Opening General Session: 'Now is the time for us to go to work'

“We will not lose. We can and will make our country and the broader world a much better place.”

Those are inspirational words from APHA President Joseph Telfair, whose message of hope and optimism was hardly an outlier at today’s Opening General Session, where speaker after speaker hit the stage to call for solidarity and action to eliminate unjust disparities and achieve health equity. In fact, Telfair was confident that public health can tackle the nation’s considerable health challenges, despite the barriers of the current political era.

“Change,” Telfair told thousands of APHA Annual Meeting attendees in San Diego, “is definitely coming.”

U.S. Surgeon General Jerome Adams was confident as well. While he told the opening session crowd that America still has a long way to go to become the healthiest nation — and, in fact, many health disparities are now widening, instead of narrowing — he also said “it’s imperative that we lift up those who are most disadvantaged by promoting health equity for all.” The issue is a personal one for Adams, who grew up poor and black in a rural community and suffered from severe asthma. Decades later, he said his 10-year-old nephew is growing up in the same house he did, also living with severe asthma and facing many of the same barriers to good health and opportunity that he faced 30 years ago.

“Equity is about showing why communities that foster health for all are important not just for my brother or nephew, but for each and every American and each and every constituency,” Adams said, adding that when people suffer from preventable ill health and disease, “it’s America that loses.”

So how do we, as public health professionals, create change? How do we get people outside the profession to support better health for all? One way is to use language and arguments that resonate with people’s lives, Adams told attendees. For example, he said that while people often tap health care as a top issue, they’re often doing so not necessarily because they prioritize health as a condition of people’s lives, but because they’re concerned about the economics of health and health care. To that end, he noted that one of his initiatives, Community Health and Economic Prosperity, which works to engage employers and the private sector in public health, will culminate in a report on the many connections between people’s health and a community’s economic success.

“Servant leadership is helping others succeed so that their successes become your successes,” Adams said. “People need to know that you care before they care about what you know.”

Adams also addressed a request he often hears from public health colleagues in the field — that he be more of an activist, to call people out for racist or bigoted views. In response, Adams, also a trauma anesthesiologist, told the story of a patient he once treated in the hospital. At the time, Adams said he was trying to pull back the bed sheets to put EKG pads on the patient’s chest, but the patient resisted. The reason: the patient’s chest was covered in white supremacist tattoos.

While he could have treated the patient with disdain, Adams said he instead tried to get to know him. They ended up chatting about their children, and Adams said he likes to believe that the interaction made a difference in the man’s outlook.

“I am convinced that we can and we will achieve better health and better partnerships for health equity for all,” he said. “But we really need to be the change we wish to see in this world. …Love and engagement — it always, always wins.”

Engagement is also key for the young activists who took to the Opening General Session stage soon after Adams. Fifteen-year-old Eden Hebron, a survivor of the Marjory Stoneman Douglas High School shooting, and 17-year-old Tatiana Washington, who lost her aunt to gun violence, came out to standing applause. Hebron began by asking audience members who know victims of gun violence to raise their hands — in a reflection of the nation’s ongoing gun violence epidemic, hands went up across the giant auditorium.

Washington, who hails from Milwaukee, organized her high school’s walkout last March to call attention to gun violence and demand that policymakers take action. While school shootings deservingly make the headlines, she noted that so many incidents of gun violence, which disproportionately impact black youth, never make the front pages. Washington called on the audience to help change the culture around gun violence — for example, stop circulating pictures of mass shooters, which only gives them notoriety, and call out police violence.

“Misuse of a firearm is misuse of a firearm,” she said. “And that includes police brutality, suicide, domestic violence and more.”

Both youth activists called for funding gun violence research. And in response to a recent NRA tweet that told doctors who advocate for commonsense gun control to “stay in their lane,” the young activists said in unison: “Gun violence is all of our lanes.”

“Students like us aren’t afraid to talk to those who don’t understand,” said Hebron. “We aren’t interested in a political debate — we want solutions to end this epidemic.”

The opening session ended with a keynote address from David Williams, a professor at the Harvard T.H. Chan School of Public Health, an internationally known health disparities researcher and creator of the Everyday Discrimination Scale. Williams gave a brief overview of the research on disparities, noting that when he first began his career, scientists believed racial gaps in health were a function of socioeconomic status.

Now we know that even after accounting for determinants such as income and education, racial and ethnic minorities in America still face greater health risks than their white counterparts. What accounts for that persistent difference? Discrimination. Another contributor to continued inequities — segregation. Where you live in America, Williams told attendees, determines where you go to school, the quality of education, access to job opportunities, quality of housing, access to primary care, the quality of city services and so much more.

“Virtually everything that drives health is linked to place,” he said, noting that if we could eliminate segregation, we could help erase the differences in income, education and unemployment — all major determinants in people’s health.

Unfortunately, surveys show that many Americans believe that climbing out of poverty is simply a matter of working harder and many don’t acknowledge the systemic and institutional barriers that people of color often face — Williams called it an “empathy gap.” Many Americans, he said, simply don’t care.

But like the surgeon general, Williams said public health professionals can be agents of change — “now is the time for us to go to work.”

“We can build a healthier America,” he told the audience of thousands. “Yes, public health — together, we can.”

At top: Opening session keynote speaker David Williams. Photo by Jim Ezell, courtesy EZ Event Photography

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