Bedi N, Smith R, Weiss M. An open letter to American academic institutions: stand behind the evidence. HPHR. 2023;52. https://doi.org/10.54111/0001/ZZ5
In an America that has heavily politicized public health issues such as reproductive rights, the climate crisis, racism, gun violence, and the opioid overdose epidemic, academic institutions have faltered in their responsibility to stand behind evidence. If academic institutions remain silent on critical issues, continue to ignore irrefutable evidence, and fail to provide a comprehensive education to the students that represent the future of the nation, preventable loss of life will continue. Academic institutions and leadership fail to take bold stances, out of concern about upsetting their students, benefactors, and supporters. Any academic institution is morally obligated to defend human rights, operate based on scientific evidence, and speak out against the discriminatory politics and regressive and oppressive movements our nation witnesses today.
The last several years of American life have left us reeling from a pandemic that overwhelmed our healthcare system and killed over one million Americans, due to an ineffectual public health response made controversial by American politics.1,2 The pandemic response has been complicated by an ongoing battle in our nation between scientific experts and evidence and political opinion. This is not unique to COVID-19, however. Several major public health crises are touted as controversial – despite decisive evidence otherwise.
Reproductive rights and freedoms have been seized, severely limiting access to life-saving procedures and medication for nearly one-third of Americans of reproductive age.3,4 Little has been done to combat the intensifying climate crisis that already affects more than 60% of Americans, most recently with the extreme weather in the West, and hurricanes battering the Southeast.5,6,7 We have seen blatant reminders of the racial violence and oppressive history of our country, rife in our healthcare system where Black women have maternal death rates up to 12x higher than White women.8,9 The gun violence epidemic injures or kills 22 children each day, and the opioid crisis killed more than 100,000 people in 2021, alone.10,11 In an America that has heavily politicized these public health issues, academic institutions have faltered in their responsibility to stand behind the evidence. If these institutions remain silent on critical issues and fail to provide a comprehensive education to the students representing the future of the nation, the preventable loss of life will continue.
As graduate students and healthcare providers in Boston and New York City, we are trained to communicate with our patients, clients, and colleagues in an ‘evidence based’ manner – by “conscientious, explicit, and judicious use of current best evidence”.12 Far too often, the words and actions of our nation’s academic institutions contrast this fundamental principle that they teach. American schools are pillars of American society – centers of knowledge and research – and Americans take note of their stances, relying on them for information and guidance. Furthermore, we expect individuals who achieve a higher education to translate science into policy. In schools’ attempts to remain impartial, however, public health issues are perpetually politicized, and both society and its leaders hold the perception that these issues have little to no scientific or factual support. This false notion manipulates our sociopolitical atmosphere.
Despite the life-threatening effects of the Supreme Court’s Dobbs v. Jackson Women’s Health Organization ruling, colleges and universities across the country wavered in their responses.13-17 In the face of extreme climate destruction, lawmakers and leading education centers waver in their decisions over fossil fuel use and divestment, and oil lobbyists are allowed to spend inconceivable funds to protect their own interests over our environment.18-21 Although evidence-based practices clearly indicate the value of harm reduction practices to address the opioid overdose epidemic, the reality of American policy strays far from this approach.22 Despite the drastic impacts of race on health outcomes, only seven state legislatures have declared racism a public health crisis.23 There were 646 mass shootings in 2022, yet in a poll of Senate Republicans’ opinions on background check measures, 31 of the 50 gave no response or deflected in their response.24,25
American academic centers bear responsibility for these interconnected crises due to their failure to educate and advise based on evidence and facts.26 We need bold, loud, specific guidance from our educators to effect positive change for our future.
Many students expect these bold stances, but they are seldom taken, out of schools’ concern about upsetting other students, benefactors, and supporters. Institutions waver in taking a position that – despite being backed by concrete scientific evidence, human rights, and basic human dignity – American society and political discourse deem ‘controversial’. We recognize that there are times when science may be unclear. We further acknowledge that controversy, public disagreement, and logical arguments are vital to a democratic process. However, when the science is clear, and conclusions can be made from evidence, we expect academic institutions to declare that these issues are not controversial at all. Any institution participating in education, healthcare, or scientific advancement is morally obligated to defend human rights, operate based on scientific evidence, and speak out against the regressive and oppressive policies our nation experiences today.
To that effect – in the hopes that adherence to reason becomes the norm – we present the facts:
We are calling on all academic institutions to take definitive stances in staunch support of the facts and evidence.
Our society requires academic institutions – whose members and stances hold significant influence – to provide reason and evidence to guide the way our society functions and direct us toward a brighter, more just future.
Neil Singh Bedi is a Medical Student at Boston University School of Medicine. He is a Research Scientist at CrisisReady, a crisis planning and response team based at Harvard University and DirectRelief as well as the Boston Trauma Institute, the research group based in the Department of Trauma and Acute Care Surgery at Boston Medical Center. His research and advocacy work serves at the intersection of public health and clinical care – with a vision to improve health systems to be more sustainable, effective, and equitable.
Rachel J. Smith is a Medical Student at Boston University School of Medicine. She is also a Research Assistant at the Clinical Addiction Research and Education program at Boston Medical Center, where she is directly involved in research to reduce the effects of the opioid overdose crisis. In addition to her research efforts, she collaborates extensively with leading public health experts and policy-makers around social health issues in Massachusetts. She also serves as a patient advocate for patients receiving reproductive care in the OB/GYN department at Boston Medical Center.
Marina Weiss is a Master of Social Work Student at the Columbia School of Social Work, and she also works as a Supportive Housing Program Coordinator at BronxWorks. She has focused her career on how local factors, such as the built environment, community relationships, and access to resources impact people’s ability to enjoy high quality life.