Transcripts For CSPAN2 Perri Klass A Good Time To Be Born 20240711

And to all of you for showing up. So we are not able to host events in our store spaces, our community of authors and reader is still here. Were grateful for your support and for the chance to make this space for conversation and connection. In our webinar tonight you can see and hear the speakers but they cannot see or hear you. They can see youre here, though and you can see a count of your fellow listeners at the top of your zoom screen. A couple of functions that well be using throughout the event you can find at the bottom of your zoom window. One is an icon labeled chat win one speech bubble. Youre welcome to post comments and thoughts in the chat. Thats great way to show your appreciation for the author and to enter act with fellow attendees. If you have a specific question youd like to have answered by the author, please post that in the q a module. You can fine it by clicking on the icon label q a that looks like two speech bubbles. Well be pulling questions only from the q a to be aned later. To be answered later. Were rerecord thing event so look for video or audio versions of our channels later on, and importantly, tonights featured book a good time to be born is available for sale from greenlight book store. We excited to offer actual shopping at our book store location, noon to to 7 00 p. M. Every day of the week, and you can purchase perris book and many others onsite or order online at greenlightbookstore dorm dorm to pick up at the store or shipping. If you care about support thing careers of authors and the ongoing existence of independent book stores, find tonights featured book is a great way to show your support. And now to introduce tonights speaker, our interviewer is andrew solomon. He is a writer and lecturer on politics, cultural and psychology. A professor of Clinical Psychology at Columbia University medical center. And the former president of pen america. Most recently he made an audio series called a new family values, an awardwinning film. Far them to tree received the award for nonfiction and 25 other national and international awards. Also the author of far and away, a National Book award winner and Pulitzer Prize finalist. The irony tower and a novel, stone boat, and activist and lgbtq rights, health, education and the arts, a founder of she sol lohman Research Fellowship at lgbt studies and served on the board of the national lgbtq task force, the president museum of art, the number Public Library and many others. Andrew will be speaking with our author, perri klass. She is a professor of journalism and pediatrics at new york university, codirector onyu florence, and National Medical director of reachout and read. She writes the week column the checkup for the new york times. Her new become a good time to be born, is about the fight against Child Mortality that transformed parenting, fostering and the way we live. Weaving her own experiences as a medical student and doctor, klass pays tribe but to Ground Breaking women and doctors like rebecca columnber, mary put numb and josephinebacker and the nurses and scientists who brought new approaches and scientific ideas about sanitation and vaccination to families. Perri will start us off with a reading from the book and then shell be talking with andrew and with all of you. Per y, please take it away. Thank you. Our grandparents and great grandparents and all of the parents before, throughout history, expected that children would die. It was a known and predictable recollection that went with being a patient. Now we expect children innovate to die. We are the luckiest parents in history. We wore part of this wave over the past 75 years or so, because we are the first parents ever who have been able to enter into parenthood in the hopeful expectation of seeing all our children survive and thrive, and we are also the luckiest children in history, born into an eastern a era when we could expect to group along with all our sisters and brothers. Driving down Child Mortality in the late 19th in and 20th center was not a single product but a unified human accomplishment, maybe our greates human fleshment, at least for pediatricians and parents. The entire world has relearned with some something and great sorrow how vulnerable or precious human beings are to the microorganizisms that find ways to take advantage how we live, eat, travel, parents have taken some comfort in knowing that for the most part children have been less severely affected by covid19, but all through Human History babies and children have been a particularly vulnerable group, and parents have lived with the fear of con day judge, infection and death. Children used to die regularly and insurprise log i barbing died a birth because they were premature or weak, pause they were born with congenital anomalies, got infections, older infants and oneyearold died of summer dieee remarks caused by mine crop cristobals in the water or cows milk they started drinking. Threeyearolds and fiveyearolds and five and six and seven and eightyearolds died of scar let fever and dip theira, pneumonia, measles and Skin Infections or influence should that turned into pneumonia. At line at the late 19th and earliest 20th century, almost every family and every ethnic group and eave country, rich or poor, was touch in some way