Columbia Mailman Professors Featured in PBS Series on Public Health
Robert Fullilove and David Rosner, both professors of sociomedical sciences, are featured in a new PBS documentary series that examines the often underfunded, undervalued, and misunderstood role that public health plays in extending and improving all our lives. The Invisible Shield, which premiered on March 26, provides a historical perspective on the rise of public health in response to industrialization and disease, alongside the social, economic, and political forces that resist its efforts—tensions that boiled over during the height of the COVID-19 pandemic.
In the first episode, Rosner, a public health historian in the Center for History and Ethics, traces the emergence of public health in the wake of industrial capitalism, urbanization, and infectious outbreaks like cholera. From an early emphasis on sanitary environments and curbing infectious diseases, the field later broadened its vision to include non-communicable diseases. “Public health became a field that was dynamic in its conception of what health was,” Rosner says. More recently, public health has come to examine the important role that social forces—and historic injustices—play in shaping our health. “We have to deal with inequality as a root cause of illness. And illness is a kind of emblem of our society,” says Rosner.
Rosner evokes Abraham Lincoln’s Second Inaugural Address, which is inscribed on a wall of the Lincoln Memorial in Washington, D.C. Lincoln’s words underscore the country’s collective responsibility for the “sin” of slavery and how the suffering of many benefited an entitled few. “That’s a theme that is at the heart of all public health,” Rosner says, “[of] trying to find ways of remedying and addressing the inequities that are part of our original sin.”
In the third episode on distrust and disinformation during the COVID-19 pandemic, Fullilove, Associate Dean for Community and Minority Affairs, speaks to why many African Americans mistrust medicine and science—owing to a long history of mistreatment and injustice, he explains, from the slavery period to the Tuskegee Syphilis experiment up to contemporary experiences of poor treatment and neglect by medical providers. Says Fullilove: “At a moment when we need people to believe us, to trust the word of a researcher, trust the word of science, you are still going to see this legacy that is going to block our ability to make those communications have an impact.”
Fullilove observes that health and longevity are largely determined by structural factors, especially where we live. Urban deindustrialization and disinvestment limited opportunities for communities of color beginning in the 1970s, leading some people there to turn to drugs and sex work. In this environment, HIV flourished. And the war on drugs only worsened the problem. Even after the introduction of effective treatments in the 1990s, HIV persists. “Cures” never make diseases go away, he explains, when “the social factors that are driving [them] are still present.”
Columbia Mailman alumnus Brian C. Castrucci, DrPH, MA'06, president and chief executive officer of the de Beaumont Foundation, is also featured throughout the series. In the second episode, Castrucci speaks about the fractured nature of the U.S. public health system where there is little coordination between federal, state, and local levels. “It’s an orchestra with a lot of conductors and very few instruments,” he says. During the pandemic, this disjointed and underfunded system was further undermined by misinformation and anti-government ideologues. Castrucci concludes, “You simply cannot practice public health in an individualistic society. You have to have some sense of community for effective public health.”