‘Why public health at WashU?’

Sandro Galea, MD, DrPh, greets members of the WashU community during a welcome event.
Sandro Galea (center) greets members of the WashU community during a welcome event. (Photo: Gara Lacy/Washington University)

Next January, Sandro Galea, MD, DrPh, will become the Margaret C. Ryan Dean for the planned School of Public Health at Washington University in St. Louis. During a June 7 welcome reception, he talked about building a world-class school and shaping a healthier world. Galea also will serve as the Eugene S. and Constance D. Kahn Distinguished Professor in Public Health. The school is set to launch in fall 2026.

Following are excerpts from Galea’s remarks.

If you will indulge me, I want to make brief remarks that address four questions that I think are critical for this journey we are embarking on together. 

  • What is public health?
  • Why does public health matter at this moment?
  • Why public health at WashU?
  • How will we realize a vision of excellence in public health at WashU?

First, what is public health?

A story to start us off.

It is the story of French painter Françoise Gilot, who died a year ago yesterday. You may have heard of her, principally because she was a lover of Pablo Picasso. But Françoise Gilot’s life also intersected with public health. After a tempestuous relationship with Picasso, she found love — marrying Jonas Salk, developer of the polio vaccine.

Now why do I tell you about Françoise Gilot? She was born in 1921. When she was born, life expectancy in France was about 43, which means that when she was born, she should have expected to live about that long. But when Françoise Gilot died last year (at age 101), life expectancy in France had risen to 83. In the course of the century she lived, people born in France could expect to live nearly twice as long. This reflected a global increase in life expectancy around roughly that time, from about 34 years in 1913 to 71 years in 2021.

Can you think of anything else in human history that has been more remarkable? In just a century, people could expect to live over twice as long.

Now why did that happen?

It was the development of vaccines and antibiotics, to be sure. But that was just a small part of it. It was because during those years of the 20th century, we created a healthier world. What is a healthier world? It is a world where all can access the resources that support health — resources like a good education, economic security, the fruits of technological innovation, global stability and peace, efforts to end racism and misogyny. It is a world where everyone can live rich, full lives where they can develop their talents and abilities, pursue adventure and love, make friends, spend time with family, and enjoy many active years doing what they want to do.

Françoise Gilot lived such a life. Part of this was due to her good fortune, being born to a well-to-do family, having received an excellent education, and having had artistic talent which her parents nurtured. But it also was because during the 20th century the world became a place where more and more people could also live such a life.

And this is public health. Public health is the work of building a world where everyone can live the rich, full, long lives that health enables. This is a radical aspiration. It is radical because it means improving the world at every level. And that is a vision that we, building a school of public health, are committing to.

Now to my second question:

Why does public health matter at this moment?

It matters because, in this polarized time, health is a universal aspiration. Health is a necessary condition for everything else we want to do, something we cannot live without. Health matters because time with family and friends matters, because reading good books matters, because falling in love matters, because being human matters. Everything we do starts with being healthy enough to do it. And health matters because in a time of conflict and turmoil health is a uniting force that can bring people together like little else. Because ask yourself this: What can everyone agree on more than that they want their children to be healthy?

Third, why public health at WashU?

Why a School of Public Health here, now? Because now is the time for public health leadership. And leadership is the business of a great university like WashU.

We have just lived through a pandemic, which was in many ways public health’s finest hour. But it also exposed cracks in our public health infrastructure, caused by years of underinvestment in health. The costs of COVID were staggering. Over 1 million people died from the disease in the U.S. alone, and the pandemic cost this country an estimated $16 trillion — roughly the GDP of China.

The pandemic also forced us to confront deep inequities in health in the U.S. and around the world. In the U.S., for example, longstanding health gaps between Black and white Americans meant that during the pandemic, Black Americans were three times likelier to sicken and twice as likely to die from COVID than white Americans. In the area of mental health, depression tripled during the pandemic and populations with fewer economic resources were likelier to suffer from depression during those years than populations on stabler financial footing.

Here in Missouri, we can see the preexisting conditions that hold back the health of communities. Here, for example, drug overdose is the No. 1 cause of death for adults between the ages of 18 and 44, and the state ranks 31st among U.S. states for drug overdose deaths.

These challenges reflect a need in this state, and in this country, for a revitalized public health capable of meeting the challenges of this moment. And WashU stands to be part of the solution, rising to the challenge with an excellent new School of Public Health.

And, finally, I will move on to the “how.” We all know that “vision without execution is just hallucination.”

How, then, will we build a world-class School of Public Health at WashU?

I propose a 10-year aspiration guided by the ideal of excellence and three key points that will inform what we do from day one. 

First, we will support excellence and innovation by engaging world-class faculty. The core function of a school is to generate knowledge and help students thrive. This means bringing in faculty who reflect a diverse range of identities and perspectives, who are accomplished, intellectually courageous, unafraid of challenging orthodoxies, toward the goal of shaping a robust, healthy climate of ideas. 

Second, we will draw from WashU’s strengths by forging partnerships within the university to advance excellence in public health and beyond. WashU is home to eight world-class schools. All these schools are essential to the creation of a healthier world. Building a great school of public health at WashU means creating public health plus, to find synergies with all the schools at WashU, to create a whole that is greater than the sum of its parts.

Third, a great school of public health has a responsibility to engage with challenges to health wherever they are found, particularly in our own backyard. Shaping a healthier world starts at home. This means that the school needs to be designed from the beginning with an eye toward local and global partnerships, to create a better world. It means a school that leads with scholarship but cares deeply about its commitment to the people we serve here and worldwide.

Outstanding faculty. Public health plus. Local and global impact.

That, I think, is a vision around which we can build excellence that transcends us all.

I look forward to working with you and learning from you in the months and years to come, and to all we will do together.