Citation

Frank E. Br. Med. J. BMJ 2005; 331(7517): E378-9.

Affiliation

Department of Family and Preventive Medicine Emory University School of Medicine Atlanta, GA, USA. efrank@emory.edu

Copyright

(Copyright © 2005, BMJ Publishing Group)

DOI

10.1136/bmj.331.7517.E378

PMID

16166108

Abstract

On September 11, 2001, 3400 people died because of four horrific, intentional plane crashes. These individuals' only unifying characteristic was that they were in the wrong place in America at the wrong time. Their deaths, and those of Londoners killed on July 7, 2005, were a tragic alarm about our vulnerability, and they understandably launched an avalanche of responses. Among the consequences of these deaths, several subsequent deaths from anthrax, and other current and potential terrorist threats, were a major redefinition and redirection of the United States government's role in and funding for public health. Since governments must protect their citizens, addressing these possible future threats is appropriate and could prove essential to Americans' health. However, there is an immediate, real threat that these government actions will allow enormous numbers of Americans to die unnecessarily. This threat is the redirection of funds away from basic, currently necessary public health services to the prevention of potential future bioterrorism (BT) threats. What problems do basic public health services try to address, and why is diversion of resources away from them of concern? Using national estimates of mortality attributable to various risk factors and actual death counts by disease, I have estimated the number of Americans who likely died on September 11, 2001, not from terrorism but from the major sources of mortality that many basic public health services work to address.