by the deaths of children. Childhood death was always there in the shadows at the edge of the family landscape in prayers and religious ceremonies and religion portraits on the wall in poems and stories and dramas and paintings, pause they figured so consistently in childhood and family life, child deaths figured in the art and literature and songs and stories of childhood and family life, from a century ago as they had all through Human History. I am a lover of babies and yet i cant seem to have them, wrote mrs. D. From brooklyn in 1917. I am married 11 years last july and would have six children and about to become a mother which i had almost feared ha two out of six, one boy nine years, and one six years work who of the them died some years ago, she didnt say how. But then within a year she had two babies and lost both of them. I gave birth to a beautiful fat boy and it lived but three days. The doctor told her the baby had a leaking heart. Three months later she was pregnant again, son lived to be a year old and then she awoke and found him dead alongside of me. Now pregnant again she worried constantly but the terrible long labor he would have and what would become of the baby. I try and live a good honest life and my home is my heaven and babies are my idol. I love them. But i am afraid something will happen to this one again. She whereas writing the letter to the United States government, to the childrens bureau, established in 1912. This new federal Office Published a pamphlet prenatal care and infant care in 1913 and 1914. Immediately popular, they were at first distributed free of charge and provided by politicians to their constituents, later available for purchase, by 1929 the government estimated these writings touched the parents of half the babies born in in the. She said i cried night and day for any big fat baby, taken from me like that. Mrs. Wd was not living in middle age orders the victorian ear ramp she was live informing 1917 when my grandmother lived and in new york city where any grandmother lived, ten years before my open parents were born. And at that time in 1917, when mrs. Wd wrote her letter, near lay quarter of the children born alive in the out died before their fifth birthday. Those mothers wrote in the early decade odd the 20th century with a certain home for medical solutions, for at vice that it might protect the next baby, even with a desire to extend that protection to all babies and children to join in the larger project of chirps bureau represented. I only wish i could take up the work of promoting baby welfare wrote a woman who lost their child. Hers from women would struggled with writing writing and otherse privileged. No part of society where childrens lives were secure. The statistical evidence has been complete, infant and Child Mortality in europe and america was extremely high, through the 17th and early 18th 18th centuries with a third of all children or some cases even 40 or more, dying before the clout drew childhood. In the first decade of the 20th century, when my grandmother was growing up, and out of every thousand live birth in United States more than 100 baby is did nod live to the first birthdays and mow at that time rates were higher among the rural, poor, micks and africanamericans. By comparison the infant mortality rate for the United States in 2017 was 5. 8 deaths per thousand live births. The majority of thieves deaths before the first birthday actually occurred the first month of life due either to con general anomalies, birth disease effects or maturity. A good time prematurity. A good time to live is a fusion of science and Public Health and medicine that transformed ore families, our emotional landscapes and our souls. All threw Human History many babies died at birth and this was true the middle ages and the renaissance, colonial america and victorian england and it was still true in the early 20th century. If where wont around any table anyone would have lost a sibling the childhood, lost a friend to death at a young age, lost a child. Infant and Child Mortality was a fact of life for almost every family, rich or poor, john. Rockefeller founded the Rockefeller Institute when his grandson died of scar let fever. Mortality was higher in 19th century, disadvantaged populations including enslaved children and the michigan poor. Let me star there. Thank you for that love live reading. Let me begin this conversation by saying this quite a remarkable book. Just had a rave review in times. Its written in an engaging and even enenthralling style. She is she brings together abstract information put she tells an neck totes and stories like the story of mrs. Wd and many other stories. Both of the people who lost children, ranging across the entire social spectrum and people who figure out how to save children. Its a very sobering study as a parent might well i was very struck over and over guy what it must have been like to have to form a more college attachment to your children. And i thought it looked forward to many of the questions of helicopter parenting that are current. What its your sense of how people responded psychologically and emotionally to these losses . Do you think that because they were common, people were better protected against them . Or too you think the quality of their despair was the same as the quality of disspare in someone