Uncomfortable conversations about COVID-19 | The Hill

“The relationship between health and income is remarkably clear. Those who are fortunate enough to have higher incomes live longer, healthier lives. The richest among us have life expectancies of more than a dozen years beyond the poorest. The COVID-19 pandemic has laid bare our class divides and points to the imperative of prioritizing health equity as we get past these terrible weeks and months.

As we describe in “Pained: Uncomfortable Conversations About The Public’s Health,” poverty is a public health problem. The COVID-19 crisis only clarifies the mechanisms by which a new health threat makes the poorest among us the most vulnerable.

The coronavirus highlights three questions: Who gets exposed? Who needs critical care? Who receives care?”

Anxiety as a Public Health Issue | Harvard Business Review

As the Covid-19 pandemic unfolds, many of us are feeling the strain on our mental health. Some people feel anxiety about getting laid off; others have to continue to work at grocery stores and delivery companies, or perform other essential services, sometimes without the protections they need to stay safe. Families are trying to balance caregiving with remote work. We all worry about someone we love getting sick or about getting sick ourselves. There’s also the sudden instability of it all, as the pandemic upends global systems that many took for granted. Meanwhile, the social distancing measures we are taking to slow the spread of the disease have meant weeks of confinement, which brings its own anxieties.

In our concern for the physical risks of this pandemic, it is easy to overlook the mental health burden many of us feel. We may even be inclined to minimize our anxiety, thinking that, compared with what Covid-19 can do to our bodies, its effect on our minds is a lesser concern.

Is collecting medical data really essential for health care? | Oxford University Press Blog

Authored by Michael Stein and Sandro Galea

“The United States spends an inordinate amount of money on health care. Much of this spending goes to data acquisition, to medical monitoring, and to assessment of how our health systems function. But are there other areas where money devoted to gathering health data might be better spent?

Our health is a product of the world around us. This is perhaps most easily understood by thinking about how much time we spend in the various places where we live, work, and gather.
Data from the Bureau of Labor Statistics offer a picture of these places. Out of 8,736 hours in a year, we spend more than half, or about 4,566, at home. We spend 1,893 hours in our workplaces or 1,198 at school. We spend 93 hours in places of worship. Far down the list, at 15 hours a year, are interactions with the health care delivery system.”

Social scientists can play a key role in stopping coronavirus | Times Higher Education

“The Covid-19 pandemic has created deep uncertainty about nearly all aspects of daily life. Into the breach of this uncertainty has stepped science. As the crisis has unfolded, scientific groups all over the world have worked quickly to offer their best analysis of the virus. How might it behave? How can we stop it? Can we safely resume our work, and how might we balance the risks from the virus with the pressing needs of our economy? This work has been the lifeblood of policy decisions worldwide.
All aspects of science have been relevant to the current moment, from natural sciences that explore the mechanics of the virus, to social sciences that look at how populations are responding to stay-at-home orders, to the political science that reflects the intersection of policymaking and public health.”

The Coronavirus Does Discriminate: How Social Conditions are Shaping the COVID-19 Pandemic | Harvard Medical School Primary Care Blog

Authored by Dr. Rebekah Rollston and Sandro Galea

Part of this developing crisis is very well known: On December 31, 2019, Chinese officials reported a cluster of pneumonia cases in Wuhan and identified the novel coronavirus as the causative agent on January 7, 2020. This novel coronavirus spread rapidly, and on March 11, 2020, the World Health Organization declared COVID-19 a pandemic. To date, there are more than 1 million confirmed cases in the United States and 3.5 million worldwide.

Through this all the virus has terrified the world, in no small part because of a sense that we are all at risk, that the virus is non-discriminating, and we can all get sick. That is true, but it is also not the complete truth. Once again, as with all other health conditions, those who are most at risk are those who are already vulnerable by way of the social and economic disadvantage that characterize their lives.

Our Public Health Systems Remind Us to Invest in a Healthy Society | Thrive Global

Authored by: Dr. Sandro Galea and Michael Stein

Every health care provider—from pediatricians to geriatricians— has seen how homelessness affects health. The disordered lives of homeless patients disrupt appointment-keeping and medication adherence, even as they generate need for more treatment by driving health challenges like depression, high blood pressure, and hospitalizations.

Some health systems have begun to address the link between homelessness and health. One Boston health system, for example, announced plans to subsidize housing for the patients for whom it is accountable, to give this population some measure of the shelter and stability necessary for good health.

This is an example of a growing practice among health systems, which are beginning to address the foundational forces that shape health. Their reason for doing so is partly financial. For example, Medicaid, in some states, adjusts payments to hospitals based on whether a patient is homeless—homelessness is treated like any other complicating diagnosis, an additional cost of care. So health systems can lose money if they do not collect and appropriately bill for housing status. But there are also more charitable reasons for health systems’ new focus, including the possibility that collecting information like homeless status can drive new program development and position the health systems to help fix under- lying economic and social problems, toward the ultimate goal of improving patients’ health.

Distancing Ourselves From Disease Is Nothing New | Elemental

Authored by Nadia N. Abuelezam, ScD and Sandro Galea

“We normally distance ourselves from disease.
While social and physical distancing may be relatively new phrases, the act of distancing ourselves from those who are sick, ill, or suffering is not new. Often this distance is clinical: We put people who are sick in hospitals or other facilities, keeping illness away from us. We have also improved our ability to prevent and treat disease, therefore providing a clinical buffer. Sometimes this distance is geographical: Disease may be happening in places far from us and among groups we do not belong to. Sometimes this distance is social: We do not think of the people who are sick or suffering as being like us. The sick are often labeled with terms that signify an “other” status.”

Politics May Kill Us, Not the Coronavirus | Think Global Health

Authored by Eduardo J. Gómez and Sandro Galea.

“In a period of public health crisis, scholars and policy makers are often quick to ask the following question: what has the new public health threat revealed about a government’s health care system and its ability to respond in a timely and effective manner? Do governments have the infrastructure, resources, and technology needed to curtail the spread of disease? While focusing on health systems is important, this can often lead us to overlook what viruses reveal about the role, nature, and consequences of a country’s political environment. In a time of the coronavirus in the United States, politics is exacerbating a public health issue, making the virus much more deadly than what it should be.

Politics, in other words, can literally kill us.”

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