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August 29, 2023
America Dissected
Drowning to Swim with Mara Gay

In This Episode

Drowning is an epidemic in America. And like so many other public health challenges, it’s what happens when we over-privatize a public good. Abdul reflects on the human right of water. Then he speaks with New York Times journalist Mara Gay, author of a recent series on drowning in America.




[AD BREAK] [music break]


Dr. Abdul El-Sayed, narrating: A new COVID variant BA.2.86 with several new mutations has scientists on edge heading into the fall. According to a new study, faulty oxygen monitors delayed care to Black patients with COVID 19. Republican candidates race to the most extreme positions on abortion and the climate crisis in the first primary debate of the 2024 election. This is America Dissected. I’m your host, Dr. Abdul El-Sayed. [music break] As you probably know by now, I’m from Michigan. What you may not know unless, of course, you’ve been blessed to be from this great state, is that we are the Great Lakes State. We’re surrounded by 21% of the world’s fresh surface water. For as much water as we have, water should basically be a birthright here. Except it’s not. Remember this? 


[clip of  unidentified Flint resident] We were being told we’re still getting used to the new system. It’s safe. It’s okay. 


[clip of unidentified news reporter] But it wasn’t okay. Far from it. Flint’s tap water was laced with dangerous levels of lead. The state knew about it and did nothing. 


Dr. Abdul El-Sayed, narrating: And that’s not all. For years in order to recoup on some long past debt, the city of Detroit shut off water on thousands of residents who couldn’t afford it. But ask yourself, why should water be so expensive in a state with so much of it? To add insult to injury, while Detroiters were being billed hundreds of dollars a month for basic access to clean potable water, Nestlé was paying less than that per year to bottle nearly unlimited amounts of our water to sell back to us. Water, and I don’t have to tell you this is a fundamental necessity for drinking, bathing, cooking and cleaning. Aside from the sun, it’s one of few resources on which literally all other resources in this world rely. Lack of access to that basic modicum of water we all need isn’t the only way that water can be used to kill. The other is drowning. And drowning is an American epidemic, an epidemic that snuffs out the youngest lives. It’s the leading cause of death for children 1 to 4 years old and among the leading cause of death for everyone under 24. See, what makes drowning so peculiarly evil is that it’s usually associated with something that should be joyful and carefree. In fact, I’m literally taping this right before I head out to enjoy one last summer weekend on a lake. And as I say that I can’t help but think about the fact that I have two kids, five and seven months, who are poised to have an absolute blast on the water this weekend. And I have to immediately balance that with the thought that the split screen of those moments of carefree joy splashing in the water could be tragedy. And that in the back of Sarah in my mind the entire time will be making sure that it doesn’t. Who’s watching the kids? Where are they? Are they wearing life jackets? And at the same time, I can’t help but recognize that when it comes to water safety, my kids are the lucky ones. My five year old has been taking weekly swimming lessons for years, just like I did. Both of us were privileged enough to grow up with access to quality public pools, with subsidized swimming lessons. And swimming even outside those lessons was accessible enough to allow us to feel comfortable and confident in the water. But just like the water people need to drink or clean isn’t available to everyone, neither is the water people need to swim. And that’s not just some luxury. It’s a matter of basic public health. Because the best predictor of not drowning is knowing how to swim. And the best predictor of knowing how to swim is having water to swim in. But just like so many other aspects of American life, what was once understood to be a basic public good, the public pool has been privatized, a function of some combination as we’ve covered on the show before, between racism and a pullback on basic public goods. See, we have nearly 2 million private swimming pools in America, but only a sixth as many public ones. Which means that those without the means or the networks to get into one of the private pools often don’t get access at all. And those folks are more likely to be Black and Brown, which helps explain why Native Americans are twice as likely to die by drowning and Black Americans three times as likely. While I’ve been an advocate for water rights for a long time. I have to admit that while I thought a lot about the water people needed to drink or clean, I’d utterly missed the need for water to swim. That’s until I came upon a series of articles in the New York Times on the American epidemic of drowning, arguing that access to public pools is a public health issue, a human right even. It hit particularly hard given that the author and our guest today used to sit in front of me at our political science classes at the University of Michigan. Mara Gay is a journalist and member of the New York Times editorial board. She loves to swim, but more importantly, she hates that too few people get to and that that too often cost them their lives. She joined me to talk about that. Here’s my conversation with Mara Gay. 


