Securing the health of communities

People do not think about health only in terms of

sickness or injury, but also in terms of what they

perceive as endangering their health and that of

their community118. Whereas cultural and political explanations for health hazards vary widely,

there is a general and growing tendency to hold

the authorities responsible for offering protection

against, or rapidly responding to such dangers136.

This is an essential part of the social contract

that gives legitimacy to the state. Politicians in

rich as well as poor countries increasingly ignore

their duty to protect people from health hazards

at their peril: witness the political fall-out of the

poor management of the hurricane Katrina disaster in the United States in 2005, or of the 2008

garbage disposal crisis in Naples, Italy.

Access to information about health hazards in

our globalizing world is increasing. Knowledge

is spreading beyond the community of health

professionals and scientifi c experts. Concerns

about health hazards are no longer limited to

the traditional public health agenda of improving