An Unexpectedly Divided Congress, Our 2023 Student Essay Contest

Paul Shafer announces our 2023 student essay contest and discusses what has happened in health politics over the last year.

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Read Time: 4 minutes


Public Health Post is holding its third student essay contest (see entry details at the bottom), which was first held in 2017 and again last year. Paul Shafer, assistant professor at BUSPH and first winner of the contest, will be selecting the winner again, as he did last year—when Samantha Burkhart was selected as the winner, writing about how critical voting rights are for promoting public health.

As I sit down to write this, the House of Representatives has now failed to select a Speaker through four rounds of voting. An unprecedented event, the first time in 100 years that it has taken more than one round to select a Speaker of the House, is just another in an era of seemingly endless unprecedented events—in our politics, climate, and public health.

The 2022 midterm elections saw the Republican Party underperform. It had been a foregone conclusion among most that the GOP would take control of Congress—as midterm elections typically go poorly for the party that holds with White House. Instead, the Democratic Party picked up ground in the Senate, bolstered by a key runoff win by Reverend Raphael Warnock in Georgia, despite losing the House. They now hold a 51-49 Senate majority, no longer needing Vice President Harris to break a 50-50 deadlock.

Last year was also a noteworthy, and perhaps infamous, year for the Supreme Court—upending almost 50 years of precedent in overturning Roe v. Wade, calling into question the “legitimacy of the Court.” Another case currently before the court (Health and Hospital Corporation of Marion County v. Talevski) threatens to take away the right for Americans to sue to enforce their access to government programs and the benefits provided through them, like Medicaid—a last resort, but an important one.

Public health is more visible and important than ever, but we are at a crossroads. We need to be louder and more involved in policy to create the more just and equitable world we seek—though others may disagree.

The Affordable Care Act appears to be on solid footing for now, a Republican minority in the Senate heads off any potential for revisiting the repeal and replace efforts of 2017. The latest major legal challenge to the ACA is working its way through lower courts—gutting the availability of free preventive care—and is likely to end up before the Supreme Court in the next few years, but nothing challenging the constitutionality of the law itself as prior cases had.

Despite stating in September 2022 that the “pandemic is over,” COVID-19 continues to kill thousands every week and new variants, aided by low uptake of boosters and ending of nearly all non-pharmaceutical interventions, like mask mandates, continue to develop and circulate. Federal funding for COVID-19 vaccines and treatment, like Paxlovid, is ending, meaning cost will soon be a barrier—layering concern on top of the existing inequities in testing, vaccines, and treatment that we have seen throughout the pandemic. And we have yet to make progress on federal paid leave, reviving the successful Child Tax Credit expansion, or other policies that would provide a buffer against COVID-19 and future crises.

Where do we go from here?

The bully pulpit is a powerful thing, our leaders have the power to shape what the public think and how they engage with government programs in ways that have real repercussions for health—and that was before COVID-19. The Trump administration relaxed environmental regulations, and made it harder for low-income Americans to get health insurance and food assistance—often rewriting policy in ways that were functionally racist on top of a long-standing bedrock of structural racism.

Public health is more visible and important than ever, but we are at a crossroads. We need to be louder and more involved in policy to create the more just and equitable world we seek—though others may disagree. There are a wide range of opinions about the intersection of science and advocacy, we all have to find our own comfort level—but doing nothing shouldn’t be an option.

What should our priority be this year?

Contest details:

Deadline: Friday, Jan. 20, 2023, 11:59 p.m.

Question: Imagine the next speaker of the U.S. House of Representatives will read your essay. How do you convince them to make public health a priority in 2023? What policy or policies do you recommend they prioritize and why? (800 word maximum)

Embed references as hyperlinks, not a separate bibliography.

Eligibility: 2022-23 undergraduate, masters, doctoral students in any program of study (ok to be a December 2022 graduate!)

Prize: $250 and publication in Public Health Post

Enter here: You’ll be asked for your contact info, school, expected graduation date, and to upload a document with your essay.

Questions? Contact Managing Editor Mallory Bersi