Dr. Abdul El-Sayed: Okay. Can you introduce yourself for the tape? 


Mara Gay: My name is Mara Gay, and I’m a member of the editorial board of The New York Times. 


Dr. Abdul El-Sayed: All right. And also my college classmate, who I distinctly remember sitting behind in college political science classes. And um I’m going to leave it to uh to to to guess someday to annoy you about whether or not I was annoying in college, as everybody says I was. Um. So with that.


Mara Gay: Uh. I don’t remember that. [laughter] But I do I will say that uh we certainly in our cohort have used those political science classes far more than we could have ever imagined. [laugh]


Dr. Abdul El-Sayed: I I think– 


Mara Gay: What a ride. 


Dr. Abdul El-Sayed: –we have. It has been quite a ride. I uh I’m trying to remember which class we had together. I think we we took a political theory class together. 


Mara Gay: I think it was more than one class honestly.


Dr. Abdul El-Sayed: Yeah. I think it probably was several. 


Mara Gay: Um, a couple. We were clearly interested in the same subjects even then. Uh. And American politics, which has become less and less theoretical, over the past fifteen years. [?]


Dr. Abdul El-Sayed: Yeah. I kind of I doubt like– 


Mara Gay: [?]. 


Dr. Abdul El-Sayed: –Donald Trump is sitting there being like, well, um is is my is my Machiavellian tendency justified by the fact that I seem to somehow have willed myself the power yet again? [laugh]


Mara Gay: Right. Yeah. This is one our professors didn’t see coming. 


Dr. Abdul El-Sayed: Mmm. Ugh. Those heady days. Um. Well, it is lovely to be back in touch, and um I just uh– 


Mara Gay: Likewise. 


Dr. Abdul El-Sayed: It’s always fun to uh to see your your your classmates um writing really important pieces in the New York Times. So I wanted to to to chat because you wrote a series of really important pieces on drowning in America. And I want to ask you, um what motivated you to write about about drowning as both something that happens way too often in our country, but then also as a look into the nexus of a series of policy failures around how we value bodies, particularly Black and Brown people’s bodies, about how we value public space, about the way that we um we tend to atomize or individualize risk in this country? What what motivated the the uh the piece? 


Mara Gay: I have actually been writing about swimming and drowning in America for years. Um. Much of it focused on New York, though not entirely, uh which was my beat for many years. And I used to call for things like free swim lessons for kids, summer camp um and all that’s really great. But once I really dove into the subject even deeper and I started looking at the national issue, what I came to learn through my reporting is that the reason so many Americans can’t swim is that they don’t have safe places to learn how to do so. And so once that came into focus, I realized that this is a much bigger but also simpler problem in a way uh with a very elegant, very achievable solution, which made it even more exciting to me as a journalist and someone who, you know, essentially is in politics in this way, which is, hey, we can build more public swimming pools and we can solve a lot of problems with one one uh solution. And of course, personally, I love to swim any day in the summer when I’m not working, I’m swimming usually at a beach, a pool, anywhere I can, a river, a lake. Um. Obviously, you and I spent time in Michigan, so, you know, I love to swim in a lake, too. And so I just want to share that joy or at least the chance for that joy with others. And I I’ve come to see both in my life as a New Yorker for many years, but also beyond New York, that so many Americans can’t swim. They don’t know how, they’re afraid of the water. Many people have family histories, generations of people, especially Black American families, um who never learned how to swim. And now, looking at the research, it’s clear that drowning itself is a public health crisis. We’re losing 4000 Americans to drowning every year in the United States. 


