When a group of Luther faculty began talking about creating a new Global Health major at Luther, we could not have imagined that the rollout of our program would coincide with the global pandemic.
The World Health Organization reports nearly 9 million confirmed cases of COVID-19, including 469,587 deaths worldwide. Over 2 million of these are in the U.S., with 119,761 deaths. A global lesson in humility, the pandemic has brought to light health disparities that have been around all along.
Why Study Global Health?
In the U.S., age-adjusted hospitalization rates are highest among Native Americans, African American and Hispanic people, according to the CDC. Prior to the pandemic, these ethnic groups have experienced higher rates of infant mortality, HIV/AIDS, and cardiovascular disease than White Americans, and substantial differences in disease incidence (new cases), severity, progression, and treatment. Far from accidental, these patterns of morbidity and mortality are rooted in the social determinants of health—factors such as social class, ethnicity, gender, education, and so forth.
The mechanisms in which social inequalities and injustices are transformed into health disparities are complex, but well documented and well researched by scholars from a variety of fields. They are the foundational inquiry of Global Health—a new major that I am proud to introduce to the Luther College community and beyond.
About the Major
Global health is an interdisciplinary field that draws on public health, clinical medicine, anthropology, political economy, sociology and history. It focuses on understanding how political, socio-economic, and environmental factors affect health domestically and internationally. It understands health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
While life expectancy and health outcomes in many populations have dramatically improved as a result of advances in public health measures and technological innovations, these gains have not been distributed evenly around the world. Global health focuses on improving health and achieving equity in health for all people worldwide.
As Paul Farmer, a tireless champion of global health equity, once noted, “aspiration of all global health work: (is) a world in which the poor and the sick get their fair share of our planet’s vast resources, medical and otherwise.”
While biological factors undoubtedly affect our physical health, the social gradient is found all over the world, i.e. people on the lower end of the social hierarchies experience more suffering and die younger. This gradient is especially steep in countries with pronounced inequalities, such as the United States. Pew Research Center reports that the wealth gap in the U.S. is the widest on record, with the median net worth of the upper-income families nearly 70 times that of lower-income families, and virtually no wealth gains made by families of any social class other than the upper-income group.
Global health scholars and practitioners work in their zones of influence (clinical, policy, scholarship, program planning, etc.) to alleviate the harmful effects of inequalities that result from uneven distribution of resources and other dimensions of oppression worldwide (along racial or gender lines, for example). They compel us to reimagine the possible and to ensure that scientific gains in medicine are accessible to people who need them the most. I hope that one positive consequence of the current pandemic will be our collective sense of the urgent work that needs to be done in translating the medical advances into programs that work worldwide. People around the world have common interests, and global health is everyone’s health.
While we have celebrated the sacrifices of the essential workers in the midst of the COVID-19 pandemic, let’s also consider how many of them earn meager wages and are not in a position to take time off work, even when they may not feel safe to do so. In my country of origin, Ukraine, for example, 20% of all COVID-19 cases are among doctors and nurses who work in the severely underfunded health care system with limited resources. This rate of infection among the medical staff as compared to the general population was the highest in the world in the height of the pandemic, once again pointing out the gaps in social protections that have always existed and have finally got the spotlight in the pandemic.
In her recent book “Contagious: Cultures, Carriers, and the Outbreak Narrative,” Priscilla Wald encourages us to question the predictable trajectory of the “outbreak narrative.” The stories that tend to circulate in popular culture and media focus on the identification of an emerging infection, tracing it through the global networks of viral contact, and eventually containing it with epidemiologic measures. This outbreak narrative runs the risk of dangerously obscuring the complex factors at play that make populations vulnerable to disease at the first place, and that Global Health works to bring to light and alleviate.
Goals for the Curriculum
Global Health students are aspiring global citizens interested in learning about the health challenges that people at home and abroad face, excited to address these challenges, and working to develop a nuanced understanding of these issues.
At Luther, they will have both a common core curriculum and the opportunity to pursue depth in a related area of interest: the science of disease and wellness; global health policy and systems; and society, culture, and human health. No matter what area they select, global health students will work to achieve both excellence and equity in their respective fields. We can’t wait to get to know our first cohort and are looking forward to working with them!