Health and the opportunity to freely think | The Healthiest Goldfish

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I was never really supposed to be able to do what I do for a living. Where I grew up, the notion that one could find gainful employment by having ideas and working to develop them in the academic space was close to inconceivable. On the island of Malta, where I am from, during the time I lived there, there were really just three options for the intellectually ambitious: doctor, lawyer, or priest. I initially chose doctor, but, over the decades, this role evolved into a privileged position of being able to work in academic public health, where I get to help inform a conversation about how to build a healthier world. Had my teenaged self been able to see into the future and glimpse what I am doing now, he would have been quite surprised.

The longer I do this work, the more I am struck by how extraordinary it is that anyone gets to do it, let alone me. One is reminded of Maslow’s hierarchy of needs, with the basics of food and shelter at the bottom, and engagement with meaning and ideas located somewhere near the top. For much of human history, it has been all most people could do to satisfy foundational needs, to access the material resources necessary to keep body and soul together. That we now have a society which supports the pursuit of ideas as a viable career path is a rare and fairly recent achievement in the grand scheme of history.

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Welcome to the Gun Show | The Turning Point

This month, with the terrible killings in Atlanta and Colorado, gun violence returned to the evening news. With in-person congregation mostly eliminated due to the pandemic, it seemed as if there were no shootings in 2020—in schools and public buildings and houses of worship—like those that have filled our television screens for decades. Yet in 2020, with much of the population staying at home, the number of mass shootings (at least four victims wounded) exceeded the year-end totals of the previous five years. With 20,000 dead from guns, Covid-19 did not slow the gun violence trend of the past decade. In frequency, fatalities, and injuries, gun violence during this past year has been hideous.

Indeed, 2020 was the highest gun sales year ever. There were two million guns sold in March 2020 alone, the second busiest month in history, the same month that Covid-19 rates first rose. First-time buyers drove this burst. Americans feared crime waves, police depletion, government repression, and sales persisted throughout the year. Americans stockpiled military weapons and high-volume gun clips. The background check system foundered under record-breaking business. The recorded numbers included only known gun sales; sales of unregistered guns, those bought at gun fairs, and online “ghost guns” assembled by the purchaser, are not tracked.

Who’s left? | The Healthiest Goldfish

In his inaugural address, President Joe Biden used the word “unity” eight times. Unity has been a consistent theme with him since the days of his presidential campaign, when he frequently spoke of his intent to bring Americans together. Politicians often tout the virtues of unity, but Biden’s message took on special resonance during the Trump years. The former president’s willingness to lean into divisiveness as a political strategy—even, it sometimes seemed, as a form of recreation—made Biden’s call for unity a marked, and ultimately winning, contrast to Trump.

As compelling as the idea of unity is, however, the reality of political division is hard to escape. Division has been a constant in our politics since the country’s earliest days. Accepting, then, that there will always be many sides to the American story, the question becomes: which side is public health on? We aspire to improve health by shoring up the socioeconomic foundations of our country and world. At the policy level, this means a stronger social safety net, regulation of harmful influences like guns, and laws which help redress historic injustice. At present, such policies tend to overlap with the goals of the political left. There are times, of course, when such goals are embraced by the right—as, for example, with the Trump administration’s work on criminal justice reform. And there are legitimate conservative approaches to the issues public health tackles. But, broadly speaking, public health is aligned with the left, and there is no sense dancing around this.

The Responsibilities of Experts | The Turning Point

The Covid-19 moment has created a seemingly bottomless demand for public health experts. Epidemiologists have been on prime-time for a year, and all manner of public health experts have appeared on broadcast television. That the media has called on expertise to help explain the moment is a good thing. But this has also put in the spotlight many who have not previously been in the spotlight. And being an expert with a public platform comes with special responsibilities.

Take the parade of experts predicting numbers of people who will be infected with Covid. Throughout 2020 we saw experts suggesting that the final Covid death tallies would be 200,000, or 2 million. All of these experts had reason to suggest what they were suggesting. But all fundamentally knew that their estimates were based on a range of assumptions that would likely not stand the test of time. And the vast majority did not. These predictions served to spread fevered worry and seed mistrust in the scientific enterprise. After all, if we cannot predict the extent of the outbreak correctly, what else might we not know?