Dr. Abdul El-Sayed: I want to I want to dive into just how much bigger the problem is here in the U.S. versus elsewhere. But first, there’s something tragic about this, which is swimming for the most part in most circumstances is a elective activity. You can choose to do it. And it’s usually as you shared, something that’s really, really fun to do and people do it because it’s so fun. But drowning is this moment when something that is so joyful turns so tragic because every drowning death is avoidable, every single one. And we don’t we don’t treat it like that. Um. And it’s always an individual who drowned and there’s always a story around the individuals, but it’s helpful to step back and ask, why do so many individuals drown? And I want to talk more about public pools, but can you give us a sense of how much worse is drowning in the US compared to other high income countries? 


Mara Gay: So here’s what’s really interesting, and you’ll appreciate this as a doctor. The data around drowning in the United States is pretty horrible. We don’t have a lot of good data, and that’s because the way we keep those statistics is not standardized, but is actually different in every state and in fact, sometimes in every county. So one of the first things that we need to do is understand where and why and how Americans are drowning in order to do that this is really a federal issue. I believe, we need to standardize data collection. We need to create a public surveillance system around drowning the same way that we have around smoking or teen pregnancy or diabetes or asthma. And of course, we have so much work to do on those issues as well. But, you know, my argument is really that both as a public health issue um this is essential, not optional, but also as a human rights issue, I believe that swimming is a human right. And so I think we should create a culture of swimming in the United States rather than one of drowning. And if you do that, if you think about it in that way, you can not only address the drowning, the bad outcomes that we don’t want, but you can give Americans an opportunity to swim as well, which is a joyful, healthy and very human experience. 


Dr. Abdul El-Sayed: So like most outcomes, the probability of drowning is not even. Who’s most likely to drown by age, by uh sex, by race and ethnicity, by location. 


Mara Gay: So drowning is actually the number one cause of death for children ages one to four. Many of those drownings do happen in bathtubs and at home. Um. Some happen in pools. Drowning is a leading cause of death among children overall. Adolescents, especially teenage boys, are particularly at risk, as are children with autism who are 160 times more likely to die of drowning. Black children, Native American children are at risk as well. And there are some other groups, but those are the highest risk groups. And I think it’s really important that there are some things that we do know about drowning. So even though we don’t necessarily have the data that we need to create the perfect public policy around this, we do know certain things. For example, it’s much safer to wear a lifejacket if you’re boating in open water or swimming in open water. That means a river, a lake, an ocean, something with a current. Um. That’s a really important and simple thing that can save lives. We also know that not allowing children or minors to swim unsupervised or to swim at night can save lives. So those are just some of the things that can mitigate the danger of drowning right away. And these are not expensive things. These are um you know, these are things that can be accomplished by public safety campaigns. I believe so so that’s another opportunity. There’s something that every community, county, state government can do in America. 


Dr. Abdul El-Sayed: Why here is drowning so much more common? How much more likely is it to know how to swim abroad, for example, versus in the U.S.? Like what proportion of Americans don’t know how to swim compared to other places? 


Mara Gay: Again, data lacking. Drowning is a worldwide problem. And actually the World Health Organization over a decade ago called on all its member nations to create uh drowning prevention water safety plans. The United States is one of the last developed nations to come up with such a plan, which it finally did this summer. Um. There are other countries that are far ahead of us, and I don’t have the data in front of me. But for example, Iceland, which is counterintuitive, you think well geez it’s cold, right? But it has a very strong fishing culture, has a strong culture of having a building a relationship with its citizens and the water. It has done um its made enormous strides to reduce drowning rates. So, you know, there are areas where this is happening. While there are also areas in the United States, though, where drowning rates are lower. We need to understand more about why. But from my reporting and from the data we do have. What’s clear is that Americans who do have the opportunity to build a relationship with the water and know how to swim safely or in some cases, for example, where not to, right? Part of swimming knowledge is the current’s too strong today, I’m not going to get in, or that’s the dangerous part of the lake and so I’m not going to enter it there. I’m not going to swim unsupervised. For those communities, drowning rates are lower we believe. And again, we don’t have national public surveillance data. So this is imperfect, it’s preliminary. But what we know is that wealthy communities across the United States, though, they still see drownings because of the lack of public awareness around some of these basic safety precautions. They have invested heavily in public pools and that those are much safer places than private pools. There are 10.4 million private pools in the United States and fewer than 300,000 public pools. That’s a figure that includes it’s a stunning figure, it includes uh hotel pools and condo association pools. So that’s not even really open to the public. So the number of municipal pools is even lower. And so that really gives you a sense of what the problem is. How could you possibly learn how to swim and swim safely if you don’t have anywhere to swim at all? 


