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I received a couple of requests to define “public health” last week from readers Anthro and MA.  As MA puts it,

Maybe…we need a definition of “public health.”  I view my health as a private matter, my food choices as a private matter, and an expression of my freedom.  To me, public health is not an individual concern, it’s a corporate (group) concern – government, schools, companies, farms, etc.  Public health includes things like properly working sewer systems, sanitation, water quality, and air quality.   Marion – can we get a definition of ‘public health’ from you, as Anthro suggested?

My definition of public health isn’t much different from mainstream definitions.  But to me, public health is a critically important expression of democracy, and the antithesis of  a “corporate” concern.  Public health approaches promote good health for everyone, not just those who can afford it or are educated enough to make appropriate choices.

A standard definition such as the one given in Wikipedia, says that public health is about promoting health and preventing disease through societal choices and efforts.   Public health deals with health at the population level, rather than at the level of individual personal responsibility, and it emphasizes prevention rather than treatment.

In my experience teaching public health nutrition, the concept of public health is sometimes hard for people to grasp, especially since populations are made up of individuals. I like to explain it this way: public health makes it easier for individuals to make healthful food choices for themselves and their families. Or to put it another way, public health makes better food choices the default.

The classic example of a public health intervention is water chlorination.  As individuals, we could all boil our own drinking water to kill harmful organisms but this requires us to have stoves, pots, and fuel, and to know how to boil water.  For many people, having to do this would be an intolerable burden and responsibility.  Instead, some societies choose to take public health measures to ensure that drinking water is safe at the tap for everyone.

Other food examples: milk Pasteurization, banning of trans fats, food labeling.

The particular example that elicited the question has to do with food safety.   We, as a society, could insist that food producers take measures to ensure that their products are free of harmful microorganisms (public health), or we could teach individuals how to manage food safety in the home or restaurants and cook foods properly (personal responsibility).

Preventing obesity is another example: We could, as a society, take measures to make it easier for people to eat more healthfully and be more active (public health) or leave it up to individuals to do this for themselves (personal responsibility). Many of the arguments about suggested public health measures to prevent obesity are about how best to balance society’s needs with individual rights.  But as I see it, the proposals aim to tweak societal choices that have already been made: which crops receive farm subsidies, for example.

An exceptionally clear example is how to avoid toxic levels of methylmercury in fish.   We can teach pregnant women to recognize which fish are high in methylmercury and hope this works well enough so they will avoid buying such fish (personal responsibility) or we could–as a society–require coal-burning power plants to scrub their emissions so mercury doesn’t get into ocean or lake waters in the first place (public health).

Obviously, both public health and individual approaches are necessary, but the overall objective of public health is to make it much, much easier for individuals to make better health choices without having to think about them.

Because public health applies to everyone, it is essentially democratic.   And that’s one of the reasons why I think it matters so much.

A reader, Lucas Pattan, writes:

I’m writing to ask if you could do a post over the next few weeks about what you expect the impact of the Gulf spill will be on America’s seafood industry.  GQ has an amazing piece about fishermen and rigmen affected by the Deepwater Horizon, and the information about the fishing industry is pretty frightening [for the GQ piece click here].

I don’t have a crystal ball about the impact of the BP disaster on the Gulf seafood industry, but I’m assuming its effects will cause problems similar to those that happened as a result of the Exxon Valdez oil spill—only worse.

The Exxon Valdez spill occurred in 1989 in cold Alaskan waters.  Fish and wildlife stocks have not fully recovered 21 years later and it will be years before they do.  According to the Wikipedia entry on this event:

Both the long- and short-term effects of the oil spill have been studied comprehensively….The effects of the spill continued to be felt for many years afterwards. Overall reductions in population have been seen in various ocean animals, including stunted growth in pink salmon populations….Almost 20 years after the spill, a team of scientists at the University of North Carolina found that the effects are lasting far longer than expected. The team estimates some shoreline Arctic habitats may take up to 30 years to recover.

The Wikipedia continues with a comment on corporate responsibility:

Exxon Mobil denies any concerns over this, stating that they anticipated a remaining fraction that they assert will not cause any long-term ecological impacts, according to the conclusions of 350 peer-reviewed studies. However, a study from scientists from the NOAA concluded that this contamination can produce chronic low-level exposure, discourage subsistence where the contamination is heavy, and decrease the “wilderness character” of the area.

It looks to me as though the ecological, economic, and corporate effects of this one will be even worse and longer lasting:

• It’s a bigger and longer lasting spill.
• The economy of the Gulf states have yet to recover from hurricane Katrina.
• Oysters don’t swim.
• Much of the Gulf was already a dead zone created by agricultural runoff and industrial pollution.
• The waters are warmer and less rich in nutrients.
• U.S. energy policy still focuses on oil.

