The U.S. Surgeon General has just released a report bemoaning the evils of teen drinking. Underage drinking can certainly carry with it serious problems, but the tone of this report (and indeed the very fact of it) says more about the peculiar role of the Surgeon General as a national moralizer than it does about teens hitting the bottle.

The post of Surgeon General, created in 1871, originally involved management of the nation’s military hospital system, and then eventually of the Public Health Service. But in 1968, responsibility for running the Public Health Service was handed over to the Assistant Secretary for Health in what was the predecessor to today’s Department of Health and Human Services, where it still resides today. The Surgeon General thereby lost the bulk of his administrative responsibilities and became instead a kind of national spokesman on public health issues.

With time, and through a long line of Surgeons General, the definition of public health has grown more and more expansive, and the Surgeon General has become a finger-wagging preacher calling on the public to give up unhealthy habits. Last year, the Surgeon General released a report on second-hand smoke—the latest in a long line of reports on tobacco use, which has certainly been the favorite subject of assorted Surgeons General since the 60’s. Also in recent years, the Surgeon General has released a report on the role of culture, race, and ethnicity in mental health, and another on youth violence—neither of them public health issues under any but the broadest definitions.

The tone of these assorted documents makes for a telling case study in the way health has come to take the place of virtue in America’s public vocabulary, so that public health is the only language left in which to speak of vice—an old-fashioned word that once would have been the obvious way to refer to, say, smoking and drinking. The mood of righteous wrath that colors the crusade against smoking (and obesity, and other modern sins) is yet more evidence that health and fitness have become the secular religion of the Left, with the Surgeon General in the role of high priest.