3 Ways to Create More Resilient Communities | Scientific American Blog Network

Natural disasters test the seams of our cities and health systems. During hurricanes like Sandy, Harvey and Maria, community infrastructure buckled under the pressure of torrential rain, gusting winds and prevention measures designed for a bygone era.

When we see areas of the country devastated by a natural disaster, we often blame nature. But the storm is only half the story. While we tend to think of a natural disaster as a single event, a disaster’s worst effects often emerge weeks, months or even years after the initial emergency, as the devastation is amplified by an already flawed environment. Disasters happen when cities are unprepared for the stress an event like a hurricane can cause. They happen when cities are not designed with resilience in mind.

To withstand disasters, then, we must first build more resilient cities. This requires a multi-tiered approach. First, we must consider the city as a whole and the foundational role urban planning, design and community dynamics play in creating health in metropolitan areas. Next, we must design specific buildings so that they maximize personal well-being. 

With hurricane season well underway, now is the time to rethink how we approach disaster preparedness. Here are three ideas to consider. 

Read full article at Scientific American.

The Fight for Transgender Rights Is a Fight for Health | Dean's Note

A key theme of the Trump era has been that of rollback, of seeing progress—often hard-won over the course of many years—suddenly threatened or reversed. From environmental protections, to reproductive rights, to voting and civil rights, recent years have shown how fragile societal advances can be. This is especially true in the area of transgender rights. In 2016, I wrote a note about public health’s responsibility to fight for transgender equality. At that time, there was indeed progress to celebrate, from the Obama administration’s decision to direct US schools to let students use restroom facilities that correspond with each student’s gender identity, to, here in Massachusetts, Boston Medical Center’s plan to launch a transgender medical center, and the state senate’s passage, by an overwhelming margin, of a transgender rights bill, which prohibits discrimination against transgender people in many areas of public accommodation, including restrooms.

Health, not healthcare | Fortune

Last month, the Trump administration took a step that will likely have significant consequences for health in the US. This step did not involve the Affordable Care Act, or the opioid crisis, or the price of pharmaceuticals, or any other area we typically associate with health policy. It involved our air. The administration announced its proposal to roll back Obama-era regulations meant to prevent coal-fired plants from polluting. Under the new plan, states will be able to relax emissions standards, a move expected to help the coal industry while increasing carbon emissions across the country. In a moment of what can only be described as political cognitive dissonance, the Environmental Protection Agency, which touted the proposal, also indicated in its analysis of the plan that the emissions increase could cause up to 1,400 premature deaths each year by 2030.​​​​​​​

The Public's Health: Denying Climate Change is Denying Health | Public Health Post

In recent years a few sentinel issues have become third rails in American culture, dividing us along political lines and becoming touchstones for particular parties. One of these issues is global environmental climate change. The current executive branch embodies the Republican party’s general feeling about climate change, espousing a range of positions from the extreme—the earth is not getting warmer—to one of agency—i.e., even if it is, humans have nothing to do with it.

Six Steps for a Healthier Massachusetts | Dean's Note

During summer, much of our school community spent time away from our campus—vacationing with family, working abroad, or simply adventuring. With the new academic year now underway, we have returned to SPH, to once more call Massachusetts home for the coming semester. With our deep roots in the state, it is worth taking a moment, as we renew our connection to the Commonwealth, to pause and consider health here.

The Public's Health: Toward a Muscular Public Health | Public Health Post

Public health often offers directives. You should wear seat belts. You should get vaccinated. You shouldn’t smoke. This command language, with its moral tinge, is at odds with the language of shared decision-making that has become central in the medical world and in some ways may marginalize the message of public health.

Why does public health seem to revel in an approach that is at odds both with notions of individual freedom and with norms in medicine? In the shared decision-making world of modern medicine, doctors are meant to discuss options with patients, the final health decision is made by the patient, who may in the end, make an unhealthy choice. But public health persists in suggesting courses of actions for the entire population.
 
Why? And is this ok?

A Word of Welcome | Dean's Note

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.

The Public's Health: Can We Reverse Course on Health? | Public Health Post

The United States lags in health indicators behind all our high-income peer countries. Most well-informed readers know this and know that we have lower life expectancy and higher mortality on multiple causes than do, for example, Italy, Greece, France, or Norway. It is worth noting that our health measures were not always this poor compared to other countries; as recently as the mid-1980s we were roughly in the middle of the pack in high income countries and we have slowly fallen behind. Other countries have passed us, both high-income nations and other not so usual suspects like Chile, Cuba, and Singapore.
 
So the bad news is that we have fallen behind. The good news, perhaps, is that if we fell behind on health in such a short period of time, we can reverse course and catch up in the next few short decades.

This is the personal website of Sandro Galea. All photos are taken by Sandro Galea.