The Contagion Next Time

Galea (Well), dean of the Boston University School of Public Health, offers a revelatory new conception of public health and disease prevention in this trenchant study of systemic inequity. In the first two sections, Galea argues that maintaining health requires more than just medical care; people must also invest in their communities in ways that prevent sickness in the first place. Primarily, this involves lifting people out of poverty and repairing the social harms that remain a legacy of Jim Crow legislation. He examines failures in public health based on such metrics as life expectancy, addiction, mental health, and noncommunicable diseases, exploring how food deserts, low wages, and homelessness ensure that some communities are less healthy than others. The last two sections focus on solutions, including concrete actions (invest in housing and safe transportation, for example) and a realigning of values in America toward a more just society that will minimize the damage of future public health crises. Galea powerfully demonstrates how inequities are detrimental to public health on a grand scale, affecting everyone: “As long as any part of our world remains vulnerable to poor health, we live, collectively, beneath a sword of Damocles,” he writes. Policy makers, take note. (Nov.)