At the moment, is seafood from the Gulf region safe to eat?  President Obama says it is.  I hope he’s right

The FDA is sampling oysters, crabs, and shrimp and doing more inspection of seafood processing plants, closing down waters that seem to be contaminated, and doing what it can to make sure that tainted seafood is not getting into the marketplace.

According to a report in Food Chemical News II (June 21), the FDA says it will not re-open oil-contaminated waters to fishing until:

oil from the spill is no longer observable and seafood samples from the area successfully pass both sensory analysis by trained screeners and chemical analysis to ensure there are no harmful oil products found in them.

Smelling the fish to see if it’s OK?  I don’t think so.

On a tour arranged and paid for by the Alaskan Seafood Marketing Institute (see Note below),  I spent last week observing salmon fishing and processing in Anchorage and at remote places 600 miles to the southwest.

I could not help thinking about federal dietary guidelines.  The 2010 Dietary Guidelines Advisory Committee has just filed its report.  It recommends consuming two 4-ounce servings of seafood per week, preferably fatty fish rich in omega-3 fatty acids.

Develop safe, effective, and sustainable practices to expand aquaculture and increase the availability of seafood to all segments of the population. Enhance access to… information that helps consumers make informed seafood choices.

This, among other fish, means salmon, particularly wild Alaskan salmon because they have higher levels of omega-3 fats than the farmed fish and because Alaska is working hard to maintain the sustainability of its wild fish.

Wild Alaskan salmon caught 6-19-10. Top to bottom: King (Chinook), Red (Sockeye), Chum (Keta), Pink

To be sustainable, fish have to remain in the sea and steams long enough to reproduce. This means controlling the number of people who are allowed to catch fish (through licenses and permits) as well as the number of fish they catch (through restrictions on fishing methods and times and places).

The Alaskan system for doing this works fairly well but is under constant pressure.  Commercial fishers want to be able to catch all the salmon they can with no restrictions. Communities that have always depended on salmon for sustenance want to be able to continue doing so, and do not want fish caught before they get to community spawning streams.  Hence: salmon politics.

Here are some thoughts about what I observed:

Labor conditions in the processing plants: workers were imported from the Philippines or Eastern Europe, and worked 12 to 16 hour days, 6 or 7 days a week, for months at a time.

The amount of hand labor involved: Fishermen haul nets and sort fish by hand, and processing plant workers remove heads and guts, fillet fish, trip fillets, and debone by hand. In canneries, they weigh cans and clean the contents by hand. Some of this work is highly skilled and so meticulously done that it qualifies as artisanal. All of it is hard and repetitive

Peter Pan salmon cannery, King Cove, Alaska, 6-20-10

The huge numbers of fish that can be caught by commercial fishers: Alaska regulates how fish can be caught (boat size, types of nets), but even so a purse seine picks up thousands of pounds of fish at one time. It is hard to imagine how such fisheries can be sustainable, even when tightly regulated.

Purse seine bringing in the catch

The waste in the system: Some plants had arrangements to supply fish heads, guts, backbones, belly fat, skin, tails, and other parts to be used for pet food or fish meal, but some just ground up the leftovers and flushed them into the water system or back into the ocean. If the wrong fish get into nets, they get tossed back into the sea.

The cold chain (temperature controls): fish stay fresher longer if they are held temperatures just above freezing throughout every step of processing. The tenders (collecting boats) do “RSW,” hold fish in a tank filled with Refrigerated Sea Water. High quality fish are sampled at arrival at plants to make sure their flesh is below 35 degrees. Two of the three plants we visited were careful with temperature controls. The third, however, allowed fish to sit in holding tanks for days or to remain on stopped processing lines at room temperature while workers went to lunch.

The role of science: Geneticists are madly working on methods to identify salmon by stream of origin as a means to settle arguments about who gets to catch which fish. This, of course, could backfire if the salmon turn out to be from Russia or Canada.

The love of fishermen for what they do: The ones we met love their work and have been doing it for decades. They just wish they got treated better by processors and paid better for the fish they catch.

As fish eaters, we don’t need to consider where fish comes from or how it gets to us. I will be looking at fresh, frozen, and canned salmon in grocery stores and fish markets with new appreciation for what it takes to get them to us.

I haven’t said anything about methylmercury and PCBs, fish safety, international disputes over fishing rights, or issues about organic or farmed fish. For these topics, see the five chapters on fish in What to Eat.

If we want to continue to have fish to eat, we must pay attention to such issues, uncomfortable as they may be to contemplate.

Note: The Alaskan Seafood Marketing Institute is a trade association supported by the seafood processing industry:

The Alaska Seafood Marketing Institute (ASMI) was created over twenty years ago as a cooperative partnership between the Alaska seafood industry and state government to advance the mutually beneficial goal of a stable seafood industry in Alaska. It is Alaska’s “official seafood marketing agency”, and is established under state law as a public corporation…[It] is divided into three distinct marketing programs: international, foodservice and retail. All three programs are designed to enhance the appeal and popularity of Alaska Seafood. The international program operates in the European Union, China, and Japan, while the retail and foodservice programs conduct their activities in the U.S.

