From the Dean: Bringing a nation together

This past Tuesday was notable in two regards. Most important of course is that it was the 80th anniversary of the attack on Pearl Harbor in Hawaii. The other event of note is that a federal court stopped (at least temporarily) the implementation of a SARS-CoV-2 vaccination mandate for employees working on federal contracts. Since UND has something like $110 million in federal contracts at present, anything related to those contracts is a big deal.

The attack on Pearl Harbor, which killed some 2,400 Americans, served to galvanize the country and unite it in entering the Second World War; we declared war on Japan the following day. Although there had been a strong isolationist faction in the U.S. prior to Pearl Harbor, there was almost uniform support for entering the fray following the attack, and the U.S. soon became a combatant in the most destructive war in human history.

And while it’s not my intent to compare the two events, note that the pandemic — which too represents a serious threat to our nation — has unfortunately seen a far less uniform public response.

The federal vaccine mandate has been assailed as an overreach — and perhaps it is. But what is lost in the debate over this issue is the importance of focusing on the health not only of the individual but also of the community.

The dynamic tension between these two imperatives – individual health vs. population health – didn’t really occur to me until I entered the University of Michigan School of Public Health about two decades ago to pursue a master of public health degree. Prior to matriculation, I was a practicing cardiologist (albeit as a part-time clinician) and focused on the care of the individual patient in front of me. As I came to understand better population health from the vantage point of the professors of public health who were my teachers and mentors, though, it became obvious to me that care of the individual patient was only part of comprehensive health care. The other part was taking a community/population approach. A simple example is the management of high blood pressure. There is no question that I can help a specific patient with high blood pressure by prescribing appropriate anti-hypertensive medications. But what an amplifying effect is achieved if we can get an entire community to reduce their consumption of salt and exercise more, for example, and thereby help control the blood pressure of the entire population.

This balance between an approach focused on the individual vs. one focused on achieving a common good for a population at large was apparent with the two events on Tuesday. In the case of Pearl Harbor, Americans came together to protect the community, even though it meant sacrifice (and even death). My father served in that war, and while he never discussed what he experienced overseas, it was clear that he felt a sense of pride in having served his country.

On the other hand, the pandemic in so many ways has further divided rather than unified the country, even though the threat of the pandemic is just as serious as any our people have faced.

Let’s hope that we can begin to get beyond the divisive rhetoric and think about not only the importance of individual choice and responsibility but also our shared sense of purpose and responsibility to each other. We found that common ground in the past, and we need to find it again.

Joshua Wynne, MD, MBA, MPH
Vice President for Health Affairs, UND
Dean, UND School of Medicine & Health Sciences