Attorney Roemer States Her Case for Public Health

Two days before she was to take office as president of the American Public Health Assn., Ruth Roemer joined astronomer Carl Sagan and Nobel Peace Prize winner Dr. Bernard Lown in speaking out against nuclear testing and the arms race during a demonstration at the Nevada Test Site near Las Vegas.

It was so windy in the Nevada desert Sept. 30 that Roemer couldn’t hold onto her notes, so she winged it, insisting to about 600 participants, “The threat of nuclear war is the No. 1 public health problem facing the world.”

Last week in her office at UCLA, Roemer, 70, was no less adamant about banning nuclear tests and weapons, and spending less money for the military and more for public health, in the United States and throughout the world.

A longtime human rights activist, Roemer is the first attorney in 80 years to head the 114-year-old association.

With a membership of more than 30,000, the association is the nation’s oldest, largest and most prominent organization of physicians and health professionals working in the broad field of public health. It publishes an internationally recognized journal and is politically active in a wide range of issues as diverse as tobacco advertising and interpersonal violence.

Roemer and her husband, Dr. Milton Roemer, are both professors in the UCLA School of Public Health and are internationally known public health care experts.

Dr. Philip Lee, head of the Institute for Health Policies at the University of California, San Francisco, who has known the Roemers since Lee served as U.S. assistant secretary of health in the mid-1960s, said in an interview: “She is an advocate and she’s very effective. People have great respect for Ruth as a public health care professional. And she’s a wonderful role model for public health in America.

And Lee added, “Milton, even more than Ruth, is a mentor to young physicians from a public health point of view. They’re a great team.”

Roemer, rifling through a file drawer in her desk at UCLA last week, observed that, “I believe we (as a nation) really have our priorities mixed up.” She found what she was searching for to illustrate her point, a list of military expenditures.

She had just returned from chairing her first executive committee meeting at the association’s offices in Washington, where the main subjects included military spending (she calculates that expenditures for health amount to only 16% of that spent on the military), international health programs (“There is no excuse for polio existing”), and AIDS (she favors more spending to find a vaccine and a public education program to eliminate prejudice against acquired immune deficiency syndrome patients).

“This will really boggle your mind,” Roemer said as she pointed to various columns of figures in support of her contentions about military spending. With equal vigor, she went on to talk about AIDS, the dangers of smoking and the need for broader health insurance programs.

Wanting to Be a Lawyer

All these impassioned comments came from a woman who never intended to have a career in public health. As a young girl in Milford, Conn., Ruth Rosenbaum was going to be a lawyer.

In 1939, she was married to Milton Roemer, a pre-med student at Cornell University in Ithaca, N.Y., where she did her undergraduate studies and got her law degree.

The couple were married “the day Hitler marched on Poland, Sept. 1, 1939,” and moved to New York City, where Milton studied medicine at New York University. He previously had received a master’s degree in sociology from Cornell.

“My father was a clinical doctor,” said Milton Roemer, 70, who shares offices with his wife. “He finished his training in 1906, I finished in 1940. But I wasn’t even sure I wanted to go to college. I was so conscious of the Depression and life at that time. In the middle of medical training, I spent summers getting my master’s in sociology. I knew then I was going into public health.”

Roemer became a member of the New York Bar Assn. and practiced law in the city while her husband interned in his native New Jersey and worked as a medical officer for the New Jersey State Department of Health in the venereal disease control division. In 1943, when her husband got a job with the U.S. Public Health Service, the couple moved to Washington.

In 1949, with a small son and a baby daughter, Roemer spent a year as a housewife in Morgantown, W. Va., where her husband, as a U.S. Public Health Service office was director of the West Virginia Public Health Training Center and county health department.

Then there were stints at Yale law and medical schools for the couple, and jobs in Geneva, Switzerland, and Saskatchewan, Canada, before the Roemers returned in 1957 to Cornell, she as a research associate at the law school, he as a research professor of administrative medicine.

“I think those years in Saskatchewan were the best,” she said. “Some very happy times, and that’s where the provincial health insurance first started. Milton was in charge of the provincial department of of public health there. When I went to school, public health really wasn’t an established field. My husband was in it, but public health was a peripatetic field. Now, it is a recognized and important field and it’s all happened in my lifetime.”

