Consider racial segregation. Epidemiological research carried out a few years ago showed that segregation was linked to an estimated 176,000 deaths each year, and may contribute to higher rates of maternal mortality.

The national turmoil we are witnessing is not just a crisis of institutions or politics or a society at a crossroads. It is also a crisis of health. Hate such as the kind we witnessed in Charlottesville is like a disease, spreading among populations and undermining health in a manner eerily similar to that of a pathogen. When a society is infected by hate, it is not hard to see how it can affect our bodies and minds. Being hated is stressful. It makes a person fear for her safety, resent her lack of respect, and worry about what the future holds for herself and her family. People who feel hated are more likely to experience major depression, and the fruits of hate — prejudice, discrimination, segregation, and interpersonal antagonism — sicken and kill Americans every day.


Or take the experience of sexual minorities right here in Boston. LGBT youth living in neighborhoods with higher levels of hate crimes involving assaults are significantly likelier to report thinking about suicide, or attempting it. They are also likelier to use marijuana.

Hate can be triggered by events and has been shown to hurt the people we scapegoat in the wake of catastrophe. Arab-Americans living in this country after the September 11 terror attacks, for example, were likelier to report high levels of psychological stress, less happiness, and poorer health. Hate is even bad for the people doing the hating; racial resentment towards blacks has been linked with smoking among whites.

Yet hate, for all its menace, can be cured. The cure begins with acknowledging the problem — and there are signs that America may be prepared to take this step. This week, the American College of Physicians formally recognized the power of hate to undermine well-being. The college released a statement characterizing hate crimes as a public health issue. Dr. Jack Ende, president of the ACP, said: “It is imperative that physicians, and all people, speak out against hate and hate crimes and against those who foster or perpetrate it.”


Meanwhile, the president of the United States continues to equivocate and suggest that the victims of hate crimes are as much to blame for the violence as the perpetrators. On this issue, President Ende is the better leader. When health is threatened by hate, speaking out is as critical to well-being as vaccination in the face of plague. The widespread denunciation of President Trump’s unwillingness to call out those who traffic in hate is an encouraging sign that our body politic still has an immune system, and that it is working to reject the infection that has seized us.

We must also come to grips with the causes of hate, just as we would the causes of disease. This means confronting our country’s fraught racial history. It is perhaps fitting that the recent violence in Charlottesville sprang from the desire of white supremacists to safeguard the legacy of Robert E. Lee, a man who fought to preserve the legacy of racism we now face.

This Saturday, a rally that has promoted speakers who espoused hate in Charlottesville is scheduled to take place on Boston Common. Its participants will meet in the shadow of a true Civil War icon who, together with his soldiers, is memorialized there: Colonel Robert Gould Shaw and the Massachusetts 54th Regiment. In 1863, the 54th became the first documented African-American regiment formed in the north, with Shaw as its leader. On July 18 of that year, more than 70 members of the regiment, including its commander, perished in an attack on Fort Wagner in South Carolina. The rebels buried the white Shaw in a mass grave with his men, an intended insult. Yet this act of hate would become an enduring symbol of the better America that Shaw and his fellow soldiers died to build. The sacrifice of the 54th would inspire poetry, a film, and a cherished monument that will continue to adorn our civic space long after the voices of hate have gone.


This is not the first time in our history we have faced hate. Yet I continue to hope that each encounter reinforces our capacity to resist and transcend this rancor, as Shaw and his men did. And that someday the fever really will break, that America will have an honest reckoning with its legacy of hate, and that we will finally come into our own as a truly healthy nation.

Sandro Galea is a professor and Dean of Boston University School of Public Health. His book, Healthier: Fifty thoughts on the foundations of population health, was published in June. Follow him on Twitter: @sandrogalea.