The Association of Yale Alumni in Public Health honored U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky with its 2021 Award for Excellence on Oct. 15. In accepting the award, Dr. Walensky spoke at length about the importance of health equity and inclusion in public health. The following is a transcript of her remarks, which were entitled "The Path to a More Inclusive Health Future."
Thank you, Ann (Prestipino, chair of the AYAPH Awards Committee), for that warm introduction. I must share that Ann is one of my heroes, particularly for the amazing work she has done running incident command at Massachusetts General Hospital since the hospital began its COVID response in 2020.
It is a great honor to be with you, if only virtually, for Alumni Day and to receive the Association of Yale Alumni in Public Health’s Award for Excellence.
I am humbled to be the one chosen for this honor. It seems unfair in this pandemic moment to declare a single person deserving of any award. So many of us have been fighting for so long together …. so many of us have suffered individually and collectively.
So many of us have staffed testing and vaccination clinics, made home visits, built and managed quarantine centers for those experiencing homelessness, established protocols to get PPE to those in need, created testing, surveillance and safety protocols … truly, so many of us have done the work of public health every day throughout this pandemic.
I accept this award recognizing that I stand on the shoulders of so many whose teachings I have benefited from, whose stamina I have emulated, and whose wisdom has shaped the work I do today. Please know, I share this award with each of them…and with all of you.
When I became CDC director, I came as a practicing physician treating patients who had to make the impossible choice between filling a prescription or ensuring food on their plates. I have witnessed firsthand the impact of health inequities on individuals and families with little or no access to regular health care. I also came as a scientist, aware of the power of research and data to drive policy changes that address disparities.
I will never forget early in the pandemic when I told a patient he and his family would have to quarantine … stay at home and away from others as much as possible for two weeks. In that moment … that definition of “quarantine” … I understood that what we considered a simple COVID public health measure, was a privilege. I’ve never again used that word without thinking to myself, “I wonder if he can?”
In April, 10 weeks after becoming CDC director, I declared racism a serious public health threat that directly affects the well-being of millions of Americans and, as a result, affects the health of our entire nation. It was important to me to bring my passion and advocacy for health equity to my role as director of the agency charged with protecting the health of all Americans.
Of course, CDC has long recognized that racism is the root cause of many health disparities. That April declaration made it clear that we were recommitting ourselves to the work of addressing the challenges driven by structural factors … racism, discrimination, and historical disenfranchisement … that deeply impact the communities we live in.
These structural factors overwhelmingly impact communities of color, people with disabilities, members of the LGBTQ community, women, individuals who are incarcerated or without homes, and those who live in rural or frontier settings. And, they can have life-long negative consequences on the mental and physical health of those affected.
We see that reflected in the data that show higher rates of chronic diseases – such as diabetes, hypertension, obesity, asthma, and heart disease – in some racial and ethnic minority groups. We see it in increased risk for HIV and maternal mortality in Black and Hispanic or Latino communities. We see it in smoking and substance use rates in the LGBTQ community and in rural communities across the country. And we see it in life expectancy. In the past year, we documented the staggering drop in life expectancy for Black and Hispanic or Latino Americans – almost 3 years – caused by COVID.
The COVID-19 pandemic started in our country among the affluent. Those who traveled on airplanes and cruise ships returned to the mainland to unknowingly and ultimately infect people who work in essential jobs: local grocery stores, drug stores, and public transit. We’ve built a system where marginalized communities are not only the most vulnerable to infection but also the least likely to receive adequate treatment and care. I hope we as a country now realize what we in public health have long known -- that the health of our country and the world depends on optimal health for everyone.
We cannot let our country’s complicated racial history follow us into the future. As health professionals, we need to understand the roots of health inequities so we can reduce barriers and build a more inclusive health system going forward.
We are also building a more equitable health workforce. Those from racial minority communities are more likely to seek out treatment and trust medical information when delivered by people in their own community.
A recently announced CDC program will award $348 million over a three-year period to support COVID-19 prevention and control by community health workers, those frontline public health workers who have a trusted relationship with the community and are able to facilitate access to a variety of services and resources for community members.
I think of a particular community health worker from my time working in the hospital and caring for those living with HIV. He was so connected to the community and his patients that they had developed a huge level of trust in him. If they were lost to medical follow up – he would unfailingly find them. I recall one such patient who had stopped coming in for treatment. He tracked her down and learned she had stopped coming because she her HIV thinned her hair. She was nearly bald and… she was embarrassed. This community health worker found her a wig. And with that solution, escorted her proudly into clinic. Only because he was close enough, trusted enough to have that conversation, were we able to ensure that she got the care she needed.
Our investment in community health workers is about more than COVID-19. It is about establishing an infrastructure for equitable public health in the future. It is about ensuring that the public health work force is trained and comes from the diverse communities they serve.
Thank you for being here with me in this work.
Thank you for understanding how our fates are intertwined, how we can’t all be healthy as a nation, until each of us is healthy.
Thank you for working to untangle the thorniest problems in our society, for leading the way in the fight for equity, economic mobility, connectedness, and so many other societal needs.
Thank you – in truth – for sharing some of your most talented colleagues with me -- who have become some of my nearest and dearest mentors, colleagues, collaborators, and friends.
Thank you for working with CDC to create meaningful change. And thank you again for honoring me with this award.