Donald Trump does not have a political record. The fleeting glimpses we are offered into his own policies are further muddied by his own ideological inconsistencies and unpredictable temperament. A better lens, then, into his policies may be through the company he keeps. In terms of policy, understanding, and regard for public health -- Mike Pence is by all counts an unmitigated disaster.
Pence's public record reveals a misunderstanding of basic science. The field of public health is dedicated to identifying and minimizing risk factors that negatively impact human health. Perhaps the most basic and fundamental example of this is the impact of smoking. The Centers for Disease Control have stated that smoking is the number one preventable cause of death in the United States, responsible for nearly half-a-million deaths annually. While the data couldn't be more clear, Pence penned an op-ed in 2001 refuting basic medical science at a time when tobacco products were being considered for regulation by the FDA. He wrote, "Time for a quick reality check. Despite the hysteria from the political class and the media -- smoking does not kill." Pence has no excuse -- the link between smoking and health has long been considered doctrine in the United States since the landmark Surgeon General report in 1964.
Further, not only has Pence failed to fight tobacco, his policies have historically been so lenient as if to support tobacco companies at the expense of American lives. Pence has defunded smoking prevention and cessation programs and also opposed Republican led legislation to increase the tobacco tax in Indiana by $0.05, despite Indiana having one of the highest rates of smoking and one of the lowest tobacco taxes in the country. At best, these efforts reveal a gross misinterpretation of history and science. At worst, however, this willful ignorance is a manifestation of a willingness to hurt the health of his constituents for corporate special interests.
In numerous instances, Pence's policies have served to further marginalize the health of populations whom are already vulnerable -- particularly women, the LGBTQ community, and those at risk for HIV. When Pence took office as Governor of Indiana in 2013, he led a crusade to defund Planned Parenthood. By 2014, state funding for Planned Parenthood had been cut nearly in half from 2005 levels forcing the closure of small clinics. This funding drought no doubt affected women's access to both primary as well as reproductive health care.
But the effects of this policy went further. One particular clinic, in rural Scott County, was closed in 2013, leaving the county without an HIV testing center. Less than two years later, the county became the center of an HIV epidemic affecting nearly 200 residents of Austin, Indiana, a town of 4,300, and leading to the highest incidence of new HIV infections in the country. Testing is not the only intervention to prevent HIV transmission, there's also strong evidence for providing clean needles via needle exchange programs. But until this crisis in his own backyard, Pence had been a lifelong, vocal opponent of needle exchange programs.
Perhaps most controversial of all, in early 2015 Governor Pence signed into law the Religious Freedom Restoration Act which effectively allows business owners to cite their religious beliefs as right to refuse services to members of the LGBTQ community. Discrimination, especially the state-sponsored type like this, can have serious public health consequences. Discriminatory practices and social stigma in the LGBTQ community have led to significant health disparities and to higher rates of depression, substance abuse, and suicide. While prudent public health policy would work towards lowering barriers of access to care, this legislation -- to use the campaign mantra -- does no more than build walls. Worse, it allows for and even may encourage further stigma.
Public health should be a non-partisan issue. The public's health is a universally desirable good -- it is needed for each individual to reach their furthest potential, just as it is needed to reach our collective potential as a nation. It is the explicit role of our public servants to champion the rights and health of the most vulnerable communities, not to further marginalize them. Mike Pence's track record on health as told through his policies on tobacco, women's health and LGBTQ rights has been outright harmful, and should lead us to question him and his running mate's eligibility for public office, let alone our highest office.