Graduates urged to fight health disparities, work for social justice.
The recent rioting in Baltimore followed the death of a black man in police custody, but the larger source of the crowd’s anger was widespread inequality and everyday deprivation.
Speaking before a rapt audience and to the Yale School of Public Health’s centennial graduating class on Monday, Sir Michael Marmot addressed how health and economic disparities in the United States (and elsewhere) are straining the foundations of civil societies.
Marmot recently visited sections of Baltimore and said that he found two vastly different cities separated only by a 10-minute car trip. One section was marked by expensive homes and obvious privilege. The other section was filled with abandoned buildings and an air of hopelessness. What’s more, the life expectancy of people living in the two neighborhoods reflected their surroundings. People in the more affluent enclave live an average of 83 years, while residents in the poorer section live an average of 63 years.
One’s mailing address, he noted, can add or subtract 20 years of life.
“We have in our hands the means to close [this] gap in a generation. The question is, what do we have in our hearts?” he asked the gathering.
Marmot received the C.-E. A. Winslow Award, the School of Public Health’s highest honor. The medal is named for the school’s founder (Charles-Edward Amory Winslow) and is given to leading public health innovators. Marmot is the first of three medal recipients this year as the school celebrates its centennial. The medal (see sidebar) has been given previously to three other public health practitioners.
Marmot has lead research on health inequalities for 35 years and is an internationally recognized scholar on how such disparities contribute influence health. He served as chair of a World Health Organization committee studying the social determinant of health and produced a report, Closing the Gap in a Generation, on the topic. He was knighted in 2000.
Dean Paul Cleary listed Marmot’s many awards and honors, noting that even one of them would be impressive for most people. But accolades are not what have driven
Sir Michael, whom he compared to Winslow and his vision that health and longevity are each person’s birthright.
“He is a fine, caring and compassionate man,” Cleary said of Marmot.
As he continued his address, Marmot noted that the life expectancy of a nation’s population is an indication of a good society and that an individual’s long life is a measure of a life well lived.
Education is a major factor in determining how long a person might live. With education, people learn life skills and are better able to navigate short- and long-term challenges. Education also confers professional skills, which result in better jobs, better incomes and better places to live.
Some countries have made great strides in addressing the health gap. Marmot cited the success of countries such as Norway and Sweden in ensuring that all citizens have a good quality of life. Addressing such disparities, he said, is a matter of social justice.
He also noted that the United States currently has more childhood poverty than Latvia.
“You live in a democracy,” he said. “This must be the level of child poverty that you want.”
Marmot closed his address by urging the graduates to “never whisper in the presence of wrong” and to join him in the struggle to achieve good health and health care for all.
The school conferred Master of Public Health degrees on 121 students, Master of Science degrees on 14 students and Doctor of Philosophy degrees on 10 students during an afternoon ceremony in Yale’s ornate Battell Chapel.
Jordan Emont, who received his M.P.H. and delivered the student address, said all of the graduating students came to the School of Public Health because they shared a belief that the status quo—marked by health inequalities for many—is unacceptable.
By coming to YSPH, “we’re really asking how can I fix this, or how can I begin to fix this,” Emont said. The school has prepared them to take their first steps in helping to create a healthier future.
Emont also touched on “remarkable bond” shared by members of the graduating class.
“It has been an honor to spend the past two years laughing and learning with you,” he said. “I learned more than I could have possibly imagined.”
Trace Kershaw, who received the 2015 Distinguished Student Mentoring Award (his third honor), said he simply provides the spark and the students fuel the flame with their enthusiasm, creativity and intelligence.
Associate Professor Mayur Desai, who was chosen by the class as the 2015 teacher of the year (the third time he has been so recognized), said that he looked forward to the student-teacher relationship that they have shared for the past few years blossoming into a relationship of alumni, professionals and public health practitioners united in the fight for better health.
Cleary told the gathering, which included family and friends of the graduates from throughout the United States and as far away as Hong Kong, that students are the best part of his job and that the graduating class has filled him with optimism for the future.
“You’ve given me a vision of the future that is absolutely great,” he said.
The C.-E. A. Winslow Medal
The Winslow Medal is the Yale School of Public Health’s highest honor. It is given in recognition of the school’s founder and leading figure in the modern public health movement: Charles–Edward Amory Winslow. Recipients have had distinguished careers in public health, as exemplified by their outstanding achievement in public health leadership, scholarship and their contribution to society.
Winslow was the chairman of Yale’s Department of Public Health at its inception in 1915. His foresight and commitment to interdisciplinary education brought the school much national acclaim; Yale was the first academic institution in the country to establish a degree-granting program in the field of public health. In 1946, the University joined a small group of schools to become nationally accredited as a school of public health.
The C.-E. A. Winslow Medal has been awarded three times previously. Past recipients are:
Sir Iain Chalmers, 2010
Sir Iain founded the Cochrane Collaboration, the leading creator and repository of systematic reviews of evidence-based health care across the medial and public health spectrum. Today, the Collaboration is a consortium of some 20,000 researchers in 52 review groups.
William Foege, 2004
Dr. Foege served as a member of the Smallpox Eradication/Measles Control Program at the Centers for Disease Control and Prevention (CDC), where he directed the Smallpox Eradication Program. As a former director of the CDC, he steered the agency during the onset of the HIV/AIDS epidemic. He also formed the Task Force for Child Survival and Development in 1984 to accelerate childhood immunization rates as well as other mandates.
Sir Richard Doll, 2000
Sir Richard is credited with identifying smoking as a leading cause of lung cancer 50 years ago. He also contributed to understanding the role of radiation on leukemia among survivors of Hiroshima, the effects of oral contraception and the role of occupational and environmental factors on disease, including the link between asbestos and lung cancer. He died in 2005.