In 1961, Roemer, a heavy smoker for years, gave up cigarettes, but she took up smoking a pipe. “One day Milton looked at me and said, ‘That’s your last cigarette.’ So I started smoking those long Italian pipes with the leather bowls.

“They’re elegant pipes. I smoked them until 1972 and finally quit. But smoking is a terrible addiction. I never get after people and berate them for smoking, because it’s just so hard to stop. Smokers are victims of that addiction. Milton smoked a pipe once in awhile, but was never a heavy smoker.”

It wasn’t until 1962, when she and Dr. Bertram Willcox of Cornell did a study of the New York law governing admission to mental hospitals that she decided public health was a field she wanted to enter.

“We published a book on the study, and 1 1/2 years later, the New York state Legislature passed unanimously a new law on admitting mental patients that was based on our study,” she said. “It was a model law that protected the health and legal rights of patients. I saw the legislation as a mechanism for implementing the law, and that sold me on the field of health law. I figured if you could get action that quickly, that was the field I wanted to be in.”

Later that year, the Roemers came to the School of Public Health UCLA, and both have established international reputations in the field of public health.

With others in her field, Roemer was involved in reforming “the century-old abortion law of California. California enacted the Bielensen Act in 1967 and in 1973, the U.S. Supreme Count legalized it. It was quite an exciting thing to be involved in that struggle. From that I saw what the power of a coalition can do--with lawyers, doctors, social scientists.

“Until we have a really 100% contraception, we have to allow abortion as a backup to failed contraception. The No. 1 issue right now in the reproductive field is teen-age pregnancy. It’s a heartening development to see the emergence of school-based clinics that give them access to health professionals. That’s a great breakthrough.”

Together, the Roemers, both consultants to the World Health Organization based in Geneva, did an international study of health care systems and manpower in five countries and published a book about it in 1981.

Milton, who in 1983 received the association’s Sedgwick medal, the highest honor in public health, has written 30 books and about 350 articles in his field. He also developed what is known as “Roemer’s law,” a concept he derived from studies in Canada 30 years proving that the availability of hospital beds creates a demand for their use.

“I was able to study the condition of life of 1 million people in 300 localities in Canada and relate that to the use of hospitals. . . . If you have more beds, they’ll use more beds where they have extensive insurance,” he said. “This gave rise to the first hospital planning laws.”

In addition to their extensive work in public health, the Roemers actively oppose nuclear testing and weapons.

Speaking of the Las Vegas anti-nuclear demonstration, she said that 139 people were arrested at the site “for crossing the line onto government property. I decided not to do that and get arrested, because I had leave for Geneva to be at the World Health Organization immediately afterward, but I have felt very strongly about this issue for a long time. I really think there might be some hope now. I think it’s very important that 600 people would show up for something like this.”

The Roemers and other activists have contributed money for the defense of those arrested at the Nevada protest.

The couple also believe that increasing immunization efforts in Third World countries is extremely important.

“We want to extend polio vaccine so polio can be eradicated,” he said. “You see a poor crippled 10-year-old child in Tanzania who will be that way all the rest of his life, and there is just no excuse for it.”

The Roemers have served as health consultants to many foreign countries--this year he has been on lecture tours and consulting trips to Burma, China, Switzerland, Sweden, Ethiopia, and Sri Lanka. They leave Saturday for Nicaragua, where they will spend two weeks in work sessions advising health officials there.

With the blessing of officials of the association and the World Heath Organization, she also intends to talk with Nicaraguan health ministers about the possibility of initiating a new program--American health advisers.

“I would like us to have health advisers to represent peace, health and human development, instead of always death and destruction,” she said. “I got the idea from the American Linguistic Society. I thought if linguists can go there and help in their field, we certainly can be of help in our field.”

Dr. William Foege of Atlanta, immediate past president of the association, former head of the Centers for Disease Control and now executive director of the Carter Center at Emory University, said that Roemer “always amazes me. . . . With all her years of experience, she continues to be like an active college student. She is interested in all health issues, and everything else. She’s a great role model for activism. I’ve worked with her and it is a great commentary on APHA to have someone like her as president.”