How Can Public Health Measures Prevent the Next Pandemic?

Physician, epidemiologist, educator, and author Sandro Galea spoke to Lawrentians today, discussing ways racism, marginalization, socioeconomic inequality left the world vulnerable to COVID-19 and the ensuring global health crisis. “I want to make a case for why public health matters to all of us [and] to change our conversations about health,” he stated.

Galea, author of “The Contagion Next Time,” explained that health is more than simply individual medical care – it requires us to invest in our communities in ways that prevent illnesses before they start. We must look beyond vaccines, he said, and focus on the economic, environmental, and political factors to prepare for future health emergencies.

Early in his career, Galea practiced medicine in a number of countries, including Somalia, where he was the only doctor for roughly 350,000 people. While he was saving lives on a daily basis, he was frustrated because he knew that once he left, none of the root causes of many illnesses would be addressed. “I was doing nothing for the long term,” he said. “I knew there must be a better way.”

Inspired to create that lasting change, he returned to school to study public health. Medicine, he said, is about treating the individual. Public health, he explained, is concerned with all of the factors that lead to the condition. Those elements begin with individual health, but fan out to include pathophysiologic pathways, genetic/constitutional factors, individual risk factors, social relationships, living conditions, neighborhoods and communities, institutions, and lastly social and economic policies.  “Our health is product of our experiences throughout our life and at multiple levels of influence,” he said.

He told the story of American Blues singer “Blind” Willie Johnson, born in Texas 1897. Johnson lost his eyesight as a child in a domestic violence incident. As an adult, the home he where he resided with his wife was lost to fire, but they were so impoverished, the family continued to live in the burned out building shell. In the 1940s, he contracted malaria, was refused treatment at a local hospital because he was Black, and died.

“What killed Willie Johnson?” Galea asked. Most obviously, malaria … but if he had received treatment, he would have lived. We must also look at the causes that accumulated over his lifetime, Galea said, including homelessness, poverty, racism, disability, domestic violence – that led to his denial of lifesaving treatment.

The current COVID-19 pandemic has shown us that public health continues to be under-resourced, according to Galea. We must work to improve the most fundamental drivers of health: education, structural racism, nutrition, opportunities for recreation, poverty, unstable housing, isolation, and the environment. “Unless we pay attention to these forces, our health will suffer,” he said. “All of these forces have made us sicker than we need to be and created the conflagration that is COVID.”

Galea is heartened by the conversations he hears among young people about the importance of combating racism, saving the environment, and other public health influencers.

“I do think things will get better,” he told Lawrentians. “[Your generation] will be at the vanguard of a better, healthier world. You all get this – previous generations have not. Thank you for being that next step. We, the people, can do quite a lot.”

Galea is the dean and Robert A. Knox Professor at Boston University School of Public Health. He previously held academic and leadership positions at Columbia University, the University of Michigan, and the New York Academy of Medicine. He has published extensively in both public media and peer-reviewed literature about the social causes of health, mental health, and the consequences of trauma. Galea is past chair of the board of the Association of Schools and Programs of Public Health and past president of the Society for Epidemiologic Research and of the Interdisciplinary Association for Population Health Science. He is an elected member of the National Academy of Medicine. Galea has received several lifetime achievement awards. He holds a medical degree from the University of Toronto, graduate degrees from Harvard University and Columbia University, and an honorary doctorate from the University of Glasgow.

For additional information, please contact Lisa M. Gillard Hanson, director of Public Relations, at lgillard@lawrenceville.org.