From the Dean: Dreams Come True

From the Dean: Dreams Come True

Dreams. We all have them, both personal and professional. They define much of our hope for the future and, as realized dreams, our contentment with the present and the past. The title of this month’s column reflects this duality: “dreams come true” can (and should) be interpreted as both the successful attainment of what were once seemingly implausible goals (dreams that have come true), and glorious aspirations (the hope that dreams will come true in the future).

Let me illustrate with specific dreams realized and those we long to achieve. For me, a child of the (pre) Civil Rights era, no dream seemed more unattainable than the election of an African-American president of the United States. President Obama’s election has caused me to revise my opinion of the American public. I do not think the election denotes the end of racism—far from it—but it does suggest that, personally, I have overestimated its pervasiveness and intensity. In particular, we have a younger generation, itself a reflection of our increasingly diverse society, that may be in the process of truly overcoming racism. A dream for the future, enabled by a dream realized November 4th, just one year ago.

What of public health dreams for the future? For decades, many of us have dreamed that health care coverage would be extended to all American citizens. SPH faculty have been participating actively in trying to bring that dream to fruition—for example, by having advised the Obama team on health-reform planning during the presidential campaign, educating the public about the issues in a Michigan Radio series on the subject, and working closely with senators and representatives in Congress to embed the principles of value-based insurance design—a field in which the University of Michigan School of Public Health is a national leader—in health care-reform legislation.

As I have noted before, in striving for universal coverage we have to learn how to put the health in health care. Historically, disease prevention and health promotion—and certainly public health more generally—have received lip service in health reform debates. Many of us are working hard today to change that. Notions such as a $10 billion public health “trust fund” are circulating among congres-sional legislation writers. It’s a bold concept, one that we have reason to dream may come true.

In my own professional domain, tobacco control, a mere decade ago I would have considered it completely inconceivable that some 30 states and 17 entire countries would have gone smoke-free by 2009, prohibiting smoking in all workplaces, including all restaurants and bars. While Michigan’s state legislature has thus far been unable to join the mainstream, your alma mater is planning for a completely smoke-free UM campus.

Another dream is that in our increasingly globalizing world, America will reestablish its role as a cooperative member of the family of nations. In tobacco control, this will be reflected in the U.S. Senate’s ratifying the Framework Convention on Tobacco Control, the world’s first public health treaty, one that is already making important inroads against the spread of tobacco addiction in the world’s low- and middle-income countries. While 166 nations have already ratified the treaty, it has not yet been brought to the Senate for its consideration. I expect it to be ratified during the current or next session of Congress. Similarly, we need to get onboard, and indeed exert leadership in, international cooperation on global warming. The U.S. President’s Emergency Plan for AIDS Relief initiative demonstrates that our country can exert leadership in tackling the most important and challenging public health problems plaguing our world. America’s dreams for the future must have much in common with those of our global partners.

While public health toils in the background, poorly supported, often invisible, we need to celebrate—and publicize—what our field has accomplished. The environment in the U.S. is far cleaner than the one we inherited on the first Earth Day, nearly four decades ago. The highways are safer. We have lived to witness the extinction or near-extinction of crippling diseases such as smallpox and polio. We have made giant strides toward reducing the disease burden produced by tobacco use. We have realized so many important dreams, yet so many others remain but long-sought aspirations. The irony is that without the triumphs of public health, many Americans, many of the citizens of the globe, would not be here to dream, and thereby to fashion a better future for all of us.

-Kenneth E. Warner

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