who loses a child to sids which you write about today. I think quality of despair was the same but in a strange way they were less isolated, because it was so common, because it was discussed, because it was an experience everyone had had. I dont think that i think that when you read the conditions that parents write, you can see they loved their children just as much in and the same ways you can see they remembered them and grieved. You can see they went over and over the question of, could i have if we hadnt moved to the city, if i hadnt done this, if you hadnt done that. They did all of that but they did it sort of in company. We have three children but only two are living. That stops the conversation. That is not something that can easily be discussed. In the past there was ways because it was so common you can at least acknowledge the child anacknowledge the grief talk a little bit in that contexabout some of the losses where it clearly cuts so deep and where the quality of accusation cuts so deep. Particularly of Eugene Oneills mother and the story you tell about the death of his what would have been his older brother. Was actually writing about measles and looking for examples in art and literature of measles. Measles was a disease that every single child got before there was a vaccine because it was an incredibly infectious disease. Its a fairly miserable disease, in a disease which hits every single child when there are relatively rare complications its a relatively rare complication times all the children in the world so you lose a fair number of children. Even so, when i looked for references in literature, what many of them were abthe disease you get big spots. And most children recover. Then i was actually watching a performance of long days journey, Eugene Oneill play, so strongly autobiographical in which we think of as a play about addiction, the mother is addicted to opiates and the father and the sons drink too much. At the center of the plague is this tragedy of a baby lost to measles. My mother who went away to be on the road with her actor husband and leaves with her own mother, her sixyearold son and her baby. The sixyearold gets measles, the older child gets measles and he goes into the room where the baby is and the baby gets measles, the child recovers, the baby dies. The mother never forgive herself for having left the children and she never forgives the son who went into the room and infected his younger brother and she thinks he did it on purpose because he was jealous of the baby. That common childhood disease basically comes into this family and devaates the family. Right. And it was all true. Eugene aEugene Oneills mother hes the reconciliation baby born later to more or less take the place of the boy who dies. Talk a little bit, i think all of us know there was enormous medical progress and that the development of vaccine has made an extraordinary difference in the lives of children but the Public Health story is less well known. How is the information not only about getting vaccines but other measures helpful to children, how is it disseminated, who were the visionaries that led the process of dissemination . I feel a little guilty. I feel that there are probably heroic names and sanitation that i probably dont know because im looking at this through a medical side. You start by going back certainly to the 19th century thinking about cities building sewer systems and cleaning up their water. Thats tremendously important. Then when you get to abone of the things happening in the 19th century as people are figuring out the importance of microbes, the importance of bacteria, later developing this technique pasteurization which makes milk safety stop all of that is tremendously important but just as you say, has to get to the individual household. Parents have to understand the dangers of letting milk spoil, using water you dont know whether its pure. One of the reasons thats important because especially in the summers, especially in the cities around the turnofthecentury there is this understanding that in the summer, something they call colorado in phantom, its not really cholera, its just upset stomach, diarrhea. It kills thousands of babies every month in the summer. Theres not a full understanding on the part of parents or medical people where that comes from. Is it bad smells, poor ventilation . What it is is its all that whole range of microbes that causes children to get stomach upset and then its the fact that babies are so vulnerable to dehydration. Get still true if youve ever brought a sick baby with a stomach bug and, your pediatrician probably told you the infection is not, do any harm, is to dehydration. Youve got to go out and buy rehydration solution, youve got to buy popsicles, keep putting the fluid back in. Absolutely. Then talk about the subject i think hasnt received abwhat was the relationship between the people who develop the vaccines and help to control or at least address so many of these problems. In the early stirrings of the Eugenics Movement and the notion that somehow where the children lived and it was unworthy children who were dying in such large numbers . Thats a really interesting question. Right around the beginning of the 19th abbeginning of the 20th century people started counting dead babies. I think the truth is that if you go back much