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Can we talk?

After a year of attempting to arrange a one-on-one conversation with Dean Bess Marcus at the School of Public Health at Brown University, the interview was abruptly cancelled at the last moment, with no plans to reschedule

Photo courtesy of Brown University website

Bess Marcus, dean of the School of Public Health at Brown University

By Richard Asinof
Posted 6/18/18
After more than a year of trying to set up a one-on-one interview with Dean Bess Marcus at the School of Public Health at Brown University, the meeting with ConvergenceRI was canceled on the morning of the interview.
If the School of Public Health does not speak out about the threat to public health from residents potentially being injured from toxic poisons in Rhode Island’s drinking water, who will? At a time when the city of Providence is proposing to sell its municipal water supply to pay off its pension liability, what questions should be asked about how the safety of drinking water will be preserved? Why did the R.I. House of Representatives refuse to hold a single meeting over two years by the legislative commission enacted to study the threat of lead in drinking water in the state? When will the pollsters conducting polls as part of the 2018 election campaign ask voters questions about how they view the threat of toxic contamination of drinking water? Which candidates running for office are willing to voice their public support for the agenda of EPA Administrator Scott Pruitt?
One of the difficulties in talking about public health outcomes is the way in which what are commonly considered externalities are never factored into the economic equation around costs. For instance, research has found that chronic student absenteeism in Rhode Island’s elementary schools has been linked to future poor academic achievement. Research has also shown that asthma conditions have been linked as the major cause of chronic absenteeism. While some amount of asthma cases can be attributed to genetics, the majority of cases are due to unsafe housing conditions and air pollution – environmental factors that are almost never calculated as risk factors in new highway construction and new industrial plant construction, particularly in low-income communities that are already overburdened with chronic asthma and chronic absenteeism.
The future health costs and educational costs that are a direct result of the rebuilding of the Route 6-10 Connector, for instance, have never become part of the economic equation in promoting the reconstruction. Why is this?

PROVIDENCE – In June of 2017, Brown University announced that Bess Marcus had been named the next dean of the School of Public Health, effective Nov. 1, 2017, replacing the retiring Dean Terrie Fox Wetle, who had served as the school’s first dean since 2013.

In the news release announcing her appointment, Marcus said: “I’m excited and honored by the opportunity to return to Brown [where she had been a professor of Psychiatry and Human Behavior] to lead the School of Public Health at such a critical time, given all of the local, national and global health challenges facing us, from obesity to climate change to so much more.”

One of the factors that was so exciting about the position, Marcus continued, was the richness of the University itself: its ability to address “important, complex issues related to population health is a central part of Brown’s mission.”

In announcing the appointment of Marcus, Brown University President Christina Paxson praised her “remarkable track record of promoting public health research” while at the University of California San Diego. “Her strong commitment to advancing high-impact research will be instrumental in inspiring students and faculty to confront the wide array of complex health challenges that face society,” Paxson said at the time in the news release.

Finding time to talk
Ever since her appointment had first been announced, ConvergenceRI had repeatedly requested an opportunity to interview Marcus one-on-one, in emails, in phone calls, and even in person, when Dr. Mona Hanna-Attisha spoke at Brown on March 1, 2018, all to no avail. [See link below to ConvergenceRI story, “There are Flints everywhere.”]

During that year-long interlude of trying and failing to gain access for an interview, ConvergenceRI continued to be vigilant in the coverage of public health news, publishing more than 30 stories about public health in Rhode Island, many involving the School of Public Health, including: childhood lead poisoning; health equity zones; the toxic stew of unregulated chemicals in Rhode Island drinking water known as PFO or PFOAs; the opening of The Mindfulness Center; why STDs were on the rise in Rhode Island; a talk by Bruce Lanphear at the School of Public Health about the need to change the way we think about disease; the importance of being earnest about data and research; and Paul Farmer’s efforts to build a public health infrastructure in the clinical deserts of Haiti, Rwanda, Sierra Leone and Liberia, to name a few.

Finally, after more than a year of trying, following the intervention in April of a member of the School of Public Health faculty, a half-hour interview with Marcus had been arranged for June 11, 2018.

