Looking Back, Looking Forward: Hopes for a Healthier 2021


Bob Hughes, Former President & CEO

2020 is a hard year. 2021 will soon be here. In my mind, it’s the perfect time to pause and take advantage of Janus’s gift of transition and new beginnings to reflect on the challenging times of the year, where we’re heading in 2021, and guideposts for using a new year to bring forth new possibilities for a healthier Missouri.

When I think about it, I can admit, there are a few unhealthy things that I wouldn’t mind leaving in 2020. I can certainly do away with all the extra snacking and lounging that I’ve gotten accustomed to since the start of the pandemic. On the other hand, there are a few things that I believe would do me some good to carry forward into a new year. I like the fact that I’ve slowed down some and taken time to prioritize and catch up with family. I’ve made exploring the beauty of historic parks in our area a part of my regular routine and, in so many ways, reminded myself to continue to appreciate a few of the simpler things life has shown me, things I may have taken for granted pre-pandemic.

Missouri certainly has a few unhealthy habits that we could leave behind in 2020. Topping the list is our failure to do what’s right by the people and put things in place to slow the spread of COVID-19. This year, COVID-19 dominates all things health. It has affected many of us personally through our families, our work colleagues and networks, our friends, and neighbors. Sooner or later it will affect us all. The pandemic’s pervasiveness can be so stifling, so overwhelming; it’s tempting to look away. And the impact is so large, it’s hard to comprehend. But at this critical time, the first step in moving forward is to face it head-on.

For weeks now, we’ve experienced record highs in Missouri cases (averaging nearly 4,000 new cases per day) and deaths (averaging 67 deaths per day), contributing to cumulative totals of more than 340,000 cases and 4,452 deaths. COVID-19 deaths will increase overall Missouri deaths in 2020 by more than 5%. Nationally we had 20% excess deaths (225,000) from March to August, the most excess deaths in a year since World War II. The number of deaths attributable to COVID-19 is four times the number killed during the Vietnam War. And, the pandemic is far from over.

I’ll trade our high COVID numbers for more empathy and less judgment in 2021. Everything happening in our environment has pushed us further from caring about each other than we should ever be. The events of these times seemed to have brought out the worst in us. I get it – the constant disruption of life and feelings of isolation that has engulfed our normal way of life has gotten to all of us, but we still owe it to ourselves and others to be kind and respectful, no matter where we come from or what we believe in. It’s the least we can do in these unprecedented times.

Moving on from 2020, I would want to leave behind the enormous amount of economic destruction we’ve experienced as a result of coronavirus. The economic impact of COVID-19 is, frankly, so large it’s almost impossible to comprehend. A recent estimate put it at $16 trillion, almost a year’s economic output. This is four times the lost economic output from the Great Recession and twice the U.S monetary outlays for wars since 2001. Notably, over half of COVID-19’s economic costs are due to health loss, a significant part of it due to poor mental health. Indeed, COVID-19 has increased mental health problems and trauma. In June this year over 40% of adults reported depression, anxiety, posttraumatic stress, or substance abuse, rates three to four times higher than a year earlier. More than 10% reported seriously considering suicide in the last 30 days. In 2021, the need for mental health care across every corner of Missouri will be extensive.

The domino effect of COVID-19 has brought forth even more health consequences. Our systemic under-funding of public health is reflected every day in the headlines despite a dedicated workforce facing a contentious public reaction to evidence-based prevention and mitigation efforts. The pandemic soaked up resources and put a sudden stop to vital ongoing prevention and health care services, including dental visits, hospital care, and vaccinations. Now we face a backlog of health needs and consequences we are unlikely to catch up with for years, if ever. More broadly, COVID-19 has distracted much needed focus on other health-related issues like climate change, racial injustices, firearm violence, affordable housing, and a healthier, more sustainable food supply.

All told, 2020 has brought discord, despair, disease, death, and distrust into our communities and our everyday lives. With this litany, it’s no wonder we are all eager to shift our view from the past to the future. We do have a few things that we can begin to look forward to in the new year, such as Medicaid expansion, vaccines, and economic recovery driven by American resiliency and creativity.

Despite the enormous challenges of 2020, we have many reasons to be optimistic for 2021. Our heritage gives us the strength and confidence we will get through this, but it also tells us that shaping the arc of history takes effort, our shared effort. What is our motivation? Let’s all take a lesson from Janus as we lean into new beginnings and healthier transitions. Look to our families and especially our children and grandchildren – our love for them and hopes for a better future keeps us positive. Our loved ones and our communities are why we care, and they are why we will work to ensure that in 2021 we will blaze a path full of hope, healing, and health.