The 2018 Midterms Were a Step Towards a Healthier U.S. | Fortune

The past midterm elections were widely seen as being among the most consequential in our nation’s history. In the lead-up to the election, voices on both sides of America’s political divide characterized the result as potentially transformative. President Trump emphasized the country’s changing demographics, stoking fears of immigrants with pronouncements like, “If you don’t want America to be overrun by masses of illegal aliens and giant caravans, you better vote Republican.” Former President Obama, for his part, said the midterms “might be the most important election of our lifetimes,” and that nothing less than “the character of this country is on the ballot.”

Last week, the country spoke, and we saw what the tide of marching, organizing, debating, phone banking, tweeting, and door-knocking has led to: Republicans expanded their Senate majority, while Democrats gained control of the House of Representatives. Time will tell if this result proves truly transformative. History, however, has shown just how significant electoral change can be, when shifts in the balance of political power overlap with a societal demand for change. Such a convergence can make seemingly intractable problems give way, even after decades of gridlock.

Looking Back, with Gratitude | Dean's Note

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This week, I joined other members of the SPH community at the annual meeting of the American Public Health Association. The meeting, held this year in San Diego, has long been an annual highlight. It is a chance to reconnect with friends and colleagues from across the country, to learn new approaches to our work, and to get a sense of where the field currently is—in terms of both its internal debates and priorities, and its place in the national conversation. This year’s meeting conveyed the sense that, in 2018, public health is flourishing. Rarely has our field been more engaged with the issues of consequence that shape our country and our world. From climate change, to socioeconomic inequality, to gun violence, to global health systems, public health is tackling the key challenges of the moment, and our school, through the work of our faculty, students, and staff, is actively engaged in all these areas. This was evident in the many contributions of our community at APHA to the work being done by our alumni, as exemplified by the outstanding graduates of our program, Aaron Cohen, Liz Cohen, and Sonja Tong, to whom we presented the Distinguished Alumni Award at our San Diego Think. Teach. Do. Reception. The latter was a lovely opportunity to reconnect our alumni with students, faculty, staff, alumni, and friends of the school, a vibrant reminder of the passion, diversity, and truly global reach of our school’s “extended family.”

When I consider our community, I am struck by a sense of gratitude. It is a rare privilege to get to work each day among such a committed, passionate group of people, who are doing so much to build a healthier world. Our strong showing at APHA comes near the end of a year in which our school continued to court excellence in its pursuit of health. I would like here to provide a snapshot of these efforts, to look back, and, in the spirit of next week’s holiday, to give thanks for all we have done together. I do so mindful that it is impossible to provide a snapshot without leaving much out of the frame. This note is meant to be just a sample of the year’s achievements—omissions are due to space limitations, not neglect. I wrote a similar reflection near the end of 2017. That note was organized around the activities of our students, faculty, and staff. I will likewise focus this Note on three categories, using as a guide our school’s motto of “Think. Teach. Do.” which covers our scholarship, pedagogy, and practice—all areas where we have much to be thankful for.

To begin with our scholarship—SPH did much this year to advance our understanding of the forces that shape health, through a robust and varied program of research. For example, a study led by SPH researchers found a link between state laws permitting denial of services to same-sex couples and mental distress in sexual minority adults. SPH researchers also contributed to a study which found that racial segregation may increase the disparity in gun homicide between black and white populations. And SPH researchers continue to lead work on the Black Women’s Health Study, the largest follow-up study of the health of African American women ever conducted. This year, we also reaffirmed our commitment to supporting a new generation of public health scholars. In the fall of 2018, we awarded support for six new pilot projects, including our Early Career Catalyst Awards, which support pilot projects from junior faculty members as they begin their independent research careers. Research projects included air pollution, hepatitis C, prostate cancer, and zoonoses in Bangladesh, among many others.

This year also saw our school maintain and deepen our commitment to innovation in teaching. Building on the success of our redesigned MPH, we last November launched our Executive Master of Public Health. This program is tailored for public health professionals with at least five years of relevant experience, to craft an educational journey that respects and augments their prior work. We have also continued to expand our educational offerings through Population Health Exchange (PHX), our digital platform for lifelong learning. And we convened our Teaching Public Health symposium in March, bringing together experts from across the country to discuss the future of public health education. Finally, October marked our school’s Council on Education for Public Health (CEPH) site visit, a milestone in the school’s ongoing accreditation process.

On the “do” front, 2018 provided many opportunities for SPH to express its commitment to advocacy and activism. Through our Activist Lab, students were able to receive advocacy training, which gave them the tools necessary to begin building a healthier community as soon as they arrived at SPH. Times have rarely been better suited for such work. As our unique political moment has created new openings for progressive change, our students have been well-positioned to take the lead on issues of consequence for health. Our participation in National Gun Violence Awareness Day and the March for Our Lives, for example, allowed us to engage with the pressing public health issue of gun safety reform. And our advocacy for keeping in place civil rights protections for transgender people in Massachusetts by voting “yes” on Question 3 in the midterm election showed our community’s willingness to engage with politics on behalf of health. That this campaign was successful, and “yes” on Question 3 won by an overwhelming margin, is yet another reason for gratitude, as we approach the year’s end.

Taken together, this snapshot portrays a school that is thriving, engaged, and committed to improving the social, economic, and environmental conditions that shape health. Just as public health stands poised to advance the cause of health in 2019, SPH is well-positioned to contribute to these efforts. And that is something to be grateful for indeed.

As we head to the Thanksgiving break, I hope our faculty and staff will join us on Monday, November 19, at noon in the Founder’s Room, for our 15th annual Thanksgiving Potluck Luncheon. If you wish to attend, please RSVP to Karen Smith, Mary Murphy-Phillips, or Joline Durant with your food or beverage contribution. I look forward to seeing many of you there. I will be baking cookies.

