When Jeanne Calment was 90 years old she sold her apartment to a lawyer named Andre-Francois Raffray on a contingency contract. The deal was that he would pay her 2,500 francs a month (about $400) until her death, whereupon the apartment would become his. This would have been a nice arrangement for Raffray, were it not for the fact that Calment lived for another 32 years, to the age of 122—the longest human life on record.
What Amazon's Move Teaches Us About Health | Fortune
At last, Amazon made its decision. After a yearlong search, in which dozens of US cities competed to host Amazon’s second headquarters, the company announced it will build new locations in New York City and Arlington, Virginia. In a statement about the move, Amazon founder and CEO Jeff Bezos said, “These two locations will allow us to attract world-class talent that will help us to continue inventing for customers for years to come…we look forward to becoming an even bigger part of these communities.”
The search took as long as it did, in part, because of the complex political and economic maneuvering necessary to close a deal of this size, and there have been plenty of cynical motives attributed to Amazon’s search for new homes. But there is something more fundamental at play here than just tax breaks and land values.
On Urban Health, and the State of the Science | Dean's Note
Urbanization is one of the two most important global demographic shifts over the past 200 years, with the other being the aging of populations. The demographic evidence for urbanization is unquestionable, and well described in an accompanying Viewpoint that appears in this SPH This Week. As urbanization accelerated, the field of urban health emerged around the turn of the 21st century, concerned with understanding how, and why, cities influence health. An appreciation of the role that cities can play in shaping the health of populations is an extension of a growing scholarship around the role of context as an inextricable determinant of the health of populations, the subject of one of my previous Dean’s Notes. In many respects, that cities influence health is intuitive. Cities influence the food we eat, the water we drink, and the air we breathe. Urban living can affect everything from available food to walkability to the spread of infectious diseases. Early writing in the field was focused on challenges to the health of populations in cities, including the coining of the term “urban health penalty.” However, as the field has matured, it has become readily apparent that the relationship between urban environments and health is complex, and that a range of determinants of health, both positive and negative, characterizes the urban experience. In the past decades, an equally apparent “urban health advantage” has emerged where, particularly in high-income countries, overall health in urban areas surpasses that of non-urban areas.
The Public's Health: Should Black Boxes Be Welcome in Medicine? | Public Health Post
It has become an article of faith that technology will improve the practice of medicine in coming decades. Medicine enthusiastically embraces novel technical approaches that may improve patient care. But what if those technical approaches bring greater scrutiny to clinical work? What if they may cast a harsh light on work that medicine typically does behind closed doors?
Such questions emerge as efforts grow to introduce “black boxes” to surgery.
When an airplane goes down, there is an urgent search for the plane’s black box. The black box contains both the audio recording of all cockpit discussion as well as a recording of flight instrument readings. These two flight recorders are required by international regulation and together offer the best possibility of learning what happened in the minutes preceding any aviation accident or incident.
Even at university, speech can never be entirely free | Times Higher Education
News that the Australian government has launched a review of free speech on campus is another reminder of just how fraught the question of who gets to speak at universities has become.
In recent years, we have seen a series of high-profile cases where the presence, absence or “no platforming” of speakers has led to deep dissatisfaction with universities in the anglophone world.
Our capacity to participate in an exchange of ideas is at the core of what we do as institutions. But while it is easy to apply blanket support to the idea of “academic free speech”, it is amply clear that, even in the academy, speech is never without limit
Hate and the Health of Populations | Milbank Quarterly
During 5 days in October 2018, 3 acts of terror starkly reminded the country once again of the pernicious consequences of hate. Between October 22 and 26, Cesar Sayoc, a supporter of President Trump, is reported to have mailed at least 14 improvised explosive devices to critics of Trump, including 2 former US presidents, current and former Democratic party legislators, and career government professionals who held leadership posts during previous administrations. On October 23, Gregory Bush attempted to enter the predominantly African American First Baptist Church of Jeffersontown, Kentucky, and, failing to gain access, killed 2 African Americans in a nearby Kroger supermarket. Most horrific of all, on October 27, Robert Bowers, entered the Tree of Life Synagogue in Pittsburgh, Pennsylvania, armed with an AR-15 assault rifle and killed 11 congregants and wounded 2 others.
Each of these incidents of terror appears to have been motivated by hatred, on the perpetrators’ part, of groups that were different from them. Sayoc mailed personally packaged explosive devices to individuals perceived to be enemies of the president, his inspirational figure. Bush’s shooting victims were African Americans. Bowers trained his weapons on persons of Jewish faith as they worshiped. All 3 incidents represent targeted efforts to kill those who were other than the perpetrators themselves. All three occurred in the context of a multiyear rise in hate crimes, particularly featuring incidents directed against Jews, Muslims, and LGBT people, among others. The year 2017 witnessed the largest 1-year increase in anti-Semitic incidents since auditing began more than 40 years ago.
The 2018 Midterms Were a Step Towards a Healthier U.S. | Fortune
The past midterm elections were widely seen as being among the most consequential in our nation’s history. In the lead-up to the election, voices on both sides of America’s political divide characterized the result as potentially transformative. President Trump emphasized the country’s changing demographics, stoking fears of immigrants with pronouncements like, “If you don’t want America to be overrun by masses of illegal aliens and giant caravans, you better vote Republican.” Former President Obama, for his part, said the midterms “might be the most important election of our lifetimes,” and that nothing less than “the character of this country is on the ballot.”
