deans note

Looking Ahead, with Hope

As new students join us, thoughts on a new beginning, in unprecedented times.

One of the enduring highlights of working at a school is the regular return of the academic seasons, and, with it, the chance to welcome our community back for a new semester, and to welcome the students who are joining us for the first time this spring. This year, the joy of welcome is tinged with sadness. Last week, the number of COVID-19 deaths in the US exceeded 400,000, a toll of sorrow which adds to the overall weight of sickness and death this disease has brought to the world. Yet even, perhaps especially, in the midst of challenge, we are grateful to be connected, and to pursue the goal of a healthier world. So, welcome to all, and, especially, to our newest students.

We begin our Spring semester at a moment of transition. The inauguration of President Joe Biden and Vice President Kamala Harris represents a political sea change, and, with Vice President Harris and the many firsts her rise reflects, a win for representation in government. Concurrent with this transition, we have also seen a potential turning of the tide in this pandemic. Sadly, ending COVID-19 cannot be accomplished as quickly as a presidential transition. However, the emergence of vaccines, and the new administration’s commitment to their effective distribution, represents what we will hopefully soon be able to say was the beginning of the end of this crisis. So, while the hour remains difficult, we have finally reached a point where we can see the dawn of a better day for health. 

This day comes not a moment too soon. Surveying the state of American health, it is clear we face fundamental challenges. In many respects, COVID-19, for all the damage it has done, reflects just the tip of the iceberg when it comes to our poor health. The pandemic has laid bare the underlying structural inequities which have long threatened health in this country. These include racial injustice, economic inequality, the marginalization of older adults, and disinvestment in the public infrastructure that sustains health and wellbeing in the US. This is on top of the many other challenges to health we face, including gun violence, climate change, a fraying social safety net, and an approach to health which prioritizes the curative power of medicine over the preventative potential of engaging with the social, economic, environmental, and political drivers of health.

But these challenges should not obscure the progress we have made, and how this is in many ways the healthiest time to be alive, both in the US and globally. The 20^th and 21^st centuries brought declines in worldwide poverty, maternal mortality, and violence. Recent years have seen global efforts to address climate change. In the US, the conversation around health has shifted in a hopeful direction. While we still overwhelmingly equate health with medicine, our health conversation has started to include a reckoning with the systemic drivers of poor health. We have started to talk about how racism and fundamental injustice lies at the heart of so much of our poor health. It has become more common to hear gun violence and climate change discussed as public health issues. Certainly, there was much about the national conversation during the Trump years that was hostile and counterproductive to the cooperation and mutual respect that sustains health. But there was also a moral clarity around the issues that matter to health which has been broadly encouraging, and positions us to do right by health in this new political era.

Our school community has a key role to play in advancing health at this historic moment. We have a chance to build on the progress we have made, address the challenges COVID-19 has made so clear, and lay the groundwork for a healthier future. Throughout the pandemic, our school community has worked to support health at the local, national, and global level. Through our advocacy, events, and engagement with the public debate, we have helped the world navigate this moment, and are primed to keep doing so in 2021. This year is the 45^th anniversary of our school. To mark this anniversary, we have chosen to elevate the theme, “Public health. Now is the time.” The COVID-19 pandemic has made abundantly clear just how true this is. Now is the time for our community and our field to engage with the foundational forces that shape health, to build a better world. With this goal in mind, we have as a school planned a range of events and initiatives, from our upcoming Public Health Conversation, “Hopes for Health in the Biden Administration,” to launching The Turning Point, a series of weekly reflections in Public Health Post on how we can support health at this transitional moment. Each month we will highlight a different academic department, center, or strategic research direction to showcase the work of our students, faculty, staff, and alumni across our areas of excellence. All of this is to advance an engagement with the issues core to health, at a time when such engagement is poised—perhaps like never before—to advance health at the structural level.       

A word to our incoming class. You are joining public health at a time of challenge and opportunity. The difficulties we face are significant, and well-defined. In recent years, public health has done much to change the conversation around these issues and articulate solutions. Now there is the potential to follow these words up with action in the policy space, at the national and global level. Thank you for your willingness to be part of this work.

During the pandemic, there was much talk of “the new normal.” Quarantines, physical distancing, the use of Zoom, disruptions to our professional and personal lives were all categorized as part of this new normal. At this transitional moment, we now have an opportunity to focus on “the next normal.” Where the pandemic dictated what the last normal looked like, the next normal is wide open—it is whatever we choose to make it. We have a chance to make it the start of a healthier world, where we have learned the lessons of past challenges and applied them to improving the structures that underlie health.

This means engaging with the complex issues that shape these structures. As with any engagement with complexity, there will be times when we do not agree on what route to take. Even as we consider the same data, the application of our knowledge is a process shaped by rigorous debate and an open airing of different perspectives, such as the conversation which has unfolded over our school’s decision to embrace a hybrid learning model this academic year. Such conversations are not incidental to the process of creating a healthier world, they are core to it. And this is all to the good. So, it is with hope for the future that we start our spring semester. It is, as always, a privilege to be part of this community, as we pursue a healthier world together.

I hope everyone has a terrific week.

Warm regards,

Sandro

Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Twitter: @sandrogalea

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

Previous Dean’s Notes are archived at: http://www.bu.edu/sph/tag/deans-note/