The moment

Our role in an unsettled, tumultuous time.

It is not my role, or aspiration, with these essays, to comment in real time on all that is happening in the world around us. I try to use this space to pause, to step back and reflect on the bigger picture—the longer arc of the issues that shape the world around us and that, in turn, shape health. It is, however, difficult to ignore events when they occur so fast and with such implications for our work—our mission of thinking, writing, and acting in pursuit of a healthier world. This feels like such a moment, one that bears reflection. Globally, we are seeing a fraying of a world order that has held for the past 75 years, as old alliances are being called into question like never before in recent memory, leaving us to wonder what shape geopolitical forces will assume and what implications this realignment will have for war and for peace. Conflicts continue to rage, from the war in Ukraine to the Iranian government’s recent killing of as many as 30,000 of the country’s citizens. Nationally, we have seen a threat to foundational political structures that we have long taken for granted, as the executive branch strains against the judicial branch. Aiming to deliver on campaign promises to change immigration in this country, the administration has launched increasingly alarming and cruel immigration enforcement measures, culminating in deaths. Protests against these efforts in Minnesota have galvanized national and global attention. All this is unfolding against a backdrop of ever-more-apparent extreme weather events, such as the one we are living through across much of the US this week, even as the drivers of climate change are neglected in federal policy.

This, then, is a moment that calls for reflection. In such times, it can feel simultaneously as though so very much is happening everywhere, all at once, and also as if the world is standing still. So much is happening that it seems like the pace of events cannot long continue at this pitch—there is disequilibrium here, and it feels like something must soon give. We are holding our breath, waiting to see what that might be, what new form the world will take. We wonder how we might act to be helpful in the moment. What can we do to help ensure the new world that emerges is better, not worse? We can sense the danger, and also perhaps the potential, all around us. This reminds me of a useful aphorism by Antonio Gramsci: “The old world is dying, and the new world struggles to be born; now is the time of monsters.” So yes, it is a moment of danger—one that affects many of us in deeply personal ways. It affects those who, like me, are immigrants to this country, facing the ever-present threat of “othering” that has become normative in the public political conversation, and the very real threat of expulsion. It affects those who have lost jobs, or have family and friends who have lost jobs, in sectors radically transformed over the past year. It affects families who continue to find the country’s economic imbalances unsustainable and have a hard time making ends meet. It affects communities devastated by climate disasters, forced to rebuild their lives amid increasingly volatile conditions. The moment is not abstract. It is real, tangible, and affecting humans every day.

This brings me back to the question: how can we constructively engage with this moment? What is the role of those of us in the community of thinkers and doers focused on the health of populations? What should we do when the world seems to teeter on the brink of…something? How do we help nudge an unstable world in the right direction? I have found myself reflecting on this time and again over the past tumultuous decade, and perhaps never more so than in this past year, when that tumult seems to be approaching some sort of crescendo. In reflecting, I keep returning to three principles. I share them here—partly to sharpen my own thoughts through writing, and in the hope that they may be useful to those who read this.

First, in moments like this it is important to be clear about the values that we hold dear—to have a sharply etched clarity about where our north star is. Each of us has our own set of values that can guide us, but I would like to think there are some universals we can agree on and hold dear. At the WashU School of Public Health, we have collectively articulated a values statement, “The School of Public Health is committed to excellence, diligence, compassion, and integrity. We aspire to be an optimistic, inclusive, collaborative community with a sustained focused on advancing our shared mission.” Perhaps that is a useful organizing framework for how we might choose to conduct ourselves in this moment, even as we acknowledge the validity of other approaches. It seems essential to have a set of values to guide us—something we can hold onto as one would hold a mast in a lashing storm—so that we are prepared to hold the line when what is core to us is threatened.

Second, there is our shared mission. What might that be? Clearly, each of us may have our own mission, and there are many such missions worth organizing around. At our school, we articulate our mission as “to promote health and well-being through excellence in interdisciplinary population health science and scholarship, distinction in education, and a deep commitment to local and global impact.” To my thinking, such a mission statement is a good way to focus what one does. And if one believes in one’s mission, then in moments of turmoil it becomes more important than ever to lean into that mission—to strive for even greater excellence in our science and in our education, and to think hard about how our work can be consequential and advance local and global impact. Yes, this is what we should be doing every day, but I would argue that it is doubly true in moments of rancor and challenge.

Third, we all have duties and responsibilities as citizens. We are not only our aspirational or professional selves. We are also citizens in a broader world, with obligations to each other and to a larger national and global project of building a better world. How do we inhabit this responsibility? Often, I fear we do so reactively, alighting with anger on a moment (which may well be angering) without carefully considering what we are trying to achieve. Sometimes, it is important to express anger, to be vocal about a world that does not align with our values or that runs counter to our mission. At other times, it is more important to show restraint—to identify practical ways we can act in countering forces that threaten the well-being of our communities, our nation, and our world. There is a long intellectual tradition of reflecting on how citizens should act in times of upheaval. From ancient ideas of civic virtue to modern calls for civil disobedience, many thinkers have argued that moments of crisis demand engaged, principled action from citizens rather than mere outrage. Hannah Arendt, for example, observed that we must act to prevent wrongdoing because the world we all share is at stake, and Martin Luther King Jr. taught that we have a moral responsibility to oppose, and work to change, unjust laws. The throughline is clear: in times of upheaval, citizens are called to thoughtful, purposeful engagement—action that is productive and not merely gestural, that helps restore a forward-looking equilibrium rather than adding to imbalance.

At the end of the day, this feels to me like what we should be doing when we pause and reflect—when we block out the noise for a moment and ask the questions I posed at the start of this piece: How do we act in the moment, and how do we do so productively, toward creating a better world? I come back to the third part of our foundational documents here at the school—our vision “to ensure all can live healthier, fulfilling lives.” We can all have different visions, but this one feels roughly right to me for guiding us towards constructive action in this moment. This brings us to the question: what do we do to advance that vision? Being clear about our guiding values, leaning into the work we do to advance our mission, and thoughtfully fulfilling our responsibilities as citizens—this is what the moment calls for. I write here, as I always do, interested in hearing what others think, so I can learn from that. Thank you to everyone who has been thinking about the moment and who is engaged every day in the work of making the world better for all.

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About the Purple Public Health Project

We are grateful for the many thoughtful reflections and responses we have received following the launch of the Purple Public Health Project last week. It is clear there is a real appetite for a space dedicated to dialogue, disagreement, and collective thinking regarding the future of public health.

To build on this momentum, we are opening the project to community contributions. We invite you to share essays, reflections, images, audio, video or other creative formats that help us explore how public health generates knowledge and earns trust across differences. Selected pieces will be featured on the Healthier Futures Lab website and our associated platforms.

If you have an idea or perspective you would like to share, please write us at healthierfutureslab@wustl.edu. We look forward to continuing this conversation together.

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Also this week

Enjoyed speaking with students at the WashU Gephardt Institute for Civic and Community Engagement about public health in this moment.