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The first of four installments of the Dean’s Speaker Series for 2020-2021 for the Colorado School of Public Health kicked off with a nod to the importance of the past, a glance at the future and an eye on the challenges of the present.

The biggest of those challenges, COVID-19, has demanded social distancing. That pushed the talk, hosted by Dean Jonathan Samet, out of a lecture hall and onto Zoom and Facebook. Another first: The presentation was the inaugural Richard Hamman Lecture, named in honor of the school’s founding dean and endowed through a gift by Samet.

The guest speaker was Dr. Alfred Sommer, Johns Hopkins Dean Emeritus, a distinguished public health expert and innovator who was dean of the Johns Hopkins Bloomberg School of Public Health from 1990-2005. His lecture title, “The Public’s Health: Past, Present and Future?” resonated on multiple levels.

Sommer has ties to both the founding and current dean of ColoradoSPH. Samet was chair of the Department of Epidemiology in the Bloomberg School of Public Health during a large portion of the years Sommer served as dean; Hamman received his Doctor of Public Health degree in Epidemiology from Hopkins.

Sommer has a long list of accomplishments in the field of public health, most notably years of research that demonstrated the link between vitamin A deficiency and childhood mortality. Samet said it is important that those whose careers in public health lie ahead hear from those, like Sommer, who have blazed trails before them.

“Since I came to the school [in 2017], I’ve been interested in having public health leaders visit and give talks that would reach to all,” Samet said. “The school needs to bring individuals like [Dr. Sommer] so faculty, staff and students can learn from them. I also think it’s good for those leaders to learn about our school.”

Samet said he sees the endowed lecture “as part of a tradition of excellence” that the school continues to build. He’s glad to make a contribution to that end.

“I’ve always given back to the institutions where I’ve been and looked for ways that I could make a difference by providing a modest amount of funds,” Samet said. “It’s good to make a lasting contribution to the story of the school.”

Hamman was instrumental in writing that story. Speaking before Sommer’s lecture, he noted that the collaborative agreement between the University of Colorado, Colorado State University, and the University of Northern Colorado that established ColoradoSPH was finalized in August 2007. He was named founding dean in December of that year before the school officially opened in July 2008. But that capped many years of groundwork to address “a crisis in the public health workforce” created by aging, limited training, and a lack of financing, Hamman said.

He and others addressed the crisis by pooling the respective individual strengths of CSU (veterinary medicine, agriculture and environmental studies, foodborne illness), UNC (community health education), and CU (epidemiology) to create the first – and still only – collaborative school of public health, Hamman said.

The inaugural class of 150 students in 2008 grew to 226 in 2009 and nearly tripled to 606 in 2019, Hamman said. This year the school has so far matriculated 370 students, up about 100 over the same period last year, impressive in the face of an anticipated state budget crisis, he added.

ColoradoSPH has expanded the ranks of public health workers society needs so badly, Hamman said. He noted that a high percentage of Master of Public Health, PhD, and Doctor of Public Health grads find employment by six months after graduation. They fill a variety of leadership positions and have helped to “make a big dent in the staffing problem we had in Colorado and regionally,” he added.

Hamman’s work made him the right choice for the named lecture, Samet said. “He got the school started and I thought that should be acknowledged,” he said. “I’m grateful to those who came before me. I can’t imagine the agonies of hammering out a three-school agreement. Frankly, Dick was the obvious first choice.”

“The Public’s Health: Past, Present and Future?”
Sommer’s presentation underscored the importance of public health in improving life around the world while sharply criticizing the resistance of some to its most basic tenets.

He noted, for example, that only a little more than 100 years ago, about half of people in England and Wales died before the age of five. By 1966, the median age of death there was the mid-70s. He attributed the jump in life expectancy to improvements in public health: better nourishment, better clothing, less crowding, and changes in child labor laws. The same factors help to explain plunging death rates per 100,000 people from tuberculosis and measles in the United States between 1900 and 1960, Sommer said.

He noted these improvements occurred well before the more recent and well-chronicled enthusiasm for research into the role of the genome and epigenome in disease. Sommer said he felt compelled to make the case for “the envirome” – the role of social conditions and behavior – in affecting health.

“The global pandemic is occurring today without anybody having changed the genomic structure,” Sommer said. “Coronary artery disease, asthma, diabetes and COVID-19 have to do with what we do to ourselves, what we do to the environment and what the environment does to us. It has nothing to do with the genome or the epigenome.”

As one of a series of examples he used to support his case, Sommer showed the explosive growth after 1991 in the number of states where 15 percent or more of the population is obese. As the years progressed, more and more states met and exceeded that figure. Now all states are above 20 percent.

“If that doesn’t look like an epidemic to you, I don’t know what an epidemic looks like,” Sommer said. He blamed it on behavioral choices and insidious societal changes like super-sizing meals, larding menus with high-calorie fare, and pricing carbonated drinks far more cheaply than fruits and vegetables.

Sommer noted that public health policies can positively address behavioral issues. He pointed to then-mayor of New York Michael Bloomberg’s anti-tobacco campaign, which significantly reduced smoking rates, thereby surely saving lives. That effort, more broadly supported by smoking bans on public transportation and in restaurants, has helped to make smoking far less accepted than it once was, Sommer said, but he emphasized that such success requires organized effort.

“Behavioral change that is not baked into systems change is hard,” he noted.

Present: COVID-19
Observing the greatest challenge of today, COVID-19, and looking to the future, Sommer rendered a blunt and harsh judgment.

“We were not up to the task of containing it,” he said. “We knew it was coming and should have been totally prepared with a playbook. Instead, we were making it up as we went along.” The cost of the haphazard response: more than 200,000 lives and counting in the United States alone.

The battle against COVID-19 requires that people observe basic steps – handwashing, social distancing, face coverings, and so on – yet “nobody can learn the basic lessons about infectious disease,” Sommer added. Now lamentably familiar scenes of people jammed together without masks at parties and rallies prove his point.

Sommer concluded with an observation that both Samet and Hamman found compelling. He urged people to think of public health not as a profession but as a goal “achieved by many professions,” including physicians, nurses, lawyers, economists, sociologists, and epidemiologists.

“We need input from many different peers,” Sommer said.

That point helps to sum up the importance of the lecture series, Hamman said.

“It’s easy to get siloed and just talk to your colleagues all the time,” he said. “It’s cross-fertilization between universities, countries, and individuals that keeps our minds open and helps us to think of new ways of doing things and understand new approaches to problems we’re trying to solve.”

Story by Tyler Smith for the Colorado School of Public Health.