POV: Biden’s Gun Control Executive Orders Are a Step in the Right Direction | BU Today

The recent mass shootings in Colorado and Georgia are tragic reminders of something we have long known: America has a gun problem. Each day, over 100 people in the United States are killed by guns, and over 230 are wounded. We face an average of 38,826 gun deaths each year, about two-thirds of which are suicides. These ongoing daily tragedies have formed a kind of white noise in the background of our national life. To our shame, we have become so accustomed to it, we sometimes forget it is there—until another horrific mass shooting breaks through and reminds us. Gun rights have become a grotesque parody of their original intent. The “well regulated Militia” specified in the Second Amendment has become the active shooter in the shopping mall, spa, or school, the toddler accidentally discharging her parent’s gun, the depressed individual turning a pistol on himself.

This problem has been prolonged and deepened by long-standing intransigence at the federal level. The success of the gun lobby has been a triumph of special interests over the will of the American people, the majority of whom favor common-sense gun laws. According to a 2019 Pew Research Center poll, 60 percent of Americans favor stricter gun laws, an increase from 52 percent in 2017.

In recent years, calls for action on guns have grown louder. The 2018 Parkland, Fla., shooting, in particular, catalyzed a new approach to the issue of gun violence, led by young people, notably reflected in the March for Our Lives.

The Price of Health Equity | JAMA

The core goal of individuals working in the population health enterprise should be to improve health for all. There are many formulations of this fundamental aspiration,1 but it is unlikely that there is much disagreement about this general notion among researchers and practitioners in medicine or in public health. Over the past few decades there has been a growing awareness of the health gaps between groups, often characterized as health disparities or health inequities across the axes of race and ethnicity, socioeconomic status, and sex among others.

Black US residents live shorter lives than their White counterparts, and they are sicker throughout life. The richest quintile of US residents can expect to live 1 decade or more longer than the poorest quintile.2 Despite improvements in health over the past several decades for the richest 20%, many measures of health have worsened for the poorest 80%.3 The focus on health inequities has grown and sharpened during the past year as issues of racial justice more broadly have risen in the public consciousness, triggered by the killing of George Floyd and the subsequent civil protests that followed—the largest such protests in US history.

Liberty and health? | The Healthiest Goldfish

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I was in New York City on September 11, 2001. I remember the event and its aftermath. I recall that the fear in the city was palpable. In the days after the attacks, I started to see this fear reflected at the national, political level, among lawmakers, and eventually in the laws they passed. The Patriot Act, passed with near-unanimous support in the Senate, emerged from this climate of fear.

There is much about the Patriot Act which has since been rethought. It has been seen as at best an overreach and at worst Constitutionally dubious, leading to no-fly lists and the discriminatory targeting of Muslims. Given how controversial it has become, it is important to remember how reasonable the Act seemed at the time it was passed, how, gripped as we were by fear, we were able to see its broad provisions for the pursuit of terrorists as a rational response to the threat we seemed to face.

Nearly two decades after September 11, 2001, March 2020 put us in a similar state of fear, with the emergence of a novel pathogen that would eventually reach a point where it would kill each day roughly as many Americans as 9/11 did. As the new coronavirus swept the world, the fear of it was amplified across a range of media. Headlines from that time reflect how quickly we came to see the virus as a threat:

“Experts worry about pandemic as coronavirus numbers increase: report,” in Fox News on February 3, 2020.

Read the full piece on The Healthiest Goldfish.

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.

Read the full piece on The Healthiest Goldfish.

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.

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