Public Health at Work in Uncertain Times
A recap of the 7th Annual Bloomberg American Health Initiative Summit
Every year, hundreds of public health practitioners, researchers, government officials, community leaders, and visionary Bloomberg Fellows gather for the Bloomberg American Health Summit. It’s an annual state of the union for five of the most critical challenges in U.S. public health: food systems, adolescent health, addiction and overdose, violence, and the environment.
The Seventh annual summit, themed “Advancing Public Health in Uncertain Political Times,” was held December 3 in Washington, D.C.
The day made clear that, even in uncertain times, it’s through evidence-based tactics and strategies, combined with indefatigable passion and dedication, that public health work gets done.
Uncertainties Ahead
But there are exceptional challenges to acknowledge now. Leaders throughout the day remarked on the proposed appointment of Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services—one of the most powerful health agencies in the U.S.— as a dangerous and potentially deadly threat that policymakers should vote against.
In his remarks, Michael R. Bloomberg, the WHO Global Ambassador for Noncommunicable Diseases and Injuries, invoked the examples of polio and measles—viruses that at one time killed and disabled millions but that are now, thankfully, exceptionally rare thanks to vaccines. He said President-elect Trump’s proposed pick of Kennedy to lead HHS threatens those gains and would be “medical malpractice on a mass scale.” Bloomberg noted that Operation Warp Speed and the advent of mRNA vaccines in the first 11 months of the COVID-19 pandemic may have been one of Trump’s greatest first-term triumphs: a win that RFK Jr. would likely roll back.
Bloomberg also pointed out another exceptional challenge at this moment: America ranks 40th in the world for life expectancy. A new Initiative report found that the U.S. trails behind every other high-income country across several measures of health and well-being and provides a specific comparison with data from England and Wales. The report found a life expectancy gap of 2.7 years between Americans and their U.K. counterparts, driven almost exclusively by four preventable factors: heart disease, overdoses, firearm violence, and motor vehicle crashes.
Public Health in Action
The Summit was a moment to acknowledge these challenges and inspire action from the hundreds of Bloomberg Fellows—people working in these areas who are also getting public health degrees—in the audience. A plenary session kicked off with a powerhouse lineup of speakers and panelists including current HHS Secretary Xavier Becerra, nutritionist and food policy expert Marion Nestle, and former Mississippi State Health Officer Thomas Dobbs (whose challenge of the constitutionality of a Mississippi abortion ban was infamously enshrined in SCOTUS’s Dobbs decision), who all highlighted public health work being done in every corner of the U.S. to address these major killers.
Some highlights from keynote speakers:
Washington, D.C., Mayor Muriel Bowser spoke about governing with a public health lens, and her work funding and creating “stabilization centers” for people experiencing overdose: safe spaces other than emergency rooms to get medical care, detox, and interact with clinical care professionals who can connect people with resources like addiction treatment.
Senator Cory Booker gave a passionate call to action to overhaul a subsidized food system “designed for failure” that has left Americans with a stressed agricultural system, fewer healthy food choices, and more chronic disease.
Cynthia Bissett Germanotta, president and co-founder of the Born This Way Foundation, spoke about the critical importance of community organizations, saying, “National and global policies often begin at the local level.”
Rep. Lucy McBath spoke about the power of finding common ground across the political spectrum, and her experience running for office—and winning—as a Black woman in Georgia on a campaign for gun safety.
Rep. Rosa DeLauro, said that public health requires commitment to improving the daily conditions of people’s lives, and that it’s “not a game where we can walk away from a bad hand or wait for our next turn.”
The morning sessions also celebrated the work of several Bloomberg Fellows, including:
Kelli Case, a citizen of the Chickasaw Nation and senior staff attorney at the Indigenous Food and Agriculture Initiative whose work aims to make food policy more flexible and tribe-driven, including tribe- specific and -driven solutions like revitalizing community gardens with traditional plants in raised beds for easier access for elders.
Priya Byati, a program coordinator with CRISP DC whose work on a health information exchange system is helping to measure and address chronic absenteeism in public schools in Washington, D.C.
Annie Andrews, a pediatrician and CEO and founder of Their Future. Our Vote. who is piloting programs in medical schools to train physicians in conversations around gun storage safety—“so it’s normalized, institutionalized, and standardized just like bike helmets.”
Malcolm Cunningham, who oversees the Save Our Community violence intervention and prevention program, and helped stand up a Violence Reduction Council in Toledo, Ohio.
