A surprising, hopeful election

Thoughts on the midterms and, perhaps, the beginning of a return to useful radical politics.

Last week, the country went to the polls to vote in the midterm elections. While the full results are not yet in, and likely will not be for some time, it looks like Republicans may narrowly win the House, with control of the Senate still undecided. These results have implications for a range of key issues, from guns, to climate change, to reproductive rights, to economic inequality, to addressing social and racial injustice. Fundamentally, such issues share a common link: they are all deeply consequential for health. There have now been four federal elections since I began serving as Dean of this school. I argued before each of them that, for all the many issues on the ballot, at core, elections are about health and the social, economic, environmental, and political conditions that shape it. This week’s election was no exception, and its results are no less consequential for the work of building a healthier world.

Like many, I was surprised by how the election unfolded. Before the vote, there was much talk of a red wave, or, at the very least, decisive gains for Republicans across the country. This outcome would have been the typical trajectory of midterm elections in the US, in which the party in power often loses seats in Congress. Yet, while we may still see Republicans gain control of the national legislature, these gains are nowhere near as extensive as many predicted.

As the results came in, I found myself feeling something I have not felt during an election in almost a decade: a sense of satisfaction. It felt as if America was, in real-time, re-embracing a willingness to make political choices based on a reasoned consideration of issues rather than on reflective partisan backlash to the party in power. In doing so, the electorate has helped mitigate some of the extremism of the present moment; this is very much to the good. When Donald Trump ran for president, he unleashed forces of ideological intemperance. Since then, this extremism has been informed and amplified by a range of factors, from social movements to the emergence of COVID-19. During this time, we saw the rise of an exclusionary politics, in which ideological rigidity was the order of the day. This polarization characterized our political divide. This extremism—this undermining of the political center—has done significant harm, regardless of which side it may seem to favor at a given moment. By creating an exclusionary dynamic, the politics of recent years has prevented us from coming together to shape a better, healthier world. 

The results of the 2022 midterms seem to suggest a change of course. In place of a red wave, voters engaged with issues and with evaluating the fitness of various candidates. This suggests a drift back to the voting habits that characterize a country with a robust commitment to working through issues carefully, doing the hard work of building and improving a country, towards a vision of a better whole.

This move towards rebuilding is, to my thinking, worth celebrating for its own sake—as a sign of greater stability in our politics—and as the best path towards supporting a radical vision of a healthier world. In the present moment, we have heard much that passes for radicalism, but which amounts, often, to mere rhetoric. True radicalism is found in the practical steps that get us to a world that is very different than the one we currently have, one informed by an inclusive vision for a better future. Radicalism is not posturing in the public square, it is not seeing who can make the most extreme statements or build the most ideologically “pure” coalition. It is helping to generate social and political outcomes that create the conditions for a healthier world. I have long felt that this calls for an embrace of radical incrementalism, in which we take the sometimes-small steps which ultimately get us closer to our destination than the radical leaps which can find us tripping painfully over our good intentions.

Clearly I worry that these election results, potentially putting in power a political agenda that is often mis-aligned with the goals of public health, could occasion challenges in the coming two years. But we have learned over the past many years that the assumption that a solution to the challenges of health can come only from one side of the political spectrum is a chimera. To the contrary, truly radical ideas—as surely the project to build a better world is—are likelier to flourish when the political center is strong. This is because movements based on compromise and moderation tend to be better at keeping people in their tent, building broad coalitions that can attract enough support to enact durable positive change. Such movements can be committed to a vision of radicalism without always embracing its noisier trappings. In recent years, American politics has been defined by these trappings. In public health, this has seen our field sometimes embracing rhetoric that alienates potential allies who could help shape a better future. This must change. To build a healthier world, we need to stop letting our radicalism get in the way of our radicalism. Last week’s election results suggest this may be happening, that we may be seeing a resurgent political common sense grounded in the creation of pathways towards better health for everybody. This is a welcome sight indeed.