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Derrick Z. Jackson

A diminished surgeon general post

Dr. Vivek Murthy’s nomination to be US surgeon general is opposed by the NRA.

Associated Press

Dr. Vivek Murthy’s nomination to be US surgeon general is opposed by the NRA.

The National Rifle Association’s opposition to Vivek Murthy’s nomination to be US surgeon general is the latest attempt to make the office irrelevant. Murthy’s unforgivable sin in the eyes of the NRA is to have called gun violence a public health issue and call for gun buyback and gun safety programs, background checks, mental health resources, and a ban on assault weapons.

His views echo the American Medical Association and scores of other medical societies that declared gun violence an “epidemic” after the Newtown, Conn., elementary school massacre. Murthy’s positions on background checks and keeping guns away from the mentally ill are shared by 9 out of 10 Americans.

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That Murthy’s nomination has been so easily wounded because of such common-sense policy prescriptions shows just how this once-proud lightpost of public health has been diminished.

Surgeon generals once made bold moves in their capacity as the nation’s top public health advocate. Luther Terry, for example, issued a report in 1964 that cigarette smoking caused lung cancer in men and warranted “appropriate remedial action.” His predecessor, Leroy Burney, set the table by saying “the weight of the evidence is increasingly pointing in one direction: that excessive smoking is one of the causative factors in lung cancer.”

That began a half century in which smoking rates were cut by more than 50 percent, resulting in 8 million fewer premature deaths, according to a study published in January in the Journal of the American Medical Association.

The fight against tobacco continued in 1980s under C. Everett Koop, who led an aggressive campaign against cigarette products and second-hand smoke.

Koop’s nomination by President Reagan was originally opposed by Senator Edward Kennedy of Massachusetts and women’s groups for his personal opposition to abortion. But once confirmed, Koop stunned liberals by waking up America to HIV/AIDS and crusading so hard against smoking that tobacco-state senators wanted Reagan to get rid of him. Reagan never did and when Koop left office in 1989, he told the Los Angeles Times that he was proud of the fact that smoking dropped because, “I called upon the citizens of the country to do it and they did it. We had 80 ordinances against smoking in 50 states (when he took office). It is now over 480.”

But since then, what surgeon general has been allowed to call upon the country for anything? Not a single surgeon general since Koop has become a household name and the one who came closest, Joycelyn Elders, was fired by President Clinton a year into her tenure for suggesting masturbation could be part of sex education in the battle against HIV/AIDS.

Often surgeon generals are strapped by the administration that nominated them. In a House hearing in 2007, David Satcher, surgeon general from the end of the Clinton era into the first year of President George W. Bush, said both administrations suppressed data on needle-exchange programs, despite evidence that they did not promote drug use. Richard Carmona, surgeon general from 2002 to 2006, was even more harsh at that hearing, saying, “Anything that doesn’t fit into the political appointees’ ideological, theological or political agenda is often ignored, marginalized or simply buried.”

The last surgeon general, Regina Benjamin, came and went quietly, wanting to tackle obesity, but working for an Obama administration that has yet to confront big contributors to obesity, such as the marketing of soda and other sugary products to children.

At his confirmation hearing last month, Murthy promised senators that obesity would be his priority and that he would not use his bully pulpit for gun control. That measure of self-censorship is ominous even if he manages to get confirmed. If someone like him whiffs on what he believes in, how many thousands more lives will be lost to inaction on guns?

That makes it critical for Obama to personally decry this latest attempt to defang the office of surgeon general. The health of the nation depends on it.

Derrick Z. Jackson can be reached at jackson@globe.com.
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