From the Editor

I'm not a very religious man, but there are times…times when my anthropomorphic self just wants to believe that some Thing has a Plan or at least a wry sense of humor. Take SARS, for example, severe acute respiratory syndrome. Could it be just chance that this real threat to human health has been visited upon us even as the national $100+ million smallpox vaccination program is reportedly diverting resources away from the very public health activities needed to combat SARS? As of April 5, this new disease has killed 144 people and sickened at least 3,169 worldwide (WHO Web site), including 100 in the U.S., while the only effect of smallpox has been sickness and at least three deaths from the vaccine itself. Who can doubt that the ability of state and local health departments to respond to SARS—or tuberculosis or HIV/AIDS—is weakened by the considerable focus on a highly unlikely smallpox terrorist attack (Policy Watch), especially when public budgets are being cut?

Besides the irony, SARS reminds us how interconnected is the world in which we live. Something happened in Guangdong Province (China) that led to this new infectious disease, perhaps a random mutation of a chicken virus combined with a chance human contact or maybe just the right combination of climactic factors that allowed the organism to jump the animal-human gap. So, like the theory of a butterfly's flapping wings in Brazil causing a tornado in Texas (the so-called "Butterfly Effect"), that event in distant China has rippled across the globe, leading to a run on surgical masks and a slew of cancelled travel plans.

This issue of Northwest Public Health also addresses the web of connections, from Carl Hild's important article about the role of food in Alaska Native cultures and the challenge of communicating risks about that food-risks that emanate from the use of pesticides in distant lands-to Sandy Rock's fascinating piece on mercury, its ubiquitous role in our lives and severe threat to our health. A focus on environmental health seems more important than ever, because, as Carl Osaki's discussion of training points out, environmental health and public health have been estranged partners in local and state government. Northwest Region at a Glance shows how responsibilities for environmental monitoring and regulation are scattered among many local, state, and federal entities, only some of which are "public health" agencies.

Another interesting theme in this issue is that Mom's often simple wisdom is still good public health practice: "Wash you hands!" There were parts of the article by Annette Heryford and Scott Seys on cattle and campylobacter that I really would rather have not read, but the importance of simple sanitary habits comes through loud and clear. What is wrong with all these guys who leave the bathroom without pausing at the sink? I'd like to put up next to every toilet one of those handwashing signs that accompanies Pamela Wild and Rebecca Brown's article on water recreational illnesses.

Finally, in this journal we encourage you to think broadly about the responsibilities of public health. Maryanne Guichard and Jude Van Buren offer practical lessons in how a local health district can support school education by helping keep the air clean. Latricia Tillman reminds us that, as in so many other aspects of American society, communities of color face environmental health threats disproportionately and offers some ways to reduce that disparity. And Amy Hagopian calls on public health educators and practitioners to take a stand on war as an ultimate threat to human health.

No, I still don't believe in some grand Plan, but irony is a good teaching tool. I wonder if we'll pay attention this time…

Aaron Katz, Editor-in-Chief
Director, UW Health Policy Analysis Program