President’s Panel Examines Public Health in the Time of COVID-19
The current pandemic has taught us that the key to addressing such challenges in the future is communication and collaboration. That was the theme of “A Conversation on Public Health After COVID-19,” a webinar hosted on September 25 by Vassar College President Elizabeth H. Bradley featuring five noted public health experts, four of whom are Vassar alums.
Panelists were: David Allison ’85, Dean of the School of Public Health at Indiana University; Linda Fried, Dean of the Mailman School of Public Health at Columbia University; Leonard Friedland ’83, senior vice president and Director of Scientific Affairs and Public Health at GlaxoSmithKline; Ashika Mehta ’04, a practicing psychotherapist in Mumbai, India and President of the Board of Trustees of Apne Aap Women’s Collective, a nonprofit agency that works with women who are victims of human trafficking; and Micky Tripathi ’83, National Coordinator for Health Information Technology in the U.S. Office of Health and Human Services. President Bradley holds a PhD in health economics from Yale University, and her scholarly research has focused on the quality of hospital care and large-scale health systems in the United States and throughout the world.
Bradley opened the discussion by remarking that the COVID-19 pandemic had “laid bare many of the limitations of the local, regional, national, and global health architecture.” She asked each of the panelists for their assessments of the system and their suggestions for how that system could be strengthened to meet the next public health crisis.
Friedland, whose work has focused on the development of vaccines, said he had learned an important lesson about the delivery of preventive health care: “Vaccines don’t save lives; vaccinations save lives.” He said getting people to accept the efficacy of vaccinations “is not new, but the rise of social media echo chambers has amplified the issue.” And he added that more must be done to vaccinate those in poorer nations and people in lower economic strata in developed countries. “Currently, there are numerous cultural, social, and political factors that are preventing us from doing this,” Friedland said. “As a society, we must build trust to make vaccines a critical public health tool.”
Mehta, whose nonprofit agency is supporting those impacted by human trafficking, said about 40 percent of the victims are children. She said she believed the most significant factor contributing to mental health issues is childhood trauma. “There is also hardship for those in financial distress, who lack resources or grow up with parents who are alcoholics or drug abusers,” she said. “All of these events lead to anxiety and depression, and studies have shown that teaching coping strategies to young people helps them manage their anxieties.” Mehta said more should be done to establish relationships between mental health advocates and educators so that these techniques are taught in school.
Like Mehta, Allison is involved in combating an ongoing public health crisis, obesity. He said one challenge in addressing this crisis is convincing the public that it is a disease. “Nutrition education alone doesn’t work,” he said. “We need to think of it as a disease that deserves to be treated scientifically. We have surgeries and pharmaceuticals that work and we need to stop resisting their use.”
Allison responded to a question from a viewer of the webinar about the role of government subsidies of large agricultural firms in contributing to the obesity epidemic in the United States. “(The policy) reduced starvation and helped to feed the country by making more food less expensive,” he said, “but there may have been unintended consequences. The government, the food industry, even college cafeterias, struggle with this.”
Fried said the importance of public health policy has grown as science continues to find cures and prevention techniques for many diseases. “Public health is the science of prevention, keeping people from getting sick,” she said. “Science has shown us over the past century that prevention of disease is possible, and we didn’t used to know that.”
Fried cited an example of successful collaboration in addressing a public health crisis in New York City: the switch to electric or hybrid buses by the city transit system. This change was the result, she said, of community organizations in Harlem letting public officials know that the fumes from gasoline or diel-powered buses were affecting those with asthma. “The collective action and collaboration between scientists and activists led the city council and the mayor to make the decision to switch to these buses,” she said.
Tripathi said he believed a major challenge in addressing health crises is the fragmentation of the system itself. “We don’t really have a public health system,” he said. “What we have is hundreds or thousands of jurisdictional agencies and local and state health departments connected by thin strands of 1970s and 1980s technology.”
Tripathi said the federal government has taken steps to streamline the system but added that more must be done. “Over the last 11 years, $40 billion has been spent creating an electronic records system, and now 90 percent of our physicians and 95 percent of our hospitals have it, but we haven’t made corresponding investments in public health,” he said. “We have a fire hose of public data but the public health system isn’t getting it.”
In summing up, Bradley said it was clear that the COVID-19 pandemic had raised public awareness about the flaws in national and global health care systems. “There is a collective recognition of the continuing struggles we’ve faced over the last 18 months, and that has brought unprecedented attention to the field of public health,” she said. “We are at an important juncture where our thinking could shift to the idea of collective action, of working together on multiple levels to focus on these issues.”
Bradley remarked that the importance of cooperation and collaboration is certainly not a novel idea: “It was Leonardo DaVinci who said, ‘Everything connects to everything else.’”