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From the Dean's Desk

  • The New Urban Agenda: Where Is Population Health?

    10/25/2016 9:27:18 AM

    Nearly 35,000 people came together in Quito, Ecuador to discuss the future of cities across the world. The meeting, formally the third United Nations Conference on Housing and Sustainable Urban Development had as its goal the adoption of the future urban agenda for the planet.

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  • Four Big Challenges for Public Health… and for Us

    9/26/2016 1:24:00 PM

    As we begin a new academic year and welcome 153 new graduate students, 22 new undergraduate majors, and 8 new faculty to our school, it is worth taking a moment to reflect on who we are and our mission as a school of public health.

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  • Soda and Guns

    7/14/2016 9:30:51 AM

    Two important, but quite different, events over the past few weeks made me reflect on what it means to adopt a true “public health” approach to improving population health, and reminded me of the often cited quote from Rudolf Virchow, famous physician, anthropologist, pathologist and politician that “mass diseases require mass solutions”.

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  • Racism and Health

    5/27/2016 1:24:29 PM

    This month Camara Jones visited our school to deliver the Jonathan Mann Health and Human Rights Memorial Lecture and eloquently spoke about racism and the multifaceted ways in which racism can affect health. When we think about the impact of racism on health one of the first things that comes to mind is what Dr. Jones refers to as “personally-mediated” racism. Personally mediated racism results in a collection of often subtle but pervasive and persistent daily experiences that can set off the body’s “fight or flight” responses leading to a cascade of physiologic effects that can trigger things like deposition of body fat, diabetes, and elevations of blood pressure. Dr. Jones also spoke about the role of internalized racism, in her words “the acceptance by members of the stigmatized races of negative messages about their own abilities and intrinsic worth”. Internalized racism can also have subtle yet important effects on health. But perhaps the most profound way in which racism affects health has to do with institutionalized racism.

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  • What kind of evidence do we need for public health action?

    4/28/2016 8:41:32 AM

    What should we do to improve health in our city? How can we shift the health of whole populations so that everyone is healthier and inequalities in health by race, ethnicity or social class are reduced? This is the big question for public health, something we are often asked but regrettably often don't have good answers for.

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  • Precision Medicine and the Health of the Public

    3/24/2016 3:45:22 PM

    There is much talk these days in the medical world about precision medicine. But what does it mean for public health? President Obama announced the Precision Medicine Initiative over a year ago in his State of the Union address on January 20, 2015. As defined by the White House, "the Precision Medicine Initiative will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients." The Initiative was launched with a 215 million dollar investment including 130 million for the National Institutes of Health (NIH) to establish a national voluntary cohort of patients to participate in various research efforts and 70 million for the National Cancer Institute (NCI) to identify genomic drivers in cancer and apply that knowledge in the development of more effective treatments.

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  • The Pervasive Link Between Income Inequality and Health

    2/23/2016 10:58:12 AM

    A recent study highlighted in the New York Times starkly showed how differences in life expectancy between the rich and poor in the United States have grown remarkably over the past few decades. Researchers at the Brookings Institute used data from the University of Michigan's Health and Retirement Study to compare life expectancy by levels of earnings for men and women born in 1920 and those born in 1940. Their analysis showed that for men born in 1920, there was a 6.2 year difference in life expectancy at age 50 between the top 10 percent of earners and the bottom 10 percent. For men born only twenty years later in 1940, that difference had nearly doubled to 11.3 years. The increase was even greater or women: the difference increased from 4.7 years to 10.3 years.

    These are striking data not only because of the large increase in disparity over time but also because of the sheer magnitude of the differences themselves: an over 10 year difference in life expectancy between rich and poor for those born in 1940. In men, this increase in the disparity occurred in the context of increases in life expectancy overall, but in women, as reported previously by other research, there appear to have been actual declines in life expectancy in lower income groups.

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  • Public Health and the Right to Clean, Safe Water

    1/25/2016 2:26:49 PM

    Over the past few weeks we have been reminded once again of the critical links between water and public health. The residents of Flint, Michigan, have been exposed to water contaminated with lead. Residents now have no choice but to utilize bottled water for drinking, cooking, and washing. The economic costs of refitting the Flint water system so that the pipes no longer leech lead into the water supply are astronomical and the repair will take many months, but the potential long term health consequences are in human terms much worse. The community has, rightly, lost any trust it had in those in charge of ensuring that they are protected from environmental hazards, a key responsibility of government.

    Environmental injustice is not only about exposures to toxic substances (important as is this) but also about the many often subtle ways in which disadvantaged communities are repeatedly exposed to environments that are not conducive to good health, including things like limited access to healthy foods and pleasant public spaces, poor quality of housing, lack of well-maintained sidewalks, lack of safety, and even simply poor aesthetic quality and absence of trees and green spaces. Some of these health effects may be subtle, but they add up and potentiate each other, and likely contribute to the large social inequalities that we continue to see.

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  • Assuring the conditions for health

    12/21/2015 12:33:11 PM

    This past year illustrated perhaps even more intensely than ever the ways in which population health is influenced by upstream factors. Countries all over the world continue to grapple with the health consequences of sedentary lifestyles and unhealthy diets linked to the ways in which we have organized transportation, work, and the production and distribution of food. At the same time a mind blowing number of people all over the globe lack something as simple as access to clean water. Average world temperatures continue to increase at an alarming pace (just here in Philadelphia last week over 60 degrees in December!). Inequalities in health by race, ethnicity or social class remain unacceptably large in many countries including the United States. But these challenges also present opportunities for public health. As we end 2015 take a minute to read about some of the ways we at the Dornsife School of Public Health are working to improve population health through evidence and action, here and abroad. And as we start a new year, let us redouble our commitment to create the policies and environments necessary for the health of all of us.

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