Monkeypox: Old Disease, New Fears | Dean's Note

On stopping the spread of a disease without encouraging the spread of stigma.

In 1958, a pox-like disease was observed in colonies of monkeys that were being maintained for research purposes. In 1970, the first human case of the disease, which had been named “monkeypox,” was recorded. Since then, it has been recognized as a disease that is similar to smallpox but less severe and rarely fatal, at least for the strain of virus responsible for the current outbreak in non-endemic countries. Its symptoms include fever, headache, muscle aches, and a rash. It spreads through close, skin-to-skin contact, through touching objects or surfaces touched by someone with the disease, or by touching respiratory secretions of someone with monkeypox. The presence of monkeypox DNA in seminal fluid suggests that sexual transmission may also occur. The multiple routes of transmission mean that anyone can get monkeypox. At this moment, in the current outbreak, it is a particular risk for men who have sex with men, with 98 percent of current cases occurring among this group. Monkeypox had been primarily reported among populations in central and western Africa until the current outbreak, which has seen the virus spread globally. More on monkeypox can be found in this helpful explainer from The New York Times.

Read the full piece here.

Can we love a country even when it falls short? | The Healthiest Goldfish

Reflections on the Fourth of July at a time of challenge for America.

This is a difficult time in America. From mass shootings, to the fall of Roe v. Wade, to the persistent denial of the need to do something about clear injustices like racism and homophobia, our country’s faults are on full display. These faults make it easy to feel like America is disappointing, failing. This creates challenges for our observance of Independence Day, which is supposed to be a celebration of this country. How, we may ask, can we celebrate something that has fallen so short? Is the Fourth of July just empty jingoism? How can we embrace fireworks and parties with so much going wrong with the object of these festivities? This essay is an attempt to organize my thoughts about these difficult questions. It is a personal reflection on all that is wrong with the country in the present moment, and an effort to balance these wrongs with what has been, and may still be, right with it. I realize that even suggesting America may have positive qualities may strike some as inappropriate in the current context. Yet creating a better world means keeping sight of the good wherever it is to be found, towards the goal of maximizing its influence. We cannot do this if we do not make an effort to look for it. This is my attempt to do so.

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Reckoning with the End of Roe | Dean's Note

It is now up to us to engage and to redouble our efforts towards supporting the laws and policies that create a healthier world.

Today, the Supreme Court issued its decision to overturn Roe v. Wade and end constitutionally protected abortion access in the US. This reflects a major shift on this issue, as choices about the legality and accessibility of abortion now fall to the states. The implications of this change are catastrophic. For the first time in decades, abortion access will not be protected in a majority of states.

In May, when a draft of the Court’s opinion leaked, I wrote about the need to center reproductive health and abortion access in the public health agenda. In early June, we came together as a school community to discuss abortion access and the future of reproductive health in the US, in the context of the decision we knew was likely coming. We now face the reality of a changed world. It is important to restate that abortion care is health care, and lack of federally protected abortion access has deep, intolerable, and unjust ramifications for health. The task of public health is to address this new reality in pursuit of our broader mission to improve the health of populations with special care for the marginalized and vulnerable.

Read the full piece here.

On Juneteenth, a reflection on the historical legacy of slavery | The Healthiest Goldfish

We cannot build a healthier world without addressing the legacy of slavery.

On June 19, 1865, federal troops arrived in Galveston, Texas. Two months earlier, Robert E. Lee had surrendered his forces at Appomattox Court House, effectively ending the American Civil War. More than two years before that, President Abraham Lincoln had signed the Emancipation Proclamation, freeing enslaved populations in states where the Confederate rebellion had been present. Yet these developments had not much affected the practice of slavery in Texas, which had continued until Union General Gordon Granger entered the state and read General Order No. 3, which said, “The people of Texas are informed that, in accordance with a proclamation from the Executive of the United States, all slaves are free.” This prompted celebrations among the newly freed population and marked the end of the enslavement of Black Americans in the US.

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The killing we continue to fail to stop | The Healthiest Goldfish

We know how to fix the problem of gun violence, so why haven’t we acted on it?