Last week, the country spoke, and we saw what the tide of marching, organizing, debating, phone banking, tweeting, and door-knocking has led to: Republicans expanded their Senate majority, while Democrats gained control of the House of Representatives. Time will tell if this result proves truly transformative. History, however, has shown just how significant electoral change can be, when shifts in the balance of political power overlap with a societal demand for change. Such a convergence can make seemingly intractable problems give way, even after decades of gridlock.
Looking Back, with Gratitude | Dean's Note
This week, I joined other members of the SPH community at the annual meeting of the American Public Health Association. The meeting, held this year in San Diego, has long been an annual highlight. It is a chance to reconnect with friends and colleagues from across the country, to learn new approaches to our work, and to get a sense of where the field currently is—in terms of both its internal debates and priorities, and its place in the national conversation. This year’s meeting conveyed the sense that, in 2018, public health is flourishing. Rarely has our field been more engaged with the issues of consequence that shape our country and our world. From climate change, to socioeconomic inequality, to gun violence, to global health systems, public health is tackling the key challenges of the moment, and our school, through the work of our faculty, students, and staff, is actively engaged in all these areas. This was evident in the many contributions of our community at APHA to the work being done by our alumni, as exemplified by the outstanding graduates of our program, Aaron Cohen, Liz Cohen, and Sonja Tong, to whom we presented the Distinguished Alumni Award at our San Diego Think. Teach. Do. Reception. The latter was a lovely opportunity to reconnect our alumni with students, faculty, staff, alumni, and friends of the school, a vibrant reminder of the passion, diversity, and truly global reach of our school’s “extended family.”
When I consider our community, I am struck by a sense of gratitude. It is a rare privilege to get to work each day among such a committed, passionate group of people, who are doing so much to build a healthier world. Our strong showing at APHA comes near the end of a year in which our school continued to court excellence in its pursuit of health. I would like here to provide a snapshot of these efforts, to look back, and, in the spirit of next week’s holiday, to give thanks for all we have done together. I do so mindful that it is impossible to provide a snapshot without leaving much out of the frame. This note is meant to be just a sample of the year’s achievements—omissions are due to space limitations, not neglect. I wrote a similar reflection near the end of 2017. That note was organized around the activities of our students, faculty, and staff. I will likewise focus this Note on three categories, using as a guide our school’s motto of “Think. Teach. Do.” which covers our scholarship, pedagogy, and practice—all areas where we have much to be thankful for.
To begin with our scholarship—SPH did much this year to advance our understanding of the forces that shape health, through a robust and varied program of research. For example, a study led by SPH researchers found a link between state laws permitting denial of services to same-sex couples and mental distress in sexual minority adults. SPH researchers also contributed to a study which found that racial segregation may increase the disparity in gun homicide between black and white populations. And SPH researchers continue to lead work on the Black Women’s Health Study, the largest follow-up study of the health of African American women ever conducted. This year, we also reaffirmed our commitment to supporting a new generation of public health scholars. In the fall of 2018, we awarded support for six new pilot projects, including our Early Career Catalyst Awards, which support pilot projects from junior faculty members as they begin their independent research careers. Research projects included air pollution, hepatitis C, prostate cancer, and zoonoses in Bangladesh, among many others.
This year also saw our school maintain and deepen our commitment to innovation in teaching. Building on the success of our redesigned MPH, we last November launched our Executive Master of Public Health. This program is tailored for public health professionals with at least five years of relevant experience, to craft an educational journey that respects and augments their prior work. We have also continued to expand our educational offerings through Population Health Exchange (PHX), our digital platform for lifelong learning. And we convened our Teaching Public Health symposium in March, bringing together experts from across the country to discuss the future of public health education. Finally, October marked our school’s Council on Education for Public Health (CEPH) site visit, a milestone in the school’s ongoing accreditation process.
On the “do” front, 2018 provided many opportunities for SPH to express its commitment to advocacy and activism. Through our Activist Lab, students were able to receive advocacy training, which gave them the tools necessary to begin building a healthier community as soon as they arrived at SPH. Times have rarely been better suited for such work. As our unique political moment has created new openings for progressive change, our students have been well-positioned to take the lead on issues of consequence for health. Our participation in National Gun Violence Awareness Day and the March for Our Lives, for example, allowed us to engage with the pressing public health issue of gun safety reform. And our advocacy for keeping in place civil rights protections for transgender people in Massachusetts by voting “yes” on Question 3 in the midterm election showed our community’s willingness to engage with politics on behalf of health. That this campaign was successful, and “yes” on Question 3 won by an overwhelming margin, is yet another reason for gratitude, as we approach the year’s end.
Taken together, this snapshot portrays a school that is thriving, engaged, and committed to improving the social, economic, and environmental conditions that shape health. Just as public health stands poised to advance the cause of health in 2019, SPH is well-positioned to contribute to these efforts. And that is something to be grateful for indeed.
As we head to the Thanksgiving break, I hope our faculty and staff will join us on Monday, November 19, at noon in the Founder’s Room, for our 15th annual Thanksgiving Potluck Luncheon. If you wish to attend, please RSVP to Karen Smith, Mary Murphy-Phillips, or Joline Durant with your food or beverage contribution. I look forward to seeing many of you there. I will be baking cookies.
And to those I do not see between now and next week’s break—have a wonderful holiday. Thank you for all you do to make our school a special place.
I hope everyone has a terrific week. Until next week.
Warm regards,
Sandro
Acknowledgement: I am grateful to Eric DelGizzo for his contributions to this Dean’s Note.