Finding the link between poverty and public health

Koe attended Harvard Medical School, where he completed his studies in 1991. After the residency, as a Cornell faculty member, he traveled to Brazil to direct a public health project jointly funded by the country’s Ministry of Health and the US National Institutes of Health. In Salvador, one of Brazil’s poorest cities, Koe trained a local group of physicians and public health professionals to address numerous public health challenges.

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“It was a period of rapid urbanization,” he says. “We have seen multiple outbreaks of the infection spread by rats or mice that became epidemic in the densely populated slum communities of the city. Infections such as dengue, meningitis, leptospirosis and Zika. “

In 2010, Koe left for Cornell- and Brazil-Yale, where he works at the intersection of public health and social justice. “So far, it’s clear that poverty is a major driver in public health,” he says. “But we need to move forward to understand what it is about poverty that affects poor health outcomes. And most of all, we need to invest in the capacity of vulnerable communities to solve their problems. “

New Haven is geographically and socio-economically far from Salvador. And Covid-19, an airborne virus, is quite different from the diseases one had to deal with in Brazil. But one element of the epidemic experience was the same. “The Kovid virus took advantage of our inherent social inequalities, like the Zika epidemic in Brazil,” he says. “Here in the U.S., we had the first devastating wave that struck nursing home communities. We saw mortality in the Black and Latin communities, which was five to six times higher than the national average. But by increasing the widespread access to testing on face masks and social distance, by enforcing commands and policies, and – importantly – by providing social security to our most vulnerable populations, we were able to bring that level down.

The lessons he draws have profound effects. “We’ve seen 5 million [deaths] In this epidemic [globally as of the end of 2021]”If we don’t want to see another 5 million die, we need to vaccinate the world. Right now, it’s mostly people living in countries who can afford to get vaccinated. Dealing with social decision makers can make a difference, and unless we can protect everyone, we can’t really protect ourselves.

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