The Summit also celebrated two major public health initiatives:
The Celebrating Life Suicide Prevention Program of the White Mountain Apache Tribe in Arizona: New resources have been added to a lifesaving suicide prevention program for Native American communities. The program addresses alarming rates of suicide with surveillance and support, and expanded resources will include policy guidelines, data collection tools, and a case management training program.
Hopkins Judicial Health Notes: Keshia Pollack Porter, PhD ’06, MPH, Bloomberg Centennial Chair of Health Policy and Management, announced a new tool for helping state, policy, and judicial leaders evaluate the potential health and equity impacts of court decisions. Unlike amicus briefs, which are submitted to justices to help inform decisions, these notes analyze established legal decisions to determine the consequences of legal action.
5 Actions in 5 Years
Bloomberg faculty gave an update on a series of recommendations across the five focus areas of the Initiative for lawmakers and federal agencies to improve health:
The Food System
Recommendation: The U.S. Department of Agriculture should promote healthier foods through food assistance and school lunch programs.
Erin Hagar, PhD ’08, said that significant progress has been made. At the federal level, this includes the expansion of the Community Eligibility Provision, which supports free school meals for all children attending schools that serve lower-income communities. At the state level, eight states passed legislation securing universal free and healthy lunches for all public school children. Further changes have been introduced to improve the cultural relevance of school meals and to make them even healthier, including limits on added sugar.
Addiction and Overdose
Recommendation: Health systems, addiction treatment providers, and prisons should offer effective medication therapy to people with addiction.
Brendan Saloner, PhD, reported on federal actions including regulations to allow prisons and jails to stock their own methadone and to treat opioid use disorder alongside other health conditions, as well as a provision to cover these and other health care costs in correctional facilities using Medicaid.
Adolescent Health
Recommendation: Everyone working to help young people should listen to engage young people themselves in strategy design and implementation.
Kiara Álvarez, PhD, spoke about youth involvement in the U.S. General Services Administration as part of the global Open Government Challenge. The GSA has announced a commitment to increasing public participation across federal agencies and, Álvarez notes, this provides “meaningful civic engagement opportunities” that also “build youth connectedness to their local communities.”
Environment
Recommendation: The EPA should return to its mission of using science to protect and promote the health of the environment.
Jaime Madrigano, ScD, MPH, applauded bipartisan federal laws like the Clean Air and Clean Water Act, statutes that “not only saved countless lives but also trillions of dollars.” In the last five years, regulatory updates regarding air pollution reduction would help avoid more than 100 million asthma attacks and continue to provide over $250 billion in net benefits annually through 2050. A strong EPA, she noted, produces a cleaner environment and more resilient economy.
Violence
Recommendation: State legislatures and Congress should enact gun laws shown to reduce violence. These include requiring background checks and permits for gun purchasers, disarming domestic violence perpetrators, allowing law enforcement to deny concealed-carry licenses, and removing guns in high-risk situations.
Michelle Decker, ScD, MPH, spoke to gender-based violence as a leading preventable cause of injury and death and cited landmark 2023 legislation: the first U.S. National Plan to Address Gender-based Violence. The plan is a “blueprint for action that addresses prevention, housing and economic support, and emergent forms [of violence] like tech-facilitated abuse,” and has the potential to save thousands of lives.
The Road Ahead
The Summit was a celebration of innovative solutions from the macro—advocating for a “health in all policies” approach at every level of government—to the local level, where lifesaving public health work is best done in communities, with diverse voices contributing to identifying and solving problems.
In her remarks, Dean Ellen J. MacKenzie, PhD ’79, ScM ’75, noted that public health work has never been easy, but “the operating premise of the Bloomberg American Health Initiative is that public health and its champions had something to offer this unwell nation, including new ideas, new solutions, new evidence, and perhaps most importantly, boundless energy to enable change.”
MacKenzie included a call to action for the Bloomberg Fellows: “From the beginning it’s been challenging, and every time, you have heeded the call,” she said. “Your voices and your actions will matter deeply in the years ahead. Your country needs you to stand up for science, to share your best evidence, and to advocate for policies that protect health and advance equity.”
Lindsay Smith Rogers, MA, is the producer of the Public Health On Call podcast, an editor for Expert Insights, and the director of content strategy for the Johns Hopkins Bloomberg School of Public Health.
