Physician and progressive politician Abdul El-Sayed discussed public health in a lecture hosted by the Winston Center for Leadership and Ethics at Boston College on Tuesday.
El-Sayed served as the commissioner of the Detroit Health Department from 2015 to 2017 and ran a campaign for governor of Michigan in 2018 following the Flint water crisis.
He ultimately finished second out of three in the Democratic primary for governor, running a platform that called for universal access to healthcare and clean water, among other progressive priorities.
El-Sayed said his job as commissioner was what opened his eyes to the generational and systemic issues Detroit faces. Public health is not simply medical health, but also an analysis of populations and contexts.
“Public health is what we, as a society, do collectively to assure the conditions for people to be healthy,” El-Sayed said.
According to El-Sayed, the main obstacles facing Detroit are related to education, employment, communities, and neighborhoods. People in Detroit do not have access to resources, nor can they afford them. The causes can be traced back to complex relationships of socioeconomic contexts.
Detroit’s population has drastically declined from 1.8 million in 1950 to 670,000 today, with most of the population leaving between 2000 and 2010.
“Density changes experiences of poverty,” El-Sayed explained.
Commerce, transportation, and infrastructure development have been pushed down the priority list by the city, prompting Sayed's decision to leave his position at the Detroit Health Department.
The city has refused to recognize even the smaller scale issues of teenage pregnancy, asthma, lead-related health issues, malnutrition, and elderly isolation. Every year 20,000 people lose access to water, and demolition programs show no sign of stopping.
“Politics are a fact of life,” El-Sayed said. "It is what we do as humans to make decisions on how we allocate scarce resources.”
El-Sayed’s campaign for governor highlighted these exact public health issues, stressing how public health can push back from being co-opted by big money companies and broken bureaucracies.
“Health itself is a scarce resource,” he said. “We don’t have a conversation about it, which is the worst way to have a conversation.”
In order to change generational and systematic marginalization of low-income communities, El-Sayed recommends targeting specific aspects of communities and working from the ground up. This process goes beyond our current “culture of mediocrity.”
Conversations about public health with El-Sayed are available on his podcast, America Dissected.