A message to new students: Clarity is power

Every August, I have the honor of welcoming the newest cohort of students to our School. It is always a joy. Here’s my address to the incoming class:

One of my favorite things about being dean is getting to know each one of you.

Already, I know you are a remarkable class. You were selected from a record number of applicants. Your diverse accomplishments are remarkable. Your lived experiences are equally remarkable.

But here is what I find most remarkable: the clarity of your vision.

You look with clear eyes at the world around you. Put another way, you refuse to look away.

You see a world where a global pandemic has laid bare the inadequacies in our health systems. Gaps in global coordination. Underinvestment in the social determinants of health. Rampant disinformation. A failure to meet the needs of — or recognize the vast potential in — the Global South. And systemic racial inequities that are as heartbreaking as they are stubborn.

You see a world where climate change is creating devastating new challenges, almost daily. A world where global warming is almost certain to reach 1.5 degrees Celsius over the next two decades. A world that will be warmer, wetter, and more volatile, with catastrophic consequences for the health and well-being of hundreds of millions of people.

There is no parallel to this cascade of crises in all human history.

Running toward big challenges

Choosing a career in public health at this urgent juncture means you’ve decided to run toward the greatest challenges of our time. It is not a task for the faint-hearted, and it’s not a task for anyone who is willfully blind to what’s happening on and to our planet.

Your honest clarity of vision, your ability to see and care about public health, has motivated you to tackle the challenges before us, to help build a more resilient and equitable world, to act.

And we can act. We can make a difference. The litany of crises is daunting indeed, but I remain fiercely optimistic—and that’s because of you. When I read your bios, when I think of what you have already accomplished, I know that you have the strength to drive change. And you won’t do it alone.

We have many smart and courageous allies across the country and around the world, and one of the things you’ll learn here at Harvard Chan School is the beauty of collaboration and the power of partnerships—across disciplines, across sectors, across continents.

Whenever I feel daunted by the challenges, I look at a quote from Arthur Ashe that I keep on the wall by my desk. He grew up in segregated Richmond, Virginia and went on to become a trailblazing Black tennis player. He said: “Start where you are. Use what you have. Do what you can.”

The first part of that quote is “start where you are.” And Harvard Chan School is a great place to start.

Here you will learn to generate powerful new ideas through scientific research — and then how to translate those insights into policies and programs that improve population health and advance the public good.

Public health: We get things done

The role that public health plays in bringing trusted, evidence-based expertise forward has never mattered more.

Because while public health is not political, we cannot afford to ignore politics, especially during an era of hyper-partisanship.

Make no mistake, politics impact public health. Over just seven days in June, the conservative majority on the U.S. Supreme Court issued decisions on gun violence, abortion, and the environment that will have an enormously negative impact on population health, particularly on the most vulnerable groups. They set us back more than 50 years.

As leaders in public health, it is up to us to address the devastating public health consequences of these rulings. It is up to us to launch a multifaceted response, to engage across disciplines, sectors, and continents to shape programs and policies to mitigate the damage.

And we will make change. A reliable truth in the world of public health is that when we researchers and scientists team up on a global level with activists, business leaders, and practitioners, with policymakers, philanthropists, and politicians, we can form truly powerful coalitions. We get things done.

A clear-eyed view of recent setbacks

Let’s briefly focus on one Supreme Court decision—the ruling overturning Roe v Wade.

Almost immediately, two dozen states moved to ban or severely restrict abortion. Nearly 60% of American women of reproductive age live in these states. That’s 40 million girls and women!

These girls and women have lost or are losing their human right to choose what is best for their own bodies, their own health, their own futures. Meanwhile, some lawmakers and judges—many without discernible grounding in public health or, in some cases, understanding of basic female biology—have decided they know best.

Let’s envision the future they seek to create. The people disproportionately affected will be young women, women of color, and low-income women. States that ban abortion will see a surge in unintended births; scientists estimate up to hundreds of thousands of such births a year.

That, in turn, will trigger an increase in maternal deaths, particularly among women of color.

Already, the number of women who die during or shortly after childbirth in the U.S. is higher than anywhere in the developed world. Way higher. Especially for Black women.

This is horrifying, and it’s going to get worse.

Sociologist Amanda Jean Stevenson has analyzed the effect of widespread abortion bans on maternal mortality in the United States. And she determined that a nationwide ban would lead to a 21 percent overall increase in maternal deaths—and a 33 percent increase among Black women. She told the Washington Post that she burst into tears as soon as she had made that calculation. As she put it: “Thirty-three percent is a really big increase in a frankly catastrophic rate of maternal death in the United States.”

Abortion bans will also deepen societal inequities.

A Supreme Court amicus brief written by the American Public Health Association and other leading voices in public health noted that “states with the most restrictive abortion policies invest the least in the well-being of women, children, and families.” In Mississippi, for example, parents do not qualify for Medicaid if their annual income exceeds 25% of the federal poverty level, which this year is $5,760 for a family of three.

Let me repeat that: A single mom with two young kids and an income of less than $6,000 a year does not qualify for the safety net of subsidized health insurance.

She would be covered during pregnancy, but Mississippi’s political leadership has insisted on ending that coverage two months after childbirth, though the risks to mothers can persist well beyond 60 days postpartum. Instead, Mississippi’s governor has proposed ideas such as promoting adoption and extending tax credits for businesses that donate to pregnancy resource centers, typically run by anti-abortion advocates.