further than that, early infant mortality, children who dont make it out of delivery, stillborn babies, babies who dont breathe, a common fact of life that nobody even necessarily really counted. Then at the beginning of the 20th century 1906, british doctor publishes a book called infant mortality social problem in which he basically says we should not be losing all of these children under a year of age and the united kingdom. We are losing a regiment of small beings. But he says some children are just going to be born we can theres nothing we can do about that. Thinks the problem one out of every 10 may just lose because they are sort of the unfit. One of the things thats really interesting about the movement against import mortality is that people who are trying to bring down infant mortality especially newborn mortality are regularly being asked, if you save all the week babies whats going to happen . Arent they meant to die . Are they really able to live . There are quite a few who say the founder of american pediatrics doctor abraham jacoby was a very weak and sickly baby himself when he was born in germany and he repeatedly references the fact that just because somebody is weak and sickly baby doesnt predict who that person is going to grow up to be. But there are other people and overlap with the Eugenics Movement in which you have people explaining very seriously that at the same time as you are saving babies, you also have to discourage certain people from marrying or reproducing. Because they are very worried about people with epilepsy, for example, some of them. Or whatever people are on their list. This is true of everybody involved in bringing down infant mortality but its a question which keeps being addressed. Will we actually weaken our population if we save these babies . On the other hand, its also very clear to everybody that even the people of the top of the social pyramid are losing babies. And losing babs frequently. Talk a little bit about abraham and Mary Todd Lincolns loss of their baby and the very extraordinary way that they responded and the audit simultaneity of their losi a child at the same time of Jefferson Davis did. You have the lincolns have four sons, they lose one as a child, probably to justabone of the things thats interesting is the press is always interested in white house children, they are always good Human Interest stories. They have o boys in the white house and then tholder boy robert already in college. The two boys in the white house got sick, because during the civil war they get typhoid and they probably get typhoid because washington is full of soldiers and their jobs and Sanitation Systems at the times are overwhelmed. They probably get sick because they are Drinking Water in white house. And one of them dies and one of the reasons i like talking about president ial children is because its a shorthand way of saying, th the best medical attention anyone could provide at the time. The child who dies in the white house, both ohis parents warned him but Mary Todd Lincoln is always felt to warn excessively to be unbalanced, inconsable, often when you say that about a woman in that era,hat you mean is that she is t able to accept this as something which has been determined. Something which has been sent by god. Although both pares are deeply deeply affected by losing their son, there is something about the way that she mourns, which upsets people. She doesnt cherish his relics, she doesnt want to save his little garments, she doesnt want to ever go into the room where he died again. And then evenally of course she has a very tragic life, her husband has been assassinated as he sits next to her. She had four sons, one dieds a baby, one died in the white house. The other little white house boy dies probably of tuberculosis not that long after his ther. So she buries three of her four children in the parallel we were talking about that the confederate white house, Jefferson Davis, and lorena davis she also outles all four of her sons. Shes got one daughter who outlives her and one who dies as an adult. I dont want to call it routinely, but this kind of tragic parental history which even when you are powerful even when you are privileged, theres this kind of theme of recurring tragedy and it was existing because is all happening at the time of the civil war when parents all over the country are losing especially sons going into the army. Right. Lets ve a little bit forward. We are obvusly in the midst of a Global Pandemic and the sense of mortality particularly abto some measure perhaps for children its confronting us anyway it hasnt in the many generations a very shocking and overwhelming fashion. Yet we find ouelves in a country where, according to many polls, a fourth of the people who were interviewed would not be vaccinated if the vaccine were develod. Tell me about the kind of Politics Around vaccines a how they grew up and what was viewed as the great miracle of modernity came also to be anathema of a large part of the citizenship. To tell you the truth, i dont think pediatricians understand this very well. As a group we love vaccines, really believe in vaccines. Its in some ways true we havent always collectively done the best job of responding to people who are weary of vaccines because we do love them and believe in them. I think that one of the things i