Dr. Abdul El-Sayed: Yeah. Do we have an estimate about what proportion of the public actually does have access to to public pools? 


Mara Gay: We don’t we don’t even have that data. What we do know is we have um a survey from the Red Cross from several years ago that showed that over half of Americans lack basic swimming skills. And that’s a stunning survey um a lot of Americans, too, will tell you that they have some swimming ability. But then when you ask them about specific skills, can you swim a lap without stopping? Can you tread water for 3 minutes? Uh. It turns out that their skills aren’t as strong as they think. Um. So that’s also a danger there’s a false confidence about that. You know, taking a few swim lessons is great, if you can. Um those are hard to come by in the United States. But it’s really also just about understanding and respecting the water, not fearing it or avoiding it, but building a healthy and safe relationship with it. Much more data collection is needed. I mean, I think just the fact that 4000 Americans are drowning every year, that this is a leading cause of death. And yet we have I can’t answer these questions because we don’t have the data around it. And if you think about what it would be like to put your child, your infant, in a car seat. Every time you do that, you know, that’s something you do automatically. Well, many years ago, that’s not something that parents did. Now, because of the data we know you wouldn’t put an infant in a car without a car seat. You wouldn’t spend hours in a restaurant unless you’re a smoker yourself where there was cigarette smoke around. And yet these things used to be commonplace, not wearing seatbelts in cars. This is the kind of relationship that America has right now with the water. It’s one that is one of danger where it should be one of health, joy and safety. 


Dr. Abdul El-Sayed: It strikes me that this is also a problem that is not getting better. You know, a lot of the public health challenges that we talk about on the show. They there are places where we’ve we have gotten better or are getting better. But for this one in particular. It feels like generationally this has actually gotten worse in so far as you have more of a public pool recession that has taken hold as these private pools have have built out. Can you talk to us about some of the political economy that has led to the privatization of, you know, of water um and the shutting down of uh of public pools? 


Mara Gay: That’s a great question. Let me start with the history, which is that in the United States, uh really the only period in which we invested heavily in public pools was in the first half of the 20th century, in particular during the Great Depression, as part of the Works Progress Administration under President FDR. And so large public pools were built and they weren’t just built for, you know, cleanliness uh in the dur– like they were during the reformer era. They were built to be enjoyed. They were built to be places that brought the public together, um often from different backgrounds. They were fun. They were beautiful. Uh. The Astoria pool in New York is a good example of that, a little bit earlier the Natatorium the Audubon Natatorium, the largest swimming pool in the South, which was in New Orleans. These were, you know, made to awe. And then after World War Two, when suburbanization took hold, there was a move away from public spaces and toward the suburbs. You saw white flight and divestment from cities. And as Americans kind of had more private space, their backyards, their picket fences, of course, these were white Americans largely. What ended up happening is people were building their own segregated communities that came with their own swimming associations, clubs, country clubs, the rise of country clubs. All of this privatization started very early on. And then across the South, not only the South, but in particular the South, the next decade and the sixties and the early seventies as public pools throughout the South were ordered to desegregate. Many towns, many communities, sadly, tragically, horrifically chose to close their public pools, destroy them or fill them in, rather than allow Black Americans to swim in them. And so what that did was it forced Black and poor white swimmers or would be swimmers, um locked them out of that opportunity where wealthier white communities built their own private pools, either in their backyards or in their country club associations. And that really set off the generational um issue that we have and the disparity across racial lines that we have here in the United States. It only was worsened during the Reagan era when privatization was fetishized and really when investment in social infrastructure like parks but also swimming pools was reduced. So I think now to your original question here, we’re in this bizarro world of late stage capitalism. Democracy is under threat, and faith in public institutions and government is really at a low in some ways. And so you have this perfect storm, in my opinion, where Americans and others outside the United States are saying, well, you know, it’s one climate change disaster, disaster after another pandemic, or we’re on our own. So I’m going to get mine. And that kind of attitude is really a sad and disturbing, I believe, fruit of this late stage capitalism obsession about privatization. Um. And it’s because of that that we’re really not investing the way we should, in my opinion, in critical social infrastructure, schools, playgrounds, health care, and what do you know, swimming pools, which are considered a luxury when really they are an essential piece of social infrastructure, we should think of it like a library or a school. [music break] 




