One of the joys of working at a school is the opportunity, each September, to reconnect with returning members of our community, to welcome new students and faculty, and to experience the accompanying sense of possibility and renewal. It is an optimistic time, informed by our hopes for the coming year. As the fall begins, and we welcome new members to our school, I would like, in this season of return, to use this Dean’s Note to reaffirm the core values of SPH and revisit some ideas I have written about in prior notes.
For many of us in 2018, our optimism about the year ahead coexists with deep concern for the unfolding political situation in this country. Last summer saw a number of developments that pose a threat to health in the US. The retirement of Supreme Court Justice Anthony Kennedy has opened the door to the nomination of Brett Kavanaugh, a jurist whose vote could undermine health in a number of areas, including LGBT rights, environmental regulation, and abortion access. The same week that Kennedy announced his retirement, the court upheld the Trump administration’s ban on travel from a number of predominantly Muslim countries. This decision both codifies bigotry in our immigration system and threatens the health of migrants and refugees fleeing difficult circumstances in their home countries. Finally, the administration’s practice of separating families at the US border represents one of the ugliest chapters in our nation’s history, echoing the internment of Japanese during World War II, and threatening the physical and mental health of those affected, particularly children. Though the administration reversed courseon this policy to some degree, many families remain separated.
These challenges have made the work of public health more important than ever. Our aspiration is to create healthier populations by improving social, economic, and environmental conditions and by closing health gaps. The US spends more on health care than any other country in the world, yet our health remains mediocre compared to peer countries. A 2013 National Research Council and Institute of Medicine report found that among the world’s 17 richest countries, we rank near the bottom of the list on most core health indicators. This is due to a fundamental mismatch in how we invest in health. The vast majority of our health spending goes to the development of cutting-edge treatments at the expense of improving the factors that determine whether or not we get sick in the first place—factors like the quality of the air we breathe and the water we drink, the safety our of neighborhoods, the fairness of our economy, and the chance to give our children a good public education.
However, it is also undeniable that the last century saw great health improvements, reflected by increases in overall life expectancy. In 1900, life expectancy in the US was about 47 years. Now it is close to 79 years. Yet too many groups remain excluded from these gains. Factors like race, income, sexual orientation, and gender identity remain important predictors of health in a society where the distribution of health is still profoundly unequal. There is, for example, a 20-year gap between US counties with the highest life expectancy and counties with the lowest. Black Americans are likelier than white Americans to die from heart disease. LGBT populations are likelier to attempt suicide. Health gaps like these emerge from, and are widened by, a range of complex causes, including economic hardship, racism and bigotry, and environmental hazard. In exacerbating many of these conditions, the Trump administration has, ironically, brought them to the fore of the public debate. As troubling as our present moment is, then, it also presents an opportunity to elevate health in the national consciousness, to shine a light on the factors that truly shape well-being.
At SPH, we pursue this goal guided by our core purpose of “Think. Teach. Do. For the health of all.” We “think” by generating knowledge through our scholarship, we “teach” by translating that knowledge to the next generation of public health practitioners, and we “do” by embracing our role as an activist school of public health, working to implement solutions, and engaging with communities at the local, national, and global level. As we do so, we are buoyed by the diverse backgrounds and opinions our students and faculty bring to this mission. With each new incoming class, our community better reflects the world in which we work. This fall, we welcome 468 new students from 37 states and 25 countries. They join our 1,177 current students, our 333 faculty, 225 staff, and our global network of nearly 10,000 alumni living in 117 countries. As we welcome these new students, we aspire to continue our work of creating an ever-more inclusive community, where all perspectives are heard and valued, and all can participate fully in the life of our school, regardless of race, gender identity, sexual orientation, or disability status. In divided times, it is, I think, especially critical to reaffirm the importance of diversity and inclusion. So much poor health is a consequence of the barriers between us—whether physical, like residential segregation, or sociocultural, like the divides of politics, income, race, or religion. By working towards a more diverse and inclusive school, we practice transcending these divides, in the hope of creating a better, healthier future.
Our work, therefore, is two-fold. We seek to give the rising generation of public health practitioners the tools they will need, when they embark on their careers, to help create a society that generates health. At the same time, we seek to model what such a society can look like right here at SPH. Changing the world takes time. The problems of the Trump era, those it has created and those it has revealed, will likely take many years to solve. These solutions will depend in large part on the emergence of generational change—on the activism of the Parkland students, the energy of young politicians and organizers, and the work of communities like ours, comprised of scholar–activists who have chosen to devote their talents to improving the conditions that shape health. During our time here, we can—by embracing the values of diversity and inclusion, by engaging in the rigorous process of scholarship and debate, and by keeping special focus on improving the health of the marginalized—create at SPH a microcosm of the shift we wish to see in the wider world.
It is a true pleasure to once more welcome our community back in its full numbers, to see faces old and new, and to anticipate all we will accomplish this year. The work of public health is never complete; neither is the work of becoming the best school we can possibly be. We still have much to do to live up to our aspirations and meet the challenges of the present moment. I look forward to working toward this goal, together.
To advance this collective engagement, we invite you to join the conversation throughout the year by participating in our school’s many platforms for discussion. A key hub of this discussion is our series of Signature Programs, where we invite to campus a range of thought leaders to explore the issues that affect health in the US and globally. To stay up to date on these programs, and everything else that is happening in the SPH community—both on campus and among our worldwide alumni network—we encourage you to visit our website, and to read SPH This Week, our weekly e-newsletter. In addition, many of our faculty, staff, and departments are active on Twitter—myself included (@sandrogalea)—where we share thoughts, discuss the latest research, and communicate about upcoming events.
I look forward to continuing the conversation in the weeks and months to come, to the work we shall continue to do together to make this the best possible school anywhere. In the meantime, I hope everyone has a terrific week. Until next week.
Warm regards,
Sandro