On May 24, a gunman walked into Robb Elementary School in Uvalde, Tex., and killed 19 children and 2 teachers. It was the third deadliest school shooting in US history. It recalls the shooting 10 years ago, when 20 students and 6 adults were killed by a gunman at Sandy Hook Elementary School. More recently, at a high school in Parkland, Fla, a shooter killed 17 people. While these are the most visible school shootings over the past decade, 27 other school shootings have taken place this year alone and over 200 mass shootings—defined as when 4 or more people are shot or killed—have happened this year as well. There were 693 mass shootings in 2021. Horrifically, two weeks ago we saw guns used in a racially motivated massacre in Buffalo, N.Y., where 13 people were shot and 10 killed, with 11 of the victims Black. The list could, and does, go on. 

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Marking Two Years Since the Murder of George Floyd | SPH Today

Today marks the two-year anniversary of the murder of George Floyd at the hands of a white police officer in Minneapolis, Minnesota. It has been two years since we were reminded, brutally, of the persistence of racism in our society, and of the threat it poses to the health of Black communities—to the health of our nation. In a tragic confluence of events, this anniversary falls just weeks after a racially motivated shooting in Buffalo, NY, in which racism once again led to violence and the murder of Black Americans. In this context, the anniversary of Floyd’s murder takes on increased urgency as a call to reengage with the challenge of ending racism, to build a healthier world.

George Floyd’s murder was fundamentally a tragedy—for Floyd, for his family and community, for the country and the world. It sparked a national reckoning with racism and police brutality. It shaped how we talk about these issues and the moral urgency we bring to this conversation. This conversation remains vital, ongoing, a living testament to a life horrifically cut short.

For many, this conversation was new, unfamiliar, perhaps uncomfortable. For those of us in public health it was an overdue profile-raising of truths we have long known, that should always have been central to our thinking. We have long known that racism undermines the health of those who face it, that racism keeps us all from being fully healthy as a society. This was particularly clear during COVID-19, a global tragedy with which Floyd’s death intersected. As the pandemic unfolded, Black Americans were three times as likely to sicken and twice as likely to die from the disease than white Americans. This vulnerability to disease long predated the pandemic and has been reflected by a range of Black-white health gaps, in which communities of color have long borne poorer health. The roots of these health gaps run deep, stemming from a history of racism that is inextricable from our country’s legacy of slavery. George Floyd’s murder, and the Black-white health gaps made unignorable by COVID-19, were a stark reminder, if we needed one, that we cannot address poor health in the present without addressing this history.

In the years since George Floyd’s murder, our school has worked to build on our longstanding engagement with the link between racism and health. We have welcomed lawmakers to our community to discuss antiracism as health policy, our scholars have engaged with the BU Center for Antiracist Research to continue this conversation, and our students, faculty, staff, and alumni work each day to shape a world free of racism and the poor health it creates. This focus is consistent with our community’s commitment to Diversity, Equity, Inclusion, and Justice, a commitment which shapes all we do, on a long journey to do better by our community, inhabiting our responsibility to create an anti-racist world.

The trauma of George Floyd’s murder remains raw, reflecting a broken status quo we have not yet fully addressed. We cannot bring George Floyd back, but we can work to ensure that his memory will forever be linked to a better future to which we should all aspire. Thank you to all who are engaging in this work, today and every day.

Warm regards,

Sandro

Sandro Galea, MD, DrPH
Dean, Robert A Knox Professor

On centering reproductive health and access in the public health agenda | The Healthiest Goldfish

A few days ago, Politico obtained a draft majority opinion written by Supreme Court Justice Samuel Alito. If the draft becomes the Court’s final opinion, it will end the constitutional protection of abortion access, first established by the 1973 decision, Roe v. Wade. If that happens, decisions about abortion access will fall to the states. Even recognizing that this leak is not yet the settled opinion of the Court, the news is heartbreaking. This leak suggests there could soon be a seismic shift around this issue, as federally protected abortion access—a fact of life in this country for nearly 50 years—reverts to a status quo not seen since before many Americans were born. The implications of this decision are enormous. 19 states will effectively ban abortion, immediately affecting access for more than 40 million women, and abortion rights will no longer be protected in a majority of states.

Read the full article here