Dr. Abdul El-Sayed: Walk me through the mechanism here. Um. My understanding is if you have public pools, you also have highly subsidized swimming lessons and observed swimming opportunities which allow people to both formally and informally learn water, water safety. And, you know, I’ll tell you, I learned to swim um ironically, when I was a kid we lived uh part of my childhood in Missouri, part of my childhood in Florida. But we’d come every summer to Michigan. And there was a public pool in my grandparents neighborhood where you had to be certified to be able to swim by yourself. And you got this little card, this Red Cross card. And then I remember the summer that I got my red dot and my red dot meant that I could go to the pool by myself because I was a strong enough swimmer, um but it was always packed and there were always kids there. And it was this just lovely place where I got to meet all of these people, these kids that I’d hang out with later on, you know, we’d we’d ride bikes together, etc.. But we met at the pool because that was like the place to go in a hot summer. Um. And I know for me it was both the swimming lessons and it was the it was the access to that public pool. I could just take my towel and go hang out by the pool unsupervised at that point, I was, you know, like ten, 11 years old. Um. How how would how does this mechanism work? Does it you know, is that the like the picture of it or um would it work in a in a bit of a different way? 


Mara Gay: Right. So that’s a great example of what we want to see everywhere, actually. So we actually don’t have to just imagine this because across the United States, communities, not even just wealthy ones, but ones that are wealthy enough, any community that is wealthy enough has a public pool. So any community that has been able to has invested in a public pool, um that’s one of the reasons that I am so convinced that they work because wealthier communities have never stopped investing in them. So, um you know, for example, I grew up in I spent my high school years in White Plains, New York, which is an economically um and racially diverse place. It’s not particularly wealthy, but it does have some money. And so we had a large public pool. It wasn’t the fanciest pool in Westchester. It wasn’t like the pool next door in Scarsdale that looked like a country club. It wasn’t the pool in Westport, which was at one time a country club, part of a part of a country club. But it was fun. It was big enough. It was open all hours so that everybody could enjoy it. It was fully staffed by lifeguards, and it was a really safe place to practice swimming and to learn how to swim. It was a fun place to go with your friends, to take your kids there. And so that’s really what we want. That’s the model. This is not a utilitarian thing. Um. This is not something where we’re saying poor people are dirty and they should bathe like Robert Moses did. That’s not what the attitude is here. The attitude is every American, every human deserves a fun place to cool off. Summers are getting warmer. So this is not something where we need to reinvent the wheel, but it is something where you need to invest a little bit. You know, it’s really a really good investment, it’s a good bang for your buck if you’re the federal or state government, because it costs very little proportionately to many of the programs that we spend money on. But if you’re an individual, there’s no way, even if you have a backyard that most Americans could afford to put a pool in their backyard, and even if they were able to do so, that pool would be less safe statistically than the town pool. So this is a no brainer, I believe. And there are examples across America of things that communities have done to make these fun places to learn how to swim. So Ann Arbor, Michigan, where we went to school, uh I’ve discovered I have a goddaughter that lives there and she’s obsessed with all the slides. There’s giant water slides throughout all the town pools. And it’s it’s not that uh this is a luxury item. This is a city that has decided this is a priority. It’s essential. And, you know, if you build it, people will use it. If you build people things that are nice to enjoy. It will pay dividends. It says a lot, too, I believe, about what government can be for. I mean, in this era in which, you know, you think the polarization and faith in politicians and government is at this all time low in some ways. Well, the government doesn’t just have to be there to arrest you to uh make it hard to vote to um collect taxes. Government can actually do something good. It can bring people together. It can give you a place to cool off, to learn how to swim, give you a life skill, um and somewhere for kids to go, especially uh in rural areas and in inner cities where there may not be a lot of opportunities for play. You know, and I think when you think about the teen mental health crisis in America, especially in the years after COVID, I mean, what an incredible opportunity to get Americans and in particular young people off of their smartphones and their social media and interacting with one another, learning about the environment around them, nature, children, what have you. They’re interacting with people from different backgrounds. And I just think that the possibilities here are enormous. And it’s such a simple, simple thing. 