was looking at writing this book is actually the way that you forget the diseases that you dont live with. The ways that a disease like justjust or polio quickly slipp from our collective memory. It helped me understand a little why people arent more frightened of the diseases and therefore why they are sometimes susceptible to worrying about the vaccine. Dicedgoing back to the no question scientific miracle of smallpox vaccines but people worry about it i give you a dose of something thats not smallpox but close enough for smallpox tricks itself into defending against smallpox you end up as if you had smallpox. I think from the very beginning for some people the biological brilliance of vaccination sometimes also feels frightening because you are turning on this in your body. When you look at the we think about diphtheria, when you think about polio, think about what tetanus was when tetanus was around, when you thing about whooping cough, there is no question that the terrors that my grandmother not that long ago, my parents grew up in new york city and there was polio epidemics every summer. They grew up with that form of social distancing in which payments were trying to keep their children away from other children because it was a terrifying virus out there that could cripple you or kill you. I think its hard to remember that when you havent lid with it. Think its very hard t remember it. One of the things that so distinguishes this book is its really vivid portit of the people who help. I feel as though our conversation so far has really been about dying children which is kind of a downbeat topic, generally acknowledged to be. The book is in many ways really about the lives of children and the lives that made the survival ochildren possible. I want to switch to somewhat more upbeat piece of the nversation. I thought i would start by asking you to give a little description of the like and activities of a woman i now think of as your josephine baker. Not to be confused with the entertainer. [laughte who did such extraordinary things and looked really quite astonishingly sculine and the photos you provide. Te us about who she was and what she did and about what was involved for a woman of heera and becoming a doctor and what she was able to accomplish in part because of being a woman as a doctor. Have to say i found myself identifying or at least aspiring to identify with some of these remarkable women. With their stories. Josephine baker, she wrote a wonderful autobiography in 1939 called fighting for life you just hear her voice so clearly as she sort of describes ab she was from a very good uppermiddleclass family in poughkeepsie, she plans to have a career, but these things happen, the family abshe needed a job and went to one of the womens medical colleges she went out Practice Medicine she was clearly very competent very smart but at a certain point she fell in love with the idea of Public Health. She started working for the City Department of health and she was going house to house she was interested in working in the school and she became interested in the question of preventing diseases because you couldnt treat them when the children got diarrhea or the children got diphtheria there wasnt anything you could do. I was looking for an example of the way that she wrote about it. She said she realized that the way to reread abthe way to deal with people being sick was to keep them well. Was to prevent them from getting illnesses and if you could teach parents coming back to what we are talking about before, how to provide clean milk, how to keep the milk safe, how to boil water, how to breastfeed babies that you could keep the children from getting sick and she wrote about doing an experiment one summer improving she said, he did not necessarily kill babies. She was one of the first people to help get nurses into the Public Schools because they were just strange situation on the Lower East Side where children were sent home if they had any kind of infections including Skin Infections are head lice are any of the very common things in the classrooms were empty because you sent doctors and, they inspected the children, they sent them home and writes about how strange it was and you got one City Department sending the Children Home because they got infections and then the honed officers coming around and yelling because the children are not in school. One City Department sending the Children Home and another City Department coming around to blame the parents because the children are home. The answer, she says, was to put nurses in the schools to deal with the infections to help the parents learn how to handle it. One of the things she wrote about mothers was is wasnt that they were callous when their babies died, then they cried like mothers, they were horribly fatalistic about it while it was going on. Babies always died in summer and there was no point in trying to do anything about it. It depressed me so. Then when she actually found ways to abpeople are thrilled, they are excited, the messages go on, my sugars go around. abthe messages go around. The babies live in the summer and they start doing better in some of the poor neighborhoods than they are doing and some of the wealthy families. This is before antibiotics. Its hygiene, its education, its what we would now call and powered parents, its nurses