“Just because we can doesn’t mean we should” | The Healthiest Goldfish

On the virtue of exercising restraint, towards better advancing the long-term goals of public health.

I have long argued for a muscular public health. We should be proactive in using the levers at our disposal to shape a healthier world. This includes shaping public policy, working within institutions to reorient priorities towards health, and maintaining clear communications with the public. A muscular public health is one which engages, out of necessity, with power, using it to generate outcomes that we believe support a healthier world. Much of public health’s successes have happened because of such engagement. There is less smoking in the US, roads are less hazardous, regulations have been put in place creating safer neighborhoods and workplaces because reformers, including many in public health, acted, because they were not shy about making choices in the context of a given historical moment which advanced a healthier present and future. Insofar as action serves such a vision, it is to be embraced.

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Health equity: Your health outlook depends on where you live - but the private sector could change that | World Economic Forum

In many ways, the world is healthier than ever before. The rate of extreme poverty is falling, standards of living are rising and overall life expectancy has significantly improved. This progress is not the full story, however. Health inequities — gaps between the health of different groups — have long characterized global health. The persistence of these inequities reflects an urgent need to close the health gaps that threaten our progress on health.

It is impossible to build a healthier future without addressing the gaps that hold us back. We believe that with the right strategies, partnerships and resources, it is possible to achieve zero health gaps. By this, we mean a world where no one is excluded from living a long, healthy life, where all have the opportunity to flourish and thrive and where no one by the lottery of their place of birth is consigned to living a less healthy life.

Read the full piece by Sandro Galea and Bechara Choucair here

Reimagining immigration with public health as a guide | The Hill

Last Sunday, President Biden made his first visit to the U.S.-Mexico border since assuming the presidency. It is good to see the Biden Ever since the U.S. became a destination for immigrants, migration has shaped our culture and politics, as Americans have balanced competing impulses. On one hand, we are the land of “Give me your tired, your poor, /Your huddled masses yearning to breathe free.” On the other, we are the country of Benjamin Franklin arguing against German immigration, the country of “No Irish need apply,” and the country of “When Mexico sends its people, they’re not sending their best … They’re bringing drugs. They’re bringing crime. They’re rapists.” administration keeping attention on the issue of migration, which remains a critical part of the American demographic landscape. The U.S. has more immigrants than any other nation. Over 40 million people living in the U.S. were born beyond our shores. Each year, over 1 million immigrants arrive here.

Ever since the U.S. became a destination for immigrants, migration has shaped our culture and politics, as Americans have balanced competing impulses. On one hand, we are the land of “Give me your tired, your poor, /Your huddled masses yearning to breathe free.” On the other, we are the country of Benjamin Franklin arguing against German immigration, the country of “No Irish need apply,” and the country of “When Mexico sends its people, they’re not sending their best … They’re bringing drugs. They’re bringing crime. They’re rapists.” 

The tension between the instinct to welcome immigrants and the willingness to demonize them has kept migration a political flashpoint for most of American history.

Read the full piece on The Hill

Building a Healthier World in the New Year | Dean's Note

On advancing a vision of health in 2023.

As we return from the holiday intersession, a word of welcome to our community. I hope everyone had a relaxing, joyous time with family and friends. Over the past week it has been wonderful to reconnect with colleagues, to hear about travels, about books read over the break, dinner table conversations, and new ideas that emerged from holiday reflections.

We are now at the beginning of a new year. This has historically been a time for making resolutions, using the fresh start of the season to become the best possible versions of ourselves. The tradition of making resolutions began about 4,000 years ago with the ancient Babylonians, who also held the first recorded new year celebrations. During a festival, the Babylonians would promise their gods that they would pay their debts and return anything they had borrowed.

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Welcoming (back) complexity and contradiction in 2023 | The Healthiest Goldfish

To shape a healthier world, we need to resist Manichean narratives and engage with reality in all its messy nuance.

We have been living in divided times. It is hard to pinpoint exactly when this started, but a strong contender for that moment would have to be 2015, which, not coincidentally, was around the time of the rise to prominence of Donald Trump. Before then, the country had known divisions, our political system characterized by entrenched ideological positions, but we more or less felt we knew where we were collectively headed. Our future seemed to be one in which the push and pull of two different views of the country continually jostled for space, with one occasionally prevailing over the other. This jostling would sometimes result in constructive engagement, with both sides recognizing the complexity of issues. We in public health found ourselves working to promote ideas and policies that generate health, reaching whenever possible across partisan divides to achieve this goal. That the world and country were getting healthier was testament to our achievements. That there was so much we could do better, so many getting left behind, was testament to how much more we still had to do.
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Reimagining science communication in a time of change for social media | The Healthiest Goldfish

It is time to ask: are platforms like Twitter really the best places for conversations about issues of consequence for health?

13 years ago, as I was considering leadership positions in epidemiology, I thought it was important to find new ways of communicating about the science of public health. This led me to the still relatively new world of social media. At the time, social media seemed to hold much potential as a place for sharing the latest science, for making connections, and for helping engage with the public around issues of consequence for health. In the spirit of this engagement, I joined Twitter, Facebook, LinkedIn, and, later, Substack. I have used these platforms to communicate broadly, because I see translation as a core part of what we do in public health. I have long believed that a robust public conversation is central to generating the ideas that shape a healthier world.

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The Qatar World Cup and the commercial determinants of health | The Healthiest Goldfish

The events leading up to the Qatar World Cup showed the dark side of a beautiful game, but they also provide a window into the forces that shape health.

In recent weeks, I have been glued to my phone watching the World Cup, sometimes I must admit surreptitiously during Zoom meetings. In this, I have been far from alone. The World Cup is, in terms of audience, by a fair measure the world’s largest global sporting event. In 2018, over half the world’s population watched the competition. The World Cup is always exciting, both for the competition itself and for the human stories of its participants. The contenders include preening superstars (Ronaldo…) and young upstarts, national clubs that are well-oiled winning machines and scrappy underdogs looking to earn an upset for the ages. It will be a while before we forget Morocco shocking Spain this week, with the former world champions heading home while Morocco moves forward.

But the World Cup has other stories as well. The narrative leading up to this year’s competition includes much that is unprecedented. It is being held in winter in Qatar—the first time the World Cup has been in the Middle East—as to hold it in its traditional time of summer would be too hot for the players. Then there are the horrific stories about the lives of migrant workers lost due to the conditions many of them experienced in building the stadiums where the games are happening. During the lead-up to the World Cup, reports of this abuse as well as bribery and corruption of officials involved in bringing the games to Qatar, and the broader issue of human rights violations within the country, have complicated the joy soccer fans take in the World Cup. It has, rightly, prompted the question: should we really be holding games in a place where human rights are not respected?

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Reconsidering our School’s Engagement with Twitter | Dean's Note

Our commitment to a healthier world will continue to inform all of our communications, no matter where they take place.

It has long seemed to me that one of the core responsibilities of academic institutions is to aspire to always align what we do with our mission. This should include our way of communicating, both within our community and to the broader population. On this front, our aspiration is to advance a communications model that not only highlights the work of our community with efficiency and reach, but also exemplifies our values as a community.

With this in mind, having weighed the impact of a number of changes around the platform over the past several weeks, we will, as a School, be disengaging from our Twitter account @busph. Relatedly, I will also suspend my personal @sandrogalea account. Neither account will be deleted. While we may in future return to Twitter if the circumstances around the platform change, this seems the right thing to do at this point, for two key reasons.

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