Dr. Abdul El-Sayed: Yeah, it’s it’s a very simple investment. And even the upkeep of a pool is not very difficult, um particularly considering all the other things that government does quite regularly. I live in Ann Arbor and, you know, we go to the public pools with the big water slides uh often, and my daughter loves it. And um we know that it’s a it’s a pretty safe place because it’s packed. And, you know, in some respects it’s interesting because there’s this notion that private equals better, that if you you can keep other people from the thing that somehow it’s more fun to use. And it’s interesting because my daughter always prefers the public pool because there are going to be kids there and kids that she can hang out with. And if, you know I, we we we don’t have a pool, but um in the times when she she you know, she gets to use them, there’s there’s one or two kids and at some point they get exhausted. But every time we’ve ever been in a public pool, if it’s just the family, we go. And inevitably she’ll make two or three friends. And there’s a little like crew of of five year old girls running around the pool, not running, walking uh [laugh] near the pool, um but uh but enjoying their time together and making new friendships, which is, you know, which is half the fun. Um. The other part of this, though, is is you talk about um a a pool wide short staffing when it comes to lifeguards. Can you can you talk through that? 


Mara Gay: So uh this is years in the making. It was really um got bad during COVID and it has not recovered. There is a national lifeguards shortage. Um. In some ways, the solution is simple They need to be paid more like most other workers in America. You need to make that job more attractive. Um. But part of the problem, too, is that so few Americans know how to swim well, that the pool, the pipeline of lifeguards is also lacking. And so there’s another example of how my reporting brought me back to we need to build more public pools [laughing] because you can’t train lifeguards without a public pool. Um. Other people wrote in after I wrote my piece calling for more swimming pools in America, and they said, well, in my day, you know, we just we were required to learn how to swim in school. That’s nice. You have to have a pool for that. That’s a great idea. Sure, I’m all for it. Do you know how many empty pools are sitting in New York City right now? The last at my last count, 37 of our pools were nonfunctional sitting there empty. So, you know, to your point Abdul, um public spaces can be beautiful spaces if you invest in them. I mean, if you look at Grand Central Terminal in New York City, another great example of a beautiful public works project, uh you know, versus Penn Station. Anybody who’s visited New York, you know the difference. You walk into Grand Central Terminal and you feel like, hey, I’m going somewhere. I’m somebody important, marble, high ceilings everywhere, all kinds of different people from around the world gathering. There’s kind of an excitement in the air. You go to Penn Station, the ceilings are low. There’s you know graffiti– 


Dr. Abdul El-Sayed: Well new Penn Station is nice. New Penn Station is better. 


Mara Gay: The new Penn Station. 