Introduction: Politics, Policies, Laws, and Health in a Time of COVID-19 | COVID-19 Policy Playbook II

Has there ever been a more important time to consider how politics, policies, and laws influence health? We are, as a country, in the midst of unprecedented turmoil, all of which has implications for our health. The COVID-19 pandemic is the most obvious clear and present danger, killing more than 500,000 Americans as of this writing, infecting more than 28 million others. Our efforts to mitigate the spread of COVID-19 have resulted in an economic slowdown unparalleled in many aspects for nearly a hundred years. More people have been unemployed than at any time since World War II. More than 26 million Americans, nearly 16% of the entire US workforce, have been either unemployed, otherwise prevented from working, or working for reduced pay during the pandemic. And both these sets of consequences have been experienced inequitably. People of color, particularly Black Americans, have experienced greater rates of, and death from COVID-19, than white Americans. Meanwhile, unemployment has been both deeper, and slower to recover, among the same minority groups who are already bearing the brunt of the COVID-19 pandemic. It is then little wonder that 2020 also saw protests about racial inequity that were probably the largest civil protests ever in American history.

Vaccines can give older adults their lives back – we should let them | Toronto Star

As a Canadian working in American public health, I have long been troubled by a rise in anti-vaccine attitudes. In recent years, we have seen the views of those who doubt the safety and efficacy of vaccines gain traction in the public debate. This is especially concerning in this time of COVID-19, when vaccines have the potential to end the crisis for good.

And make no mistake: COVID vaccines are safe and effective, as the data have consistently shown.

We expect doubts about vaccines to come from people who are explicitly anti-vaccine, and they have. But in recent months, a new kind of vaccine skepticism has emerged. It has come from those who should know better, those who work in health and patient care, who understand the value of vaccines, but whose fear of the virus has kept them from acting on what they know. Out of an overabundance of caution, they would keep pandemic restrictions in place, even as vaccination becomes widespread.

This is why, in Canada, many nursing home residents remain under the strict lockdowns they have been enduring for a year, despite being among the first groups to be vaccinated.

Who’s left? | The Healthiest Goldfish

In his inaugural address, President Joe Biden used the word “unity” eight times. Unity has been a consistent theme with him since the days of his presidential campaign, when he frequently spoke of his intent to bring Americans together. Politicians often tout the virtues of unity, but Biden’s message took on special resonance during the Trump years. The former president’s willingness to lean into divisiveness as a political strategy—even, it sometimes seemed, as a form of recreation—made Biden’s call for unity a marked, and ultimately winning, contrast to Trump.

As compelling as the idea of unity is, however, the reality of political division is hard to escape. Division has been a constant in our politics since the country’s earliest days. Accepting, then, that there will always be many sides to the American story, the question becomes: which side is public health on? We aspire to improve health by shoring up the socioeconomic foundations of our country and world. At the policy level, this means a stronger social safety net, regulation of harmful influences like guns, and laws which help redress historic injustice. At present, such policies tend to overlap with the goals of the political left. There are times, of course, when such goals are embraced by the right—as, for example, with the Trump administration’s work on criminal justice reform. And there are legitimate conservative approaches to the issues public health tackles. But, broadly speaking, public health is aligned with the left, and there is no sense dancing around this.


The Long Shadow of Medical Racism | The Turning Point

In the first decades of the twentieth century, medical experts insisted that Blacks were not susceptible to polio, based on presumed biological differences between Blacks and whites that had, conversely, also been used to allege that Blacks were more vulnerable to syphilis.

There is of course no racial difference in susceptibility to polio, or to syphilis, or to most other medical conditions. There are substantial racial differences in how we treat and approach medical conditions, and an equally long history of grappling with bringing an equitable approach to treating these conditions.

President Roosevelt claimed he had overcome polio at Warm Springs’ polio rehabilitation center. During the 1936 presidential campaign, Roosevelt was confronted about the center’s all-white admission policy. Roosevelt, who enjoyed extraordinary support among Black voters, responded by announcing, in 1937, the formation of the National Foundation for Infantile Paralysis (later called, The March of Dimes), which soon became the nation’s largest disease philanthropy, and quickly announced “the disease attacked all races.”

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