News Release

The Politics of Health


In light of the White House’s recent Summit on Covid-19 Equity, the Institute for Public Accuracy spoke with Brian Castrucci, an epidemiologist and the president and chief executive officer of the de Beaumont Foundation. Castrucci emphasized the importance of varying vaccine campaigns that are specific to the diversity of Americans who bear disproportionate burdens of Covid-19 morbidity and mortality––including rural communities.

BRIAN CASTRUCCI;, @BrianCCastrucci

Castrucci called the summit an “opportunity to look back on what the White House has done to ensure marginalized communities have access to [Covid] vaccines.” Castrucci was complimentary of the administration, though he called this “necessary work” that should have been done long before the vaccines were rolled out. 

Castrucci said that the usual concept of the social determinants of health leaves a lot out. In contrast, Daniel Dawes’s more structural idea of the political determinants of health “does not “let elected leaders off the hook.” Many of the factors that make people predisposed to illness or death, including from Covid, are political choices, Castrucci said. “Elected officials have a greater influence over your health than your doctor. That is a fact. The prescription for better health in this nation is policy. Yet every policy we have about health is about pills and procedures, not public health, policies and partnerships.” Castrucci points to 12 of the potential policies outlined in City Health’s policy package as a remedy.

Castrucci said: “The country’s ideological divides are reflected in urban and rural divides.” As such, there can’t be “one vaccine campaign… This country is extraordinarily nuanced. There has to be several campaigns at once.” It also does not need to be a “battle” between different vulnerable groups. “It’s not a choice or a binary,” Castrucci said. “We need strategies to reach every American.”

He added: The pandemic “split us along many lines. We never came together” as a country. “We’ve paid with a million American lives. How many Americans have to die before we put the health of the people over partisanship?” There are consequences to the emphasis on so-called medical freedom, Castrucci said. “We’ll pay with the lives of more American citizens. That’s a high price to pay.”

Castrucci is particularly concerned about rural Americans who have been affected by vaccine inequity. Rural Americans have suffered a disproportionate burden in the pandemic––in part, due to the closures of over a hundred rural hospitals in the last decade.