One point of the Alaskan Seafood Marketing Institute’s invitation to visit remote fishing and processing operations was to publicize the state’s fish sustainability initiatives (see Note below).

Everyone wants to catch fish.  But who has the right to catch them?  Fish swim long distances and pay little attention to political borders.  The commercial fishing industry is highly efficient at using technology to catch fish (the fish hardly have a chance).  And cultural issues are involved, as well as economic issues.  Indigenous communities have long standing cultural traditions related to fish.

Fish stocks are not infinite.   Hence, the need for management.

In Alaska, fisheries management is so complex that it takes a chart to explain how it works.  The goal is to have enough seafood available so all the stakeholders in the fish system can make a living.  Salmon, groundfish, halibut, and crab each require a different agency to manage stock conservation, set policy (local, national, and international) for who is entitled to fish, and enforce the rules.

For example, the Alaska Department of Fish and Game regulates the amounts of fish that can be taken, the Alaska Board of Fisheries decides who gets permits to fish, and Alaska Wildlife Troopers make sure everyone follows the rules.

The main management tools limit the time and place where fishing is allowed, and limit the number of commercial groups allowed to fish.  Alaskan fisheries are closed unless the Department of Fish and Game says they are open.   Nobody can fish in a closed area.

The number of fishing permits is fixed and finite, making them a market-driven commodity.  They are often handed down from generation to generation, but also can be sold.   A king salmon permit, for example, might cost as much as half a million dollars.  Yes, this allows rich commercial fishers to work in Alaskan waters.  But fishing area controls are democratic.  A closed fishing area is closed to rich and poor alike.

This system creates some tricky situations.  On the day we observed fishing in action near Sand Point, the area was open to salmon fishing. But it was closed to cod fishing.

Catch from a purse seine, Shumagen Islands, Alaska, June 2010

The boat shown here was out salmon fishing.  It caught salmon, but also picked up an almost equal number of cod (we were told this was highly unusual).

The salmon would go to the cannery to be processed.  The best salmon would be processed with special care by Aleutia, an organization specializing in high quality Alaskan wild salmon getting high prices for fishermen.

The salmon were caught legally.  The cod, however, were by-catch.  They were not supposed to be caught in the salmon nets or, for that matter, at all that day.

What happened to the caught cod?  We ate one of them for dinner that night, prepared for us by Michael Cimarusti, chef owner of Providence (Los Angeles), who conveniently was a member of our group. It was worth the trip.

The others went for personal use or were thrown back into the sea to become food for crab or other seafood.  Under the rules, they could not be sold.

Does this complicated management system work?  It looked to me like it does the job pretty well.

• Stocks of major Alaskan seafood—salmon, groundfish, halibut, and crab—are holding their own.
• Everybody who fishes or depends on fish complains that they don’t get the chance to get enough of their fish.

Now, if only this system could go international, we might have a shot at keeping fish in the sea.

Tomorrow: Wild Alaskan salmon, from ocean to table.

Note: The Alaskan Seafood Marketing Institute is a trade association for seafood processors::

The Alaska Seafood Marketing Institute (ASMI) was created over twenty years ago as a cooperative partnership between the Alaska seafood industry and state government to advance the mutually beneficial goal of a stable seafood industry in Alaska. It is Alaska’s “official seafood marketing agency”, and is established under state law as a public corporation…[It] is divided into three distinct marketing programs: international, foodservice and retail. All three programs are designed to enhance the appeal and popularity of Alaska Seafood. The international program operates in the European Union, China, and Japan, while the retail and foodservice programs conduct their activities in the U.S.

I’m writing this while on an Alaskan Seafood Marketing Institute press trip (see note at end).  We are at Sand Point, Popof Island, Shumagin Islands, Alaska, about halfway out the mainland part of the Aleutian archipelago.  Sand Point is the largest town around, population 800 to 1000.

The town has a grocery store, coffee shop, bar, cafe, and a Chinese restaurant (the Aleut China), but centers around a seafood processing plant run by Seattle-based Trident Seafoods.

The fish arrive at the plant from “tenders,” fishing boats that collect fish caught by other boats, weigh the fish, and store them in ice cold sea water until they reach the plant.

Workers at the plant eviscerate the fish, clean them, and cut them into clean fillets.  These will go to Costco and Sams’ Clubs (Walmart) in the lower 48.

Trimming Halibut, Trident plant, Sand Point, AK, 6-18-10

The men and women doing this work are mostly seasonal workers from the Philippines.  They work 12 to 16 hour days, 6 or 7 days a week.

