On centering health as a value that informs politics, particularly in divided times.
The newly installed administration, like every new administration, inherits a country facing many challenges. These include challenges in our energy sector, at our border, in the emergence of natural disasters, and in the geopolitical tensions that threaten to destabilize our world. They also include, centrally, challenges in health. The U.S. faces a range of problems that have held our health back relative to peer countries, problems such as substance use, gun violence, chronic disease, mental illness, and deep inequities that have created pockets of persistent poor health among populations. For example, black Americans sicken and die at a much higher rate than white Americans from a host of health challenges, such as diabetes, heart disease, and asthma. Black maternal mortality is also higher, as is the likelihood of this population being injured or killed by gun violence. The scale of these problems echoes the scale of challenges to health we see at the global level, including under-five mortality, the threat of infectious disease, and global inequities in health that concentrate a disproportionate burden of poor health in certain regions.
These challenges raise the question: How do we create health? This question is core to the work of public health, and our efforts to answer it have yielded a great deal of data on how to go about building a healthier world. Fundamentally, we create a healthier world by creating the conditions that generate health. This is reflected in the animating metaphor of The Healthiest Goldfish — that of the goldfish who died for lack of clean water. When it comes to health, our “water” is a metaphor for the conditions in which we live. Building a healthier world takes creating healthy conditions, such as clean air and water, nutritious food, accessible education, livable wages, and an end to the misogyny and racism that deprive many of opportunities for health achievement. Ensuring these conditions are in place can play a decisive role in improving health locally, nationally, and globally.
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