going house to house weighing babies and encouraging parents, its milk stations where pure milk is made available to families that nathan strauss, one of the owners of macys thats his cause is milk stations and milk stations become fairly clinic where the children can be examined. Its sort of this very hands on Public Health, you can take care of your baby and keep your baby safe, which goes back before antibiotics which goes back before most vaccines. Do you think of that message of empowerment ultimately cause the chains to come about . Its interesting to look at sources that go back a long way that are advocating for breastfeeding, i think you have a coowner from the asian century or early 19th century all about abthere was a lot of attention to the good and right in that way but there was also a great deal of fatalism, and in a way that fatalism that was significantly has disappeared from our contemporary experience as we more and more believe not only that our children will survive but our children deserve to survive and that we deserve to have surviving children. What has that shift been like and how, aside from abto think it was achieved . One of the reasons i wrote this book was by the time i trained in pediatrics in the 1980s, when im talking about my grandmother im talkin about having her children in the 1920s. About a little more than half a century later by the 1980s when m training in pediatrics there is no such thing as predictable routine acceptable deaths for children and infants. Premuch every dth represents either a failure we havent made the world safe enough sudden infant death syndrome, just figuring out about sleep position and other risk factors. Ther we havent made the world safe enough, car seats, better protections for children in cars, we need to prevent the accidents or some medical conundrum we havent soed yet. They are gng down one after the other and thats largely true, congenital anomalies, the cardio, malaise, genetic diseases. Yes, sometimes you come across one of the ones which hasnt yet but medically there is no sense of fatalism, medically there is like this is onof the ones we still have to solve. I think what that translates to two parents. This is a greaand glorious thing, a certain promise. Had talked about a promise of safety and that you go into parenthood nowadays and parenthood, as you know, its always terrifying. There are never any guarantees. Its always you are putting your heart on the line in so many ways. But there is a sort of underlying assumption that unless one of the terrible tragedies happens, your child is going to live to grow up. I do think that what that does toarents as it does place a tremendous responsibility on us as parents. That is to say that if i say to yo arent you lucky if you make the right decisions and you take the right precautions starting with taking that baby home from hospital in a car seat and putting that baby down in the safest possible sleep position, if you do all these things right you can keep your baby safe but the certain emphasis is on that you. Is a certain emphasis on the fact that at every moment you are doing the right safe thing. I would say to you i dont think my grdmother lay awake at night worrying she perhaps made the wrong decision she knew the world was a dangerous place and she probably tried to catch the right spells and she certainly did whatev the doctor said but i think she knew on some very profound level that there was no guaranteed safe. I mentioned John D Rockefeller the first billionaire in history partly because that might be what my grandmother would say. Even if that were John D Rockefeller himself. There is not any real abi think that one of the things that does to us nowadays as parents and maybe also as pediatricians, its not that we would trade it for the uncertainty or the danger but we do feel responsible and we do feel anxious. One of the things i wonder out is why are we as anxious as we are as parents when by any objective standards there enough food, i could give you a long list of all the things you dont have to be entries about and then at the end of the long list i could say to you, are you anxious . You would still be just as anxious or more. Right. Let me move on now to some of the questions that have been coming in from participants in this conversation. Let me say we have some very good questions but if anyone else has a question there is a q a function, feel free to type in a questioand we will attempt to get to them all. Betty fibrous rights, and connection with something you address in the book, she says although this book seems to be about contagious diseases and the significant decrease from infections, the death of children that continues today is from nonviolence, gun violence has been identified as a Public Health problem, not just a public safetmatter, and some communities it is not a good time to be born with many families dealing with the loss of one or more children from gun violence what are a thinking about how to elevate this issue . I do try to talk about that and i thk that the issue of gun violence but also the issue of other kinds of trauma other kinds of death in fact, i believe, and i think most pediricians believe, that the way to think about gun violence is in facto think about it as a publichealth problem, to think about it as a problem that Needs Research