Making a Difference in 2020Dec 16, 2019
Inevitably, the start of a new year is a time for assessment and reflection, looking back over what has happened in the year that is ending and what is to come in the next. This was my task in the “State of the School” address for 2019. As always, the accomplishments of faculty, staff and students were too numerous to repeat here, but my comments emphasized the collective success of the Colorado School of Public Health. At the 11-year mark, the school has responded to the needs that led to its founding; we have more than 2,000 alumni working in Colorado and beyond across the diverse sectors where people with public health training work to make a difference. Our research probes some of the most pressing public health problems—obesity and diabetes, the health of disadvantaged populations, the delivery of health care services, the prevention of disease, making workers healthier, emerging environmental hazards and more. These accomplishments reflect teamwork among staff, faculty, and students, all playing indispensable roles in meeting our mission.
Looking ahead, there are visible challenges. Nationally, applications to schools and programs of public health dropped in the last admission cycle, as did applications to the Colorado School of Public Health. This decline follows increasing admissions over the prior five years, and lacks a clear explanation. Speculations touch on demographic shifts, employment opportunities that draw potential students away from graduate school, and perhaps displacement of master’s graduates by those with training at the bachelor’s level. Regardless, we are revising our marketing, communications and recruitment strategies to do the best job possible in telling potential applicants about our school. And, as always, research funding remains highly competitive and, in some areas—particularly around the environment, under threat.
More generally, we continue to grapple with disturbing general trends: mistrust of science, including what we do in public health, at the highest levels of leadership and among the public generally; avoidable epidemics, such as vaping and its lethal consequences; and the sweeping epidemic of behavioral and mental health problems. The last is particularly concerning, given its rise and intractability. A very disturbing report in November in the Journal of the American Medical Association described declining life expectancy in middle-aged Americans from so-called “deaths of despair” due to drug use, alcohol, and suicide. Other causes of death have also risen in this age range and the loss of life expectancy is particularly prominent across the middle of the country. We can characterize and track these trends and point to the complex factors that drive them at levels ranging from individual to societal, but concerted approaches to solutions are lacking.
As we look to next year for the Colorado School of Public Health, we are moving forward with implementation of the strategic plan, completed in the fall with engagement of many faculty, staff, and students. Behavioral and mental health is among the priorities as we align our activities with the problems faced in Colorado. Here, we can make a difference through research and training. Reading through the strategic plan and receiving feedback on it, I was struck by the pervasive thread of making a difference, and engagement and practice ran throughout the plan. The plan also speaks to the need to extend our partnerships to amplify our impact. I look forward to describing where the plan has taken us when I write this commentary in a year.
This New Year is notable—2020. We are two decades out of the 20th century. Soon, some entering students will have been born in the 21st century. Their thoughts about public health will not have been shaped by seeing the initial toll of HIV/AIDS, the SARS epidemic, and the Bhopal tragedy. What will be the bellwether events for this generation and the next? A relevant quote attributed at times to the physicist Niels Bohr reads: “Prediction is difficult, particularly about the future.” Remember the Y2K concerns as date problems emerged in legacy systems. On that New Year’s Eve, I was flying across the Atlantic taking the Y2K risk. Fortunately, the plane did not drop from the sky at midnight and the flight was terrific—a large jet with about 20 passengers and the same number of flight attendants. Back to the quote, I can predict that our current and future students will face unanticipated problems and climate change will likely be a driver for some of them.
And, a few thanks to close. Lorann Stallones turned over leadership of the CSU program to Tracy Nelson, after leading it from its start; Elaine Morrato, who has served the school well in many ways, including being Interim Dean, is leaving to be the founding dean of the Parkinson School of Health Sciences and Public Health at Loyola University Chicago; and Mary Dinger is leaving the position of Associate Dean for Student Affairs. Thanks to Lorann, Elaine, and Mary for their contributions.
I am looking forward to next year as Dean. Enjoy the holiday time ahead and let’s look for a healthier world in 2020.
Jonathan Samet, MD, MS
Dean, Colorado School of Public Health
Postscript: After writing this commentary, I read, with sadness, the obituary of Dr. Fitzhugh (Fitz) Mullan. Read the obituary to learn about the life of a pioneer, who moved from what he learned about health inequities in caring for patients to their structural origins. His book, that I read long ago, White Coat, Clenched Fist: The Political Education of an American Physician, was influential and influenced me. Fitz spent time in New Mexico, as did I, where health inequities play out every day for health care workers. A few quotes from the obituary: “The prestige walks of medical life today are research and the subspecialties…No one gets a Nobel Prize for ghetto medicine.” And, “We will never improve the infant mortality rates or the longevity of the inner city by hunkering down among the radioisotope scanners and incubators of the large hospitals.” We have lost an important voice.