Dr. Abdul El-Sayed: Yeah. Old Penn Station was awful. [laughing]


Mara Gay: The old one. It’s still there, so we’re [laugh] okay. So, um yes, the new Penn Station is very nice. Um. But the point is, is is this right? Which is there was a period and I think it continues, sadly, in which we weren’t investing in public spaces. And, you know, you don’t have to be a conspiracy theorist to know that part of the reason is because companies make more money when you convince Americans that buying something private that nobody else can have to your point, or that’s a luxury item is superior. And so whether that’s a school or uh whether that is a country club, you know, um I’m not saying that we should ban country clubs, but I am saying we should invest in our public pools. 


Dr. Abdul El-Sayed: Yeah. To your point Mara, I I uh I remember flying into LaGuardia recently, the new LaGuardia, because old LaGuardia was trash. 


Mara Gay: Oh terrible. 


Dr. Abdul El-Sayed: New LaGuardia, flew in and I remember just looking at Sarah and being like, man, this feels like an international airport. And then for a minute I was like, wow, what an indictment on American infrastructure that my first comparison of an actually, like, beautiful new airport was to an international airport. 


Mara Gay: Yeah. 


Dr. Abdul El-Sayed: Right. And we’ve got a pretty nice airport here in Detroit. Um. But, you know, the truth is, is that we have so disinvested in these basic infrastructure pieces of public space that that all of us can use, that it is a norm that you expect that any of these public spaces are going to be substandard, um not inspiring. And that’s why I think to your point, Grand Central is so is so awe inspiring because it’s such an example of of of a public space that care was taken to invest in. I happened to go to a high school where we had a pool and they they required us to learn basic water safety skills. And, you know, in order to be able to graduate and finish your gym class and get your gym credit, you had to be able to to swim. Uh. I think it was like 100 yards nonstop, something like that. Um. And and I hear your point about um about needing public pools to be able to do that right and a high school pool is nothing but a public pool. Um. I’m wondering if there may be a space to sort of build some of this into curricula and into schools as we think about, you know, a place to get started. I’d love to hear your sense of, you know, where do we go from here? Like, what is the first step to being able to invest in that water infra– infrastructure? It seems to me that, you know, filling those 37 pools in New York could probably be a great place to start. But, you know, how should we think about operationalizing this to to maximal efficiency? 


Mara Gay: Yeah. Well, I do think that really declaring this a public health crisis is important um to just prioritize this and give it a sense of urgency that it deserves, demands. I spent a lot of time speaking to the parents of children who had died of drowning. And uh when you do that, you get a sense not only of how important the issue is, um but how, you know, their stories are very commonplace. And I don’t think that really many Americans understand um the basic facts of water safety. And really, anybody can drown just like anybody can swim. And so I think that’s part of the answer. The other part of the answer is the federal government, Congress and the White House can show some leadership. This is a rare opportunity, I believe a very rare opportunity for some bipartisan collaboration. Um, you know, this really does affect every single American community, make some funds available to communities to build swimming pools. Um. It is a very afforda– I don’t have a cost estimate on hand, but I promise you, it costs a lot less than many of the things that we spend money on. Um. And so it’s a worthy investment. And I think some incentives would go a long way. Um. I think that’s a good place to start. You know, since writing this piece, I’ve also heard from just uh council members across the country who said that it started conversations that these are things they’ve been thinking about as the country has been suffering from one of the hottest summers or I think the hottest summer on record, parts of the country. So this is an issue that I think even just because of global warming, because of climate change, has been gaining some salience. Um I also just I hope it’s an opportunity not just for pools. I mean, not everybody is going to be as obsessed with swimming as I am, and that’s perfectly fine. But just to to reinvest in public infrastructure in general and to say, hey, you know, we want as citizens, we want our government to provide services that actually improve our lives, that can build stronger communities. And, you know, it doesn’t just have to be government telling us what we can and can’t do. I mean, what better way to start building some faith in government than by providing a service that can build a stronger country and just, you know, healthier Americans too. 


Dr. Abdul El-Sayed: I’m uh I’m waiting for the new the new Bernie Sanders tagline. Medicare and pools for everyone for all. Anyway, um. 