Four days in advance of the interview, a request had been made to ConvergenceRI to provide the topics that would be covered in the interview, so that Marcus would be properly prepared.

ConvergenceRI responded, providing a list of 10 potential broad topics, with the caveat: “I tend to look upon interviews as a kind of improvisation, a call-and-response jazz riff, depending on where the conversation goes.”

The broad topics included:

The definition of public health in the 21st century.

The research opportunities in Rhode Island to expand the school of public health footprint

The need to change the way that disease is viewed, re: Bruce Lanphear.

The diseases of despair and the research of sociologist Shannon Monnat.

Pediatric screening for toxic stress.

What makes for an engaged community in the public health arena?

A renewed focus on drinking water; the lessons learned from Flint?

The Sankofa Initiative.

In addressing the opioid epidemic, [whether there was] the need for distinct strategies for men and women.

Quantifying the externalities [of public health] into the economic equation.

All of the “broad topics” had been the focus of recent reporting by ConvergenceRI during the past year. [In fact, Marcus had been forwarded the ConvergenceRI newsletter and “briefed” about the stories on a regular basis, according to sources.]

However, the response received from the communications staff was surprising: ConvergenceRI was told that a “meet and greet” would be a more appropriate format, given that Marcus had only been on the job for six months and “may not have a full understanding of many of these topics.”

[Why did it take more than a year for a meet and greet? ConvergenceRI wondered.]

In response, ConvergenceRI pushed back a bit, asking why the interview could not be a conversation with “some substance.”

In particular, the definition of public health in the 21st century seemed an apt beginning to the conversation, something Marcus should be able to talk about, given her past scholarship.

Also, given that the School of Public Health had invited Dr. Mona Hanna-Attisha to speak [a lecture at which Marcus had introduced her], the topic around the safety of drinking water seemed appropriate to the conversation.

And, talking about the ways in which the School of Public Health had opportunities to expand its research footprint seemed to be “an easy, appropriate” part of the conversation.

Interview cancelled
On Monday, June 11, three hours before the one-on-one interview was scheduled, it was cancelled, with the following email message:

“Some urgent business has come up for Dean Marcus, and we must cancel your interview scheduled today,” the email said. “We sincerely apologize for the short notice and will be sure to contact you if there is a future opportunity to connect with the Dean.”

ConvergenceRI followed up with a number of phone calls, attempting to reschedule the interview, a bit concerned by the wording: “will be sure to contact you if [emphasis added] there is a future opportunity to connect with the Dean.” If?

The next day, the executive assistant to the dean wrote back, apologizing for not returning the phone calls, saying that: “Unfortunately, the Dean will be traveling quite a bit in the coming weeks, so there’s not much to play with right now in terms of her availability. It is probably best that I reach out to you again in mid-July.”

ConvergenceRI responded: “I look forward to our potential conversation sometime this summer, which given the Dean’s busy schedule, would seem prudent to lock it in for the last week in July, if possible,” adding, “As a very wise woman, my mother, once told me, “You always make time for the things you want to do.”

Message delivered
For whatever reason, the message had been delivered: talking with ConvergenceRI was not a priority nor was it a welcome opportunity, at least apparently from Dean Bess Marcus’s perspective.

[And, by writing this story about the inordinate difficulties of arranging a half-hour conversation with Marcus, the likelihood of such a talk ever happening may be further, ah, diminished.]

To be clear, ConvergenceRI occupies a unique position: it is the only journalistic enterprise in Rhode Island that consistently writes about public health as part of the emerging innovation ecosystem in the state, breaking down the existing silos. Admittedly, as such, it is not a likely candidate to be a mouthpiece for Brown’s institutional public relations needs. [A request to interview Dr. Jack Elias, dean of the medical school, made at Elias’ own suggestion, to talk about the efforts underway to spur translational research, has been pending with Brian Clark, director of communications at Brown, since November of 2017.]

