Deadly Sins and Living Virtues of Public Health

Deadly Sins and Living Virtues of Public Health
President and Staff of United States Institute of Medicine    Full document here

Harvey V. Fineberg, Jennifer Cohen, Patricia Cuff, Rick Erdtmann, Patrick Kelley, Janice Mehler, Livia Navon, Laura Pillsbury, Stephanie Pincus, Sheri Sable, Patti Simon, Isabelle Von Kohorn, and Sarah Ziegenhorn

At a recent meeting for Institute of Medicine (IOM) staff, I delivered a version of my 2011 Frank A. Calderone Prize  Lecture, which included reference to the seven deadly sins. As originally enunciated by Pope Gregory I in 590 A.D., the deadly sins  are lust, sloth, gluttony, greed, wrath, envy, and pride. I used these as a foil to suggest there are also seven deadly sins of public health. Retaining three of the original sins (sloth, greed, and gluttony), I added four more: ignorance, complacency, timidity, and obstinacy. Sloth blocks us from doing the daily activity that would help keep us healthy. Gluttony cajoles us to eat even if we are no longer hungry and has, along with sloth, produced an obesity epidemic. Greed drives companies to continue to market and profit from items that are bad for health, such as cigarettes.

To these I added three sins of omission—ignorance, sometimes willful, colors judgment and leads to poor health decisions by both individuals and policy makers;  complacency is responsible for the acceptance as “normal” of health hazards that are, in fact, preventable or avoidable; and  timidity prevents individuals from demanding health-enhancing changes to policy and practice and inhibits policy makers from doing the right thing. For the seventh deadly sin, I suggested obstinacy—the refusal to accept evidence on best practices and the refusal to change practices or customs that are familiar. I then invited staff to propose additional candidates for a deadly sin of public health and submit them to Clyde Behney, deputy executive officer of the IOM. Clyde then compiled the results, and we thought it would be worthwhile to make them more widely available through a discussion paper.

Harvey V. Fineberg
President, IOM