Yesterday was Juneteenth, a day celebrating June 19, 1865, when African American slaves in Galveston, Texas, were informed of their freedom after the Civil War’s end. It is a federal holiday and this year for state employees and on the CU Anschutz Campus, a paid day of observance. Juneteenth offers a needed reminder that slavery’s legacy is lasting and still imprinting our country. Juneteenth inevitably brings 1619 to mind as a year when captive Africans landed on a ship at Point Comfort (the later site of Ft. Monroe in Tidewater, Virginia), and were sold as slaves
. I grew up in nearby Newport News and recall being taught that 1619 was a momentous year in Virginia’s history but with no attention to slavery’s enduring consequences. For those who have not read Nikole Hannah-Jones' 1619 Project in the New York Times
, it should be read by all.
Last week, I commented on the article by Dave Leonhardt in the New York Times
on the reversal of COVID-19 disparities with COVID-19 death rates for white Americans now exceeding those for Black and Latino Americans. One faculty member directed me to comments on the Leonhardt article by “Your Local Epidemiologist,” a blog previously unknown to me but with a terrific title. The local epidemiologist, Katelyn Jetelina, points out that Leonhardt did not take age into account in the article’s analyses and hence differences between the older white population and the younger Black and Latino populations were exaggerated. With age adjustment, the rates for Black Americans were higher, but the trend of a narrowing gap remained.
Ryan Masters in the Department of Sociology at CU Boulder, along with colleagues from Virginia Commonwealth University, posted a preprint last week that also shows a temporally changing impact of the pandemic across racial and ethnic groups
. Masters and colleagues used death data for 2019-2021 to calculate changes in life expectancy for the U.S. population and 21 comparison countries over the three years. Overall U.S. life expectancy dropped by 1.87 years in 2020 with much larger drops in American Indians/Alaska Natives (4.48), Hispanics (3.72), and non-Hispanic Blacks (3.20), compared with non-Hispanic Whites (1.38). The decreases in life expectancy were far smaller in 2021, but greatest for non-Hispanic Whites. The picture in the comparison countries was far different with an average life expectancy decrease of only 0.55 years between 2019 and 2020, and an increase of 0.26 years comparing 2020 and 2021.
The findings of Masters and colleagues need thoughtful reflection. The life expectancy losses of 2020 have received much comment previously with emphasis on their root causes in our societal structure. The picture in 2021 is encouraging, but the widened gaps from 2020 have not been erased. We should be very troubled by the comparison to peer countries. Why does the United States perform so poorly, given our extraordinary level of spending on health care?
A few months ago, Dr. Ashish Jha, then dean of the Brown University School of Public Health, became the White House COVID-19 response coordinator (or “coronavirus czar"). When the pandemic emerged, he quickly became an omnipresent and sensible communicator on COVID-19 while moving from Harvard to Brown to take on the dean position. For those interested in his path from academia to the White House, he is featured in the latest issue of the Brown Alumni Magazine
and also in an interview in The New Yorker
. His comments on the critical need for clear communications are on-target and reflected in his example, although I have marveled that a dean can be omnipresent on national media. We can hope that his view of the future—a tolerable endemic state—will be realized. One step toward that future was the just announced approval of vaccines for children under age five
. Unfortunately, all news stories that I have heard follow the announcement with statements about the small percentage of parents who intend to vaccinate their young children.
And, the pandemic is still slowly surging in Colorado. Hospitalizations were at 323 last week and test positivity was still high but dropping. The most recent modeling suggests that we may reach the peak of the epidemic curve by month’s end. The projections are encouraging, but I remain impressed by how many close colleagues have had COVID-19 recently. My untestable hypothesis—many of us who are boosted, even doubly, have relaxed the personal measures that protected us for the pandemic’s first two years. And we are traveling again with largely unmasked fellow travelers. Even with an N95 respirator, I remain fearful of the shuttle train between terminals at Denver International Airport. I fantasize that I can feel the impact of airborne SARS-CoV-2 on my N95 mask as unmasked travelers, sometime inches away, exhale in my direction.
Stay cool as we break heat records.
Jonathan Samet, MD, MS
Dean, Colorado School of Public Health