Sources suggested to ConvergenceRI that the reasons behind the deflection of the interview with Marcus might be related to internal pressures at Brown related to conflicts between the med school and the School of Public Health related to limited financial resources. The ability to corral the recent $100 investment in neurosciences would seem, at first blush, to swat some of that concern away.

The reality is that Brown University and its School of Public Health, as separate from the Warren Alpert Medical School, also occupies a unique position in Rhode Island: a place where research and rigorous scholarship can nurture talent and identify threats the public health of Rhode Island residents in the best tradition of public health advocacy.

To be unwilling to engage in a conversation about public health at a time of great danger posed by the rollback of environmental regulations by the Trump administration is, in ConvergenceRI’s opinion, a missed opportunity.

Documenting the threat
One of the undercurrents of the assault by the Trump administration on the Clean Air and Clean Water laws and the Toxic Substances Control Act as part of its strategic efforts to roll back regulations protecting citizens from harmful toxic and chemical pollution is the growing importance of public health research in identifying, analyzing and ringing the alarm bells to potential threats.

More than 67 environmental rules have been targeted by the Trump administration, according to an analysis conducted in January of 2018 and published by The New York Times. [See link below to story, “67 Environmental Rules on the Way Out under Trump.”]

EPA Administrator Scott Pruitt, despite facing continuing investigations into the alleged misuse of his position for private gain, including seeking a Chick-fil-A franchise for his wife, has sought to increase the aggressive pace of deregulation: on Friday, June 15, the EPA advanced a proposal to role back a rule designed to limit pollution in the drinking water of about 117 million Americans.

As Sen. Edward Markey from Massachusetts tweeted in response: “Don’t let Scott Pruitt’s ethics scandals distract you, because they’re not distracting him from executing his agenda of dismantling even the most basic public health protections like keeping antifreeze chemicals & paint strippers out of our drinking water.”

Who will speak out to protect Rhode Island?
The question is: who will speak out to protect Rhode Islanders from the potential dangers from the threat of poisoned water, documenting the risks?

There are numerous “environmental” groups – from Save The Bay to the R.I. Chapter of the Sierra Club, from the Environmental Justice League to the Conversation Law Foundation, from Clean Water Action RI to the digital weekly ecoRI News, among others. But these groups often lack the specific research expertise to document the science behind the public health threat.

The R.I. General Assembly, in particular the House of Representatives, failed for two years to convene a meeting of the legislative commission enacted to study the threat of lead in drinking water in Rhode Island, without ever giving a satisfactory answer why.

The R.I. Department of Health, a statewide agency whose mission and mandate revolves around protecting public health across a broad spectrum of potential urgent threats, is very much on the front lines – from flu to food contamination, from the opioid epidemic to lead poisoning, from the safety of patients in hospitals to the safety of swimmers at beaches across Rhode Island, from suicide prevention to promoting health equity.

The School of Public Health at Brown University, which recently received full accreditation, is at the academic end of the spectrum, nurturing academic talent, engaging in research and epidemiological studies, pursuing innovative programs such as the Mindfulness Center, often working in partnership with the R.I. Department of Health. [Much of that work is often “separate” – if that is the right word choice – from the clinical work of students and faculty at the Warren Alpert School of Medicine.]

Translated, if our drinking water and air are being poisoned by toxins, pesticides and chemical pollution, injuring the health of Rhode Island residents, who will document the problem, research the outcomes, and share the outcomes publicly – if not the School of Public Health? When Marcus was first hired as dean, she spoke of the critical time we live in, “given all of the local, national and global health challenges facing us.”

Paxson, in turn, talked about the leadership by Marcus to inspire students and faculty “to confront the wide array of complex health challenges that face society.”

Perhaps, at the most basic level, most disheartening is the realization that Marcus – and Brown University – apparently believe that they have little to learn or benefit from by engaging in a conversation with ConvergenceRI. That kind of disdain and smugness – as well as the apparent command and control posture by Brown’s communications staff – undercuts the university’s mission: “To serve the community, the nation, and the world by discovering, communicating, and preserving knowledge and understanding in a spirit of free inquiry, and by educating and preparing students to discharge the offices of life with usefulness and reputation.”

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