on what are the risk factors what are the most effective strategies to protect children and as the person asking the question probably knows that was research which was actually blocd it was blocked as something which cannot be studied and which is now being studied better. The question of how you abate the risk, how you actually ab when you think about trying to abate that kind of risk as when you think about trying to abate the risk of dying in a car accident, you can think abt technological fixes, things that you can build in which protect children. Are there laws you can pass, educations you can do . The answer usually is yes, yes, yes, you need to think abt it and all those different ways but the person who asked the question is asking right, there is one of the things you see when especially when these Infectious Diseases abate as you start to see what else is hurting children. What ee is children akilling children. Maybe not in the numbers of the school pox epidemic but in great numbers and needless unnecessary tragic deaths. Its in the book and you write about it movingly and you write about the importance of taking action. It ties in with these large questions it affects disadvantaged people more. In connection with which, i will go on to terrys question. The excerpt you read speaks to the profound advances in reduced infant mortality over time. Can you talk about how your research addresses the infant mortality rate in the u. S. Versus other wealthy countries and how and why women of color are at particular risks in the u. S. Of thosdeath in childbir and infant mortality. Absolutely. Let me try to take those ab let me try to take those both but kind of an order. First of all, i cited the infant mortality rat we measure infant mortality as the mber of children from every thousand who dont make it to their first birthday. That is something with which we really only have been ing since the beginning of the 20th century. Its one of the reasons itso hard to get comparative numbers across the centuries because people werent necessarily using the same denominator people werent necessarily counting things in any way now youre trying to get down, those 5. 8 is a very low number compared to the numbers i was siding earlier. 200 out of every thousand live births dying but 5. Is three times as high as the countries with the lowest infant mortality rate so countries like singapore, finland and japan iceland, they are closer down to two deaths per thousand live births. United states does not lead the world in this way and has repeatedly been repeatedly pointed out that our numbers are not the best and people, we also you may have noticed a country without a National Health system. In the kind of preventive universal primary care thais probably most of thepoint in trying to make sure all women get this care. Not only during their president dominic pregnancy but also before. Second pt, and the second question which i come back to ain and again in the book is this issue of the disparities. The fact that the infant mortality rate is twice as high in African American children in this country as white children and eternal mortality rate is also much higher in africanamerican women. The thing that is interesting and tragic about that is that the mortality rate among African American children has actually come down very dramatically over the same period of time. Since the beginning of the 19th century was astronomically high at the end of the 19th century. There is a lotf research right now about what goes into those disparities and why they are persistent but its a tremendous subject of concern and tremendous subject of research. I have one other question from the audience, this ifrom martha ado u think adults would take common sense covert precautions like mask wearing more seriously if this virus were more dangerous for Young Children . I think the questi is covid and childhood is a really interesting question. The wa we responded to covid and how much they are tied to the myth that it doesnt affect chdren at all or even the accurate informaon it doesnt affect children as severely. I think everyone who takes care of children thinks abou what it would mean if this virus were more severe in children, as many respiratory viruses have been. I will add the obvious pediatric lesson that children are more vulnerable to respiratory diseases because they have ti airways just as they are bo more vulnerable to diarrhea and dehydratn because they ha small blood volumes and more surface aa to memory in relation to their volume. Influenza has also often been hard on babies and Young Children. How different with this pandemic look to us if this disease was actually more dangerous to our children . I dont know. Is it easier to imagine people being vigilant, being furious out in public if they are worried that you are coming too close to me yoare going to hurt my chil i dont know. I think its possible that we would be more vigilant and that vigilance would be policed more strictly if thought it was a question of keeping children safe. But i dont know. It feels like something which parents are already so frightened for their children, so worried for their children, but not absolutely sure how to calculate the risk, given that this is a virus which has been harder on the old. I think thats a powerful statement with the situation. The