by Philip Alcabes, Ph.D.
The public policy scholar Robert Puentes (a Senior Fellow at the Brookings Institution) has advised that we look at extreme weather events — like last month’s Hurricane Sandy — as part of the “new normal.” To which we can add last year’s Hurricane Irene, the derecho of summer ‘12, a devastating drought in the middle of the country, paralyzing snowstorms in both October 2011 and last week that felled trees and branches that were still in leaf, and so on.
But the new normal – extreme weather, rising sea levels in the Northeast, higher storm surges, and, as the National Aeronautics and Space Administration (NASA) reported, ecosystem change – isn’t just a matter for transportation and land-use planners.
It means that we need new norms for health – and new ways of protecting the gains in human capacity and longevity won in the course of the previous century.
How will we train a generation of health professionals to be capable of taking on dire problems of tomorrow whose outlines are only beginning to be perceptible today?
Here are five issues to consider in training future health professionals to confront the New Normal:
- Ecosystem alteration will both accelerate and alter the evolution of microbes. Microbes outnumber humans (by a lot!) and they can adapt far more readily to changed circumstances. What will ecosystem change mean for infectious diseases of humans? What sorts of responses will replace antibiotic therapy – already hopelessly out of date?
- The great gains in life expectancy of the past 150 years were partly attributable to improvements in waste management and water purification. How will our leaders protect those gains – when infrastructure is imperiled by rising sea levels, harmed by extreme weather, or out of power? How will waterborne illness be kept at bay? What sorts of microbial adaptions will create health concerns even outside of emergency situations?
- Energy shortages will exacerbate food insecurity – already a serious problem in our region and a pressing one worldwide. When poverty limits people’s access to nutritious food and failures of refrigeration or shipping curtail the availability of those foods that are (or were) accessible, we can anticipate new forms of debility. What will our leaders to do guarantee nutritional stability – and how will they do it without amplifying the damage to ecosystems already under way as a result of industrialized agriculture?
- Communities are challenged not only to develop new structures to prepare for dire events and respond to the unexpected, but especially to promote the solidarity necessary to respond collectively to trauma – both individual level trauma and that experienced by the community itself. What kind of leadership will be needed? Who will cultivate such solidarity at the same time as providing services?
- Finally, leadership itself is at stake. We can already see that some leaders hear cries for help while others simply preach to the victims about altering their risk-inducing ways.
A cautionary tale on leadership:
Two weeks after Hurricane Sandy, 55,000 NYC residents were still lacking power, many of them in buildings that also lacked running water. The New York City Commissioner of Health and Mental Hygiene, a leader in banning large servings of sugar-sweetened beverages and promoting bicycling, has done almost nothing to mobilize aid for threatened food and water supplies or provide warmth or medical care. Instead, the Department of Health and Mental Hygiene addresses suffering residents solely with warnings: “Never use stove burners or ovens for heat,” “Dry ice: safety tips,” “Hypothermia after Hurricane Sandy,” and other messages populate the website.
Effective leadership in the New Normal will mean being proficient technically, of course. But it will also mean not wasting time and resources preaching about behavioral “improvement.” It will mean recognizing the enormity of suffering and the depth of human needs. And it will mean being able to plan and respond in ways that are both smart and humane.
Acknowledging, with the advent of Sandy, that the New Normal has arrived, we who train health professionals are challenged to produce the right kind of leaders for the future.
Philip Alcabes is a professor in the Adelphi University School of Nursing and director of the Public Health Program. He is an epidemiologist and has studied the history, ethics, and policy of public health.