I should note that some states with strict abortion bans have expanded Medicaid coverage to six or 12 months post-partum—among them, Tennessee, Texas, and Alabama. And some lawmakers are pushing hard for Mississippi to join them. But there remain deep and alarming gaps in health coverage and health care access for pregnant women, mothers, and children in these and many states advancing strict abortion restrictions.

We also know that when women are denied wanted abortions, they suffer long-lasting economic consequences, which can have significant effect on their health and well-being.

An eye-opening study from the University of California, San Francisco found that women in this situation have more difficulty paying for food, housing, and transportation for years — years — after such an experience, compared with peers who were able to terminate pregnancies. Their credit scores are lower. Their debt is higher. Their children are more likely to live in poverty. They’re more likely to suffer from health problems and to experience physical violence from a male partner. These issues can expose women and children to significant traumas whose lifelong physical and mental health effects trigger intergenerational harm.

Given these data…. Given the stark polarization of our country… It’s easy to feel hopeless.

But here is my message to you: Clarity is power.

The scientific consequences of depriving girls and women of this essential component of health care are clear. Polls show a strong majority of Americans want their states to guarantee access to abortion. I predict that a strong majority will become an overwhelming majority in the months to come as we continue to shine a spotlight on the real-life consequences of this ruling.

Let me say it one more time: We get things done. In my many years in the Harvard Chan School community—rapidly closing in on four decades—I’ve seen it over and over again: There’s no limit to what we can achieve when we keep fighting for a safer, more equitable, and more sustainable world.

And so, we are thrilled to welcome you to our ranks.

Tap into your North Star

Needless to say, you are embarking on a challenging year—academically and otherwise.

You will absorb huge amounts of new information, new tools, and new ways of thinking. All while navigating the tumultuous times we are all living in.

There will be days when you will feel depleted. Days when you might even ask, “What have I gotten myself into?” One piece of advice I have for you is to take such moments as a reminder to reconnect with your why, your North Star, your guiding principle. Tap into that clarity of vision that brought you here in the first place.

And as a fellow traveler who has been where you are now, I have three more helpful tips.

First: Get to know your peers. Over the course of this coming year, you’re going to learn that your fellow classmates are one of this School’s greatest resources. We hear this year after year—learning from this incredibly diverse group of students from all around the world is a rare and wonderful opportunity. So as busy as you will be, set aside some real time to build friendships. It will be the gift that keeps on giving, for years to come—trust me, as an alumna of this great School, I’m speaking from experience here.

And while you’re at it, challenge yourself to seek out differences.

One of the great strengths of this School is the diversity of thought and experience on our campus. I am committed to bringing outside voices from a wide variety of backgrounds to campus as well, to further expand our understanding of the world.

As passionate as I am about reproductive rights, for instance, I have supported the Harvard Chan Studio in airing the voices of powerful members of Congress who oppose abortion access—because they can be important allies on other issues of deep importance to public health, such as pandemic response. As I’ve said time and again, we will not make progress on any issue if we refuse to talk with those we can’t agree with on every issue.

Students from many backgrounds, holding many differing viewpoints, sit in this auditorium today. I embrace and welcome that diversity. Without it, we will never be able to solve the great global challenges threatening the world’s health and wellbeing. I’ll note that faculty and staff, too, hold a variety of views and bring a rich diversity of lived experience. And as I mentioned, we bring speakers to campus who further add to the rich debate.

I urge you to listen and engage with the full diversity of opinions.

And please do your part to ensure everyone feels comfortable making their voice heard and has an equal chance to thrive.

Learn to fail better

Second: Learn to fail better. What I mean by that is: Find the power in recognizing that you can acknowledge mistakes and learn from them. Things will go wrong; you will make mistakes; your colleagues will make mistakes. What matters is your ability to learn and move on.

This is a cardinal public health lesson from the COVID-19 pandemic that can be applied to your own growth: the first step for improvement is honest reflection. That readiness to hear criticisms, acknowledge error, and recognize the power of leaning on others for help, is the beginning of real improvement. This clarity is the phenotype of a public health leader. Believe me, I have lived this myself. I know it’s not easy. But it is essential.

Third: Push yourself to move beyond your academic comfort zones. Just as new people enrich your lives, so do new ideas. A unique strength of the School is our excellence in both laboratory-based sciences and policy and population sciences. Whatever your professional goals, I urge you to explore both. If you love working in communities, make sure to discover what people in the labs are doing, and vice versa. Whatever your field of expertise, getting outside of your comfort zone will spark insights and open doors that you otherwise could not imagine.

Finally: Never lose sight of the need to take care of yourself and your loved ones. We are living in a time of enormous uncertainty and stress—and in many ways you are at the epicenter.

Find time for exercise. Stay in touch with friends and family. Binge-watch a new show on Netflix, even! Don’t worry, we don’t judge around here.

Every one of us—faculty, staff, and of course, your classmates—wants you to succeed. Every one of us stands ready to help you however we can, all the way through to your own commencement ceremony. This community belongs to all of us, and we are so glad that you are here.

I’ll leave you with a haiku. It was recently shared with me by a colleague and friend: Dr. Ayman El-Mohandes, Dean of the City University of New York Graduate School of Public Health.

       The source of light within

       Dispels all doubt and fear

       Clarity is key.

I could not agree more. Thank you for choosing to join the Harvard Chan School community.