of slavery. There was great debate at the time about whether or not the new territories or states would be “slave” or “free.” New Mexico was central in that debate. The “compromise” was that California would be admitted to the Union as a Free State and that the slave trade would be banned in Washington, D.C., while the Fugitive Slave Act would be strengthened and a decision on slavery in Utah and New Mexico would be postponed to some undetermined date in the future. It is believed that this Compromise delayed the start of the Civil War by about 10 years. The impact of that delay on the health and well-being of thousands of African Americans will never be known for certain.

Although most people were unaware of the anniversary, the relevance of this 164-year-old policy decision was in the background as participants in ASTHO’s Policy Forum discussed today’s policy issues. Whether the policy discussions related to access to care, environmental or infectious disease impacts on health, emergency preparedness, e-health, or prevention strategies, it was obvious that people in the policy forum recognized their deliberations and recommendations could have a huge impact on the health of millions of people far into the future ‑ especially on low-income individuals and populations of color and American Indians. The growing evidence that public policy decisions have a bigger impact on health than health care underscored the importance of public health focusing on policy, systems, and environmental change if public health is going to be relevant and have a significant impact in the 21st century. That’s why this meeting is so important.

I shared the history of the 1850 Compromise with some of my colleagues at the last session tonight. I will be curious to see how knowing about that bit of history changes the conversations, or not. I will let you know.

Today’s public health efforts emanate from the policies and actions of the past and lay the groundwork for the activities of the future. History gives us context for the public health struggles of today. I hope our grandchildren and great grandchildren will be pleased with the policy decisions we will be making over the next few years ‑ decisions that will have a profound impact on the health of our society.

Ed