And to those I do not see between now and next week’s break—have a wonderful holiday. Thank you for all you do to make our school a special place.

I hope everyone has a terrific week. Until next week.

Warm regards,

Sandro

Acknowledgement: I am grateful to Eric DelGizzo for his contributions to this Dean’s Note.

The Public's Health: The New Elderly Surveillance State | Public Health Post

Millions of older adults will develop dementia over the coming decades. The middle-agers who assume responsibility for this older generation face a looming concern: how can we keep our parents safe and at home? Can technology help make this possible?
 
If we read the popular press on this, the Internet of Things will carry part of the load of caring for our elders. New, in-home smart systems will reduce caregiver stress through electronic surveillance, allow doctors to get real-time insights into the health of our loved ones, and improve their quality of life. 
 
Teams of clinical, economic, security, and technical experts are now at work on a new form of “assisted living.” The model patient in her home will have passive environmental sensors (the stove turns itself off), medical devices, wearable technologies, and interactive apps connected to her body and bed, floor and door frames, collecting a fast-moving stream of data, a “velocity challenge.”
 
Such “living labs” are already deployed and being evaluated. These new “trusted patient homes” will require a new kind of workforce of healthcare practitioners, not only persons who can read the new dashboards but also technicians who can maintain the sensors. But will these new, technologically sophisticated homes really tackle the core problem? At the moment these homes feel, to us, like new sites of isolation. They remind us of a surveillance state, albeit one that aims to preserve health.
 
Yes, we will all have more data. Yes, we might better understand the physiological patterns of persons living with dementia at scale. But can we really improve the quality of lives of our elders with dementia and their families with easy-to-follow audio instructions piped in over speakers? Will a daughter feel safe leaving her mother alone at home in this surveilled new world?
 
The world of continuous monitoring will bring new challenges. And the technology by itself will not be the full solution. Somewhere we have to figure out the role that old-fashioned social networks, humans checking in on humans, will play, and how technology can help augment, not replace, the role that caregivers play in maximizing quality of life for those who can no longer look after themselves. That will require a serious examination of the role of work and obligation, borne by those in middle age, and how this can fit in with the increasing responsibilities that they will inevitably bear as the population ages.
 
We need space in the public conversation for this too.

Warmly,
Michael Stein & Sandro Galea 

What We Need to Talk About When We Talk About Health | Thrive Global

The midterm elections are over and the results are in many ways unclear. The vote was expected by some to deliver a decisive verdict either endorsing the direction of the country as led by President Trump or repudiating this course with a dynamic “blue wave” of Democratic victories. The actual result was more akin to a split decision. Republicans expanded their control of the Senate, while Democrats made significant gains in the House of Representatives, winning control of that body. With each side plausibly claiming a “win,” it is nevertheless a win tempered by uncertainty.

The 2018 Midterms: A Public Health Takeaway | Dean's Note

In my last Dean’s Note, I argued that health was on the ballot in the 2018 midterm elections. This week, health won. From climate change, to gun control, to health care, the issues that shape health were at the heart of campaigns across the country. Soaring voter turnout showed the power of these issues to mobilize millions of people in pursuit of a healthier world. Even more encouraging is how many candidates won on platforms that are good for health—from commonsense gun safety reform, to universal health care, to a willingness to address climate change. Arkansas approved a ballot measure raising the minimum wage by 29 percent over three years, a move which will help about 300,000 workers in the state access the resources they need to be healthy. Washington state approved a ballot measure to raise the legal age for buying assault rifles. Florida approved a ballot measure restoring the right to vote to more than 1 million former felons, allowing them to participate in the political process that shapes their health and the health of all. These are just a few of the changes ushered in by the election, changes with positive implications for health.

Invest in Health, Not Death | Thrive Global

We all die and, despite some fanciful aspirations to the contrary, we will all keep dying into the future. Our daily routines keep us closed off to this fact. Death’s inevitability suggests that we should keep it in our sights as we think about the public’s health. There are three areas which might fruitfully draw our attention.

The Public's Health: Invest in Health, Not Death | Public Health Post

We all die and, despite some fanciful aspirations to the contrary, we will all keep dying into the future. Our daily routines keep us closed off to this fact. Death’s inevitability suggests that we should keep it in our sights as we think about the public’s health. There are three areas which might fruitfully draw our attention.
 
Once we accept that we are going to die, how we spend our money and our time on the business of health begins to shift. At core we should aspire to die healthy. That means focusing our energy on creating a world that maximizes health, not one where we invest our resources into the last few months of life, aiming to fight death at all cost. This would represent a radical shift in how we think about our limited health investment dollars. Perhaps death can help focus our mind on living better, on the conditions that we need to create to generate health, rather than asking serial medical specialists to tackle symptom after symptom until we die.

The 2018 Midterms: A Public Health Takeaway | Dean's Note

In my last Dean’s Note, I argued that health was on the ballot in the 2018 midterm elections. Last night, health won. From climate change, to gun control, to health care, the issues that shape health were at the heart of campaigns across the country. Soaring voter turnout showed the power of these issues to mobilize millions of people in pursuit of a healthier world. Even more encouraging is how many candidates won on platforms that are good for health—from commonsense gun safety reform, to universal health care, to a willingness to address climate change. Arkansas approved a ballot measure raising the minimum wage by 29 percent over three years, a move which will help about 300,000 workers in the state access the resources they need to be healthy. Washington state approved a ballot measure to raise the legal age for buying assault rifles. Florida approved a ballot measure restoring the right to vote to more than 1 million former felons, allowing them to participate in the political process that shapes their health and the health of all. These are just a few of the changes ushered in by the election, changes with positive implications for health.

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