In a changed world, the agenda for public health remains much the same

The prospects for public health altered dramatically on the morning that journalist Mark Schoofs left his New York City apartment in search of coffee “and was greeted by the sight of a gaping hole in the World Trade Center.

“You are being graduated into a world that has changed,” the Wall Street Journal reporter told students from the School of Public Health at their May 26 Commencement ceremony at Battell Chapel. “Things are different. … Some of you may find yourselves organizing vaccination or treatment against the deliberate infliction of disease,” said Schoofs. “But I suspect that most of you will not work directly on terrorism. And, without belittling the war on terrorism, that is as it should be.”

In a single day, he said, malaria kills almost 3,000 people. Tuberculosis kills about 5,500 people, and aids another 8,000-a toll of more than 15,000 people daily. “That’s five World Trade Center attacks, ten towers collapsing, every day.”

For the 123 students graduating with degrees in public health, Schoofs said the terrorist threat should underscore the impact of politics on public health. “It was a political vision that led those 19 hijackers to mass murder. But it is also politics that condemns many thousands to die of preventable or treatable infectious diseases every year,” said Schoofs, a 1985 Yale College graduate who won a Pulitzer Prize for his coverage of AIDS in Africa in 2000. Parents still lose their children to infections that could have been prevented by inexpensive vaccines. African-Americans die at higher rates than whites and receive inferior care, even after accounting for differences in socioeconomic status. “That’s politics,” said Schoofs.

He rejected the argument that the terrorists were motivated by anger over poverty and injustice. They were not poor, and their attack was not a protest but rather “an act of pure destruction and obliteration.” To counter this, he said, public health graduates must “insist that every life matters … Partly this is sheer pragmatism-infectious diseases do not stay in marginalized groups, but leak out into the general public, and your job is to protect the public. But insisting that every life matters is also a profound political statement, perhaps the most profound statement you can make.” In doing so, he told the graduates, “you are putting forth a philosophy that is the exact opposite of callousness and nihilism.”

The Rev. Thomas Gariepy, the student speaker, also emphasized “the political determinants” of health. He said that while the diseases afflicting people may have changed little over time, the political forces that influence disease are unique to our era. “Social justice is born in political engagement,” said Gariepy, a Catholic priest who was among the graduates. “If public health is social justice, then for us, public health will be political engagement.”