How tuberculosis kills its victims is reason enough to appreciate what Nick Casner is doing.
“It’s a horrible way to die. Your lungs disintegrate and you drown in your own blood,” said Casner, an assistant professor of environmental history at Boise State University.
And even though tuberculosis is one of history’s most prolific killers, a constant threat as recently as 50 years ago, “I can go into a classroom and people have never heard of it.”
That kind of public indifference contributed to a resurgence of TB. While the disease has been in general decline since effective treatments were found in the 1940s, the number of cases increased nationally during the 1980s as drug-resistant strains developed.
Casner sees an important lesson there.
“We have a real tendency to be smug and overconfident about these things,” he said. “It’s a pretty good thing for decision-makers to see where we’ve been, how we’ve taken care of ourselves. Things change, but we shouldn’t lose sight of the past because it’s pretty rough.”
So Casner is studying the history of public health in Idaho, tracking how the state has responded through the years to the health challenges that go along with being a rural state with a diverse, rugged landscape.
His research began last spring with a $34,300 state Board of Education grant and figures to continue for at least another year. It’s the first project of its kind for Idaho, and one of the first anywhere in the West.
Judy Austin, publications coordinator for the Idaho State Historical Society, is excited about Casner breaking new ground.
“It’s a fresh field. And it strikes me, particularly with budgetary matters affecting how governmental bodies approach public health concerns, that some understanding about how the government got involved in public health in the first place could turn out to be very useful,” she said. “It could be discouraging, and it could be instructive.”
Casner plans to pursue additional grants from private foundations and government agencies like the National Institute of Health to continue the research, and ultimately to write a book about his findings and develop interdisciplinary courses at Boise State.
So far most of his work has involved scouring federal documents in Seattle, records of The Church of Jesus Christ of Latter-day Saints in Salt Lake City and files at the U.S. Public Health Service library in Washington, D.C., and Johns Hopkins University in Baltimore.
But even before studying state and local government records that figure to be limited and sketchy, Casner can trace public health back more than a century.
Through the years there have been occasional outbreaks of smallpox, diphtheria, scarlet fever, typhoid and even some instances of bubonic plague. But Idaho generally has avoided the kind of devastating epidemics that have afflicted other areas for the same reason early health care was such a problem - remoteness.
Casner is seeking documents, anecdotes, artifacts, letters, diaries and other information on public health from throughout Idaho. He can be reached at (208) 385-4309, toll-free at (800) 632-6586 ext. 4309, or via e-mail at ncasnersspafac.idbsu.edu.