book feels particularly urgent coming at a time when what seems to me and so many other people, such a bizarre divide between the people who believe in taking safety precautions because a deadly pandemic is ravaging the world and the people who argue that those precautions are merely a political move and have nothing to do with the illness which in many cases not so severe and dangerous. Given the death rates from covid, and some ways it parallels but the approach people believe that somehow People Like Us in this time in history in these countries in these circumstances are not subject to the wild nature and we saw a version of that during hiv also in sars and ebola and the other illnesses that are propped up in the course of our lifetime. The hiv was mostly affecting gay people and the general population thought it was terribly bad but didnt feel highly motivated necessarily to address it certainly in earlier days. Why dont we close because we are coming to the story you told me earlier about the lecture at harvard in the early days earliest days of hiv. I think its a good object lesson for all of us to bear in mind in these days of covid which is the days we are livin in and the days i hope many people ll be reading your book. I hope they will because it is a book about using science and Public Health but also will and fellowship to defeat the invisible microbes which bring tragedy. I think its not necessarily a simple caaign or a simple process but its a book about the ct that science and Public Health and advocacy and rents working with nurses and doctors and scientts can make lives better. A story that he is talking about is that when i started Harvard Medical School in 1982 we heard a somewhat infamous truth which s we were told that basically Infectious Diseases were over that our job, our generation of doctors would be to solve the chronic diseases of civilized living. Heart disease, diseases of living long and eating well and and over civilized world because the infections had essentially been defeated. That was in 19 when hiv was not yet identified, not yet understood. What it would be to be the disease that shaped the medical education during our years and i remember some of the extreme before people understood good how abthe extremes of fear and some of the rush to judgment of, okay, its too dangerous for this child to be in their school, the stuff wi which when you look back on it made no sense at all but came out that fear and anxiety. What i was remembering was the arrogance of our idea that we had outsmarted the invisible world of viruses and bacterias. Bacteria around us which of course we dont have outsmarted but we have to keep thinkg about and keep working on the science and the Public Health. Right. Theres been a couple of other questions that came in from our audience. I believe people are going to need to go as of 7 30 p. M. When we quickly do one of them and then we will call it close. absaid, what fraction and the Life Expectancy gain in the last century has been due to improvements in infant mortality . I cant give you a single number but i think that most of the Life Expectancy that you see in the first half of the 20th century comes from the decrease in infant mortality because you have such a dramatic decrease in infant mortality. One of the reasons, this is a little geeky and i wont spell with it too long, one of the reasons its hard to figure out that because before the 20th century, you dont have the denominator of 1000 like bloods, instead what you get is people counting numbers like this of all the deaths in new york city are infants. Thats shameful, we have to bring down percentages. I think the answer that is really overwhelmingly dramatic part of increase in Life Expectancy in at least the first half of the 20th century is from bringing down infant mortality because its not so much what youre doing for ults is that the babies arent dying so the average is getting better. I would just emphasize that its an extraordinary book and im sure oths of you have questions will be able to depend them on to perri, as you wish to do. Thank you so much for taking this time and sharing your book with everyone. Thank you andrew, thank you so much. Thank you, perri, andrew, for the knights of idle conversation and think everyone who came out and made space for the conversation tonight. A reminder if you dont already have your hands on theok ab if you are local to brooklyn you can stop by the store any day of the week 912 noon to 7 00 p. M. Or shop online at Greenlight Bookstore. Com you can find t link directly to the book by paige in chat. You can arrange a curbside ckup or get the book shipped to you if you are anywhere in the u. S. In case you msed any part of tonights event i just want to abyou wanto indulge in a rewatch or share with friends and fami, stop, tonights event has been recorded and will be up on our Youtube Channel Greenlight Bookstore in the next couple days. Thanks so much everyone, have a wonderful rest of your evening. Booktv continues now on cspan2. Television for serious readers. Greetings from the national archives, its my pleasure to welcome you to this virtual book talk on the some of the people how the census has shaped nations from the ancient world to the modern age with a special guest andrew whitby. Before we hear from our guest author i want to tell you