Several people who have lived here all their lives told us that when they were kids, they could hardly wait until they were 16 so they could work in the cannery.  They made good money.

When Trident came in, the company lowered the wages to minimum or just above, discouraged locals from working there, and outsourced the labor.

The company also reduced the price it paid for fish  from just over $2 per pound in the late 1980s to today’s just over $1.

If I remember correctly, wild Alaskan salmon costs nearly $30 per pound in New York City grocery stores.

The fishermen aren’t getting much of that.  The people who work in the processing plant aren’t either.

We met people here who are trying to help the fishers get more money for their work.  We haven’t met anyone lobbying for higher wages for workers in the processing plant.

The rationale?  Fish come in seasonally when they can be caught.  They have to be processed as soon as they come in.  If the workers were paid more, the wild fish would be so expensive that nobody could afford to buy them (and everyone would turn to farmed salmon).

I will be thinking about all this the next time I’m in a Costco or read about recommendations in the dietary guidelines to eat more fish.

I needed five chapters to talk about issues related to fish in What to Eat. I will have more to say about Alaskan fish politics in the next two posts.  Stay tuned.

Note: the Alaskan Seafood Marketing Institute is a trade association paid for by seafood processors::

The Alaska Seafood Marketing Institute (ASMI) was created over twenty years ago as a cooperative partnership between the Alaska seafood industry and state government to advance the mutually beneficial goal of a stable seafood industry in Alaska. It is Alaska’s “official seafood marketing agency”, and is established under state law as a public corporation…[It] is divided into three distinct marketing programs: international, foodservice and retail. All three programs are designed to enhance the appeal and popularity of Alaska Seafood. The international program operates in the European Union, China, and Japan, while the retail and foodservice programs conduct their activities in the U.S.

It’s too little too late for fish policy, alas, but the EU is trying.  It is asking for comment on its Green Paper on Reform of the Common Fisheries Policy.  If the Green Paper is too much to tackle, try the Citizens’ Summary.  It explains why it’s so important to urge the EU to make sustainability a priority in fish policies.

The Monterey Bay Aquarium’s Seafood Watch program has a new report out on The State of Seafood.  Fisheries are at a turning point, it says, and we must act now, or goodbye fish.

And the Seafood Choices Alliance publishes a webletter, Afishionado.  Its latest issue deals with the effects of climate change on fish migration, invasive species, and ocean acidification.  The short articles come with references, which I always appreciate.

Many groups are doing excellent work to promote seafood sustainability.  Support what they do!

My book, What to Eat, has a chapter on the mercury-in-fish dilemma.   Do we follow dietary guidelines to eat more fish or do we worry about the amount of toxic methylmercury those fish might have?

The U.S. Geological Survey and Department of the Interior have just released a report that will not make this dilemma easier to resolve.     Fish in every one of 291 streams sampled throughout the country are contaminated with mercury.  According to the press release, the good (well, slightly better) news is that “only” a quarter of the samples exceeded federal guidelines for people eating average amounts of fish.

Where does the mercury come from?  “Coal-fired power plants are the largest source of mercury emissions in the United States — but 59 of the streams also were potentially affected by gold and mercury mining.”

The remedy seems pretty obvious: let’s insist that coal-burning power plants and mining operations clean up their emissions.   How about right now!

Among the many publications that flood my snail mailbox is the trade magazine, Pacific Fishing. I’m not sure why it gets sent to me but I do look at it since it covers a world I know little about.   The May issue has several articles about banned pesticides in Chilean farmed salmon.  I had completely missed this story, even though the New York Times discussed the problem on February 5.  That was the day the Pew Environmental Group revealed the results of its FOIA (Freedom of Information Act) request to the FDA.  The otherwise undisclosed documents say farmed fish from Chile contains residues of pesticides banned by the FDA since 2007.

But Chile is not alone in using banned pesticides.  British Columbia salmon farmers use SLICE, a pesticide that kills sea lice.  Because such pesticides are toxic, it is not surprising that they also seem to be killing local prawns and other invertebrates along the Canadian West Coast.

A Pacific Fishing reporter, Don McManman, went to great pains to find out what the FDA was doing about all this.  His interview makes entertaining reading.  The FDA’s final answer?  Looking into it, apparently.

I’m wondering why the Pew Group had to file a FOIA request to get information that the FDA should be releasing to the public.  The lack of disclosure makes it appear that the FDA cares more about protecting the salmon farming industry than consumers, especially now that the public has the right to choose.  Seafood has Country-of-Origin labeling (COOL).  With COOL , you can see whether farmed salmon comes from Chile or British Columbia and decide for yourself whether you want to eat fish raised on pellets containing banned pesticides.

Want to check out the documents?  Go to the Pacific Fishing website, then Resources. Scroll down and look for “Insecticides–It’s What’s for Dinner,” “Chile Salmon Report,” and “Chilean Contamination History.”