Everything Going On Right Now

I’ve seen some Tweets poking fun at people who refer to the COVID-19 pandemic, the economic downturn, the protests against police brutality, the inexcusable lack of U.S. leadership, and, well, everything as just “everything going on right now”. It’s even got a hashtag. It’s its own public health problem, everything going on right now.

And it’s true that the old public health problem of racism and the new public health problem of the COVID-19 pandemic have intersected to create an even bigger public health problem. Black and Latino people are significantly more likely to become infected, get seriously ill, and die from COVID-19 than white people. This is now in addition to the public health problems of unequal access to quality education, healthy food, livable wages, and affordable housing, along with a greater risk of being killed by law enforcement.

The CDC plainly explains what factors are behind this (i.e. not genetic): “The conditions in which people live, learn, work, and play contribute to their health. These conditions, over time, lead to different levels of health risks, needs, and outcomes among some people in certain racial and ethnic minority groups.” The webpage is titled “COVID-19 in Racial and Ethnic Groups” and they go into detail with the data for each social determinant of health.

These disparities and the reasons for them should not be news to anyone who works in medicine or public health. But if you go to the excellent article published in STAT on this topic just a few days ago, “Covid-19 lays bare how discrimination drives health disparities among Black people“, and look at the comments… Wow, you will see a lot of people with the title “Dr” who openly profess their ignorance, and then double down on it. My first thought was: These could not possibly be real doctors making these comments.

But then I remembered: It was just a few months ago that an actual medical school Dean (a person who is, presumably, a physician and an educator) wrote a derogatory and denigrating opinion piece for a pretty well-established newspaper titled “Take Two Aspirin and Call Me By My Pronouns” basically stating that we shouldn’t be teaching our students about public health, because he feels advocacy is a waste of time. He went pretty low, like snake-belly low. Many of us had a few things to say about his medieval ignorance, myself included.

The piece was horrible, racist, misogynist, homophobic, all the bad words. But then even more horribly, the entire editorial board of that pretty well-established newspaper doubled down on the badness and ignorance, actually stating that incorporating public health education into medical education was corrupting.

What? Yeah. If you read me regularly, you probably care about health, public health, and education, and you’re rightfully horrified. Me too.

Sooooo what do we do about it, about all of it, about everything going on right now?

Let’s take our horror and turn it into action. Me, I’m trying to use my little podium to preach, to educate. I’m writing pieces and trying to publish in other venues with bigger reach. I’m following people who are more expert than me and reTweeting their quality Tweets, amplifying their voices. I’m donating to relevant nonprofits, nationally and locally. I’m brainstorming with colleagues: How do we turn this around, how do we reform ourselves and our system? How do we do right by our patients, by our communities?

When I can, I participate in demonstrations, like last Friday’s kneel-in vigil at our hospital. It was heartening and hopeful to be part of the crowd (and we did observe social distancing, wear masks, and wash hands like crazy, as usual):

I’m doing what I can, and I plan to keep it up over time. After all, this is part of public health, about helping all people by identifying and addressing the root causes of disease, like promoting healthy diet and lifestyle, and preventing illness and injury. This is everything going on right now, and it’s my lane as a healthcare provider, and our lane as humans.

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