A Tribute to Elizabeth Fee for Her Powerful Work on Behalf of Public Health

In 1990, Liz Fee wrote a short, but powerful piece on the history of lead poisoning in Baltimore, Maryland, her adopted hometown. Liz was then a professor at Johns Hopkins School of Hygiene and Public Health, and “Public Health in Practice: An Early Confrontation With the ‘Silent Epidemic’ of Childhood Lead Paint Poisoning” embodied her belief that history has real, practical import for public health professionals and working-class communities. History can explore, empower, and even embolden those whose lives have been transformed by exposure to lead, a subtle, sometimes deadly, neurotoxin.¹

Even its title, with its allusion to “confrontation” and “silent epidemic,” suggested that her work was more than an interesting scholarly tale from the past. Rather, it was a well-documented, almost plaintive call to practitioners to heed the lessons of the past and to remember activist traditions, traditions that by the 1990s were in danger of being abandoned. She called on all of us to confront an industry that poisoned Americans and others around the world²: “This account emphasizes the importance of enlightened public health leadership on the local level of urban politics,” she announced. “It demonstrates that public health in practice is not only a matter of scientific knowledge, although that may be essential, but is equally a matter of social commitment, political will, and . . . building constituencies and public support.” It was “remarkable,” she maintained, that public health professionals, even at the height of the Cold War, were willing “to challenge . . . powerful interests to protect the health of the most powerless and disenfranchised members of the population, the poorest children of the inner city.”³

Liz could not have known that her work would have as significant a role as it did. The “confrontation” that she spoke about—between public health advocates and officials and the “powerful interests” of the lead industry—was in the 1990s about to be launched in what would become a 30-year-long battle over who should be held accountable for the dispersal throughout the world of innumerable lead-laced products, most prominently paint. First in New York City and Massachusetts in the 1990s, and then in Rhode Island and California in the early 2000s, a series of legal challenges to the industry by state attorneys general, city officials, and public health advocates demanded that paint and pigment manufacturers be held accountable for having knowingly polluted our largest cities with leaded paint, thereby poisoning hundreds of thousands of children. Recently, the State of California scored a huge victory when it won a $400 million verdict that held the industry responsible to pay for detoxifying tens of thousands of homes in San Diego, San Francisco, Los Angeles, Oakland, and other counties around the state.⁴

Liz’s work was an important part of this long and demanding effort. Although she didn’t participate directly in the case, her work was certainly part of it. This can be easily documented. If you simply go to the Web site toxicdocs.org and type in “Public Health in Practice,” the short title of her article, you will quickly see four references, the final one being a well-worn copy of Liz’s article, replete with the underlines, markings, and notes of the lawyer who paged through it. On the bottom of its first page is “N39087,” the Bates number used to identify it as an exhibit in all the various legal cases that led up to the important California decision in which the lead industry was held responsible for polluting the state with lead paint many decades ago. Here’s to you, Liz. We hope you knew that your work was a part of the confrontation with—and victory over—this powerful industry. Yours was a powerful voice for public health!