Mara Gay: Right. 


Dr. Abdul El-Sayed: I uh. I want to ask you, um you know, just obviously you’re very passionate about this. When did when did, when and how did you learn to swim? 


Mara Gay: Yeah. So I actually don’t remember not being able to swim. My parents grew up in Michigan. My mom is white. My dad is black. They both grew up um poor, but they knew how to swim. And um on my dad’s side, my grandparents. So my Black grandparents didn’t learn how to swim until much later in life. My grandmother remained afraid of the water um for, I mean, I guess until her death, even though she technically knew how to swim. Um. And when I was a child, though, my parents really they loved the water. So we spent around a lot of time around beaches and pools when I was young. But they also went out of their way to make sure that I learned how to swim. I think there’s pictures of me floating around in a like one of those floaties that you put a child in and kind of send them off, supervised, into the pool with little palm tree. So I was in that from the time I was like nine months old. Um. And then I remember my father. I must have been four or five when he took me to the ocean. And he said, you don’t need to fear the ocean. You just need to respect it. And that’s the kind of love of the water that they instilled in me. Um. I think as I got older and I just have a personal love for water, but I realized that, you know, my father’s family as Black Americans, I think that for my dad and his five siblings learning how to swim, which they did actually at a historically Black college, where their father was the dean of the law school, South Carolina State, that was in some ways a form of resistance, of resilience, of joy. It was a way to say this isn’t just something for white Americans, this is something for all of us. It was a way to reclaim a human experience, and it was a way to be in nature and just to be equal and to feel free. And that’s how I feel um just on my own personally, let alone I can only imagine, you know, my dad, who grew up in the Jim Crow South and partially in Detroit, also Jim Crow, Detroit. So I’m very passionate, I think in part because of that, about making sure that this experience is one that’s available to all people. And of course, as a Black American, it is especially devastating that this is seen as something that is for white people or for wealthy people. To me, that is heartbreaking because I can’t think of any experience that is more needed than something like swimming for Black children and children who are living in poverty, children from marginalized communities. I mean, what a what a great opportunity for them to build a relationship with nature, um with their own bodies, and just to know that they deserve every human experience on the planet. And also that there’s nowhere that should be off grounds for them. So the idea that the ocean isn’t a place where Black kids, for example, belong. Like that just makes me very angry. Um. But the reality is so many Americans of color can’t swim. And so I think it’s it’s an equity issue. It’s a justice issue. There’s history there. And it’s really quite simple. Not everybody has to be obsessed with the water, but everybody deserves the chance to try to swim. 


Dr. Abdul El-Sayed: Yeah. And to be safe in the water. I really appreciate you sharing that and um appreciate you joining us today. Our guest today was Mara Gay. She is a member of The New York Times editorial board and author of a fantastic series about drowning and swimming in America. Mara, thank you so much um for taking the time and go blue. 


Mara Gay: Thanks for having me Abdul. Go blue. [music break]


Dr. Abdul El-Sayed, narrating: As usual, here’s what I’m watching right now. Okay so after like months of being able to truly move on from COVID, this is now the third week in a row that I feel compelled to talk about it with you. And that should tell you something. It’s almost fall, Covid’s doing its COVID evolution thing and that spells well not great news at best. In today’s version, it’s BA2.86, while the Omicron sub variant EG.5, which we talked about a few weeks back, is currently top of the heap. What’s got scientists a bit perturbed about this variant is that well, it’s a wide leap from the usual Omicron cousins. Since 2021 it’s been one Omicron variant after another, each building incrementally on the past. This one appears to be something different almost entirely. And that means that all this immunity we’ve built up over the waves of Omicron, well, it just might not be as protective. To start with BA2.86 has 35 new mutations on its spike protein. And if you’ll remember, that’s the piece of the virus that helps it stick to our cells. To put in perspective the jump between Omicron and BA2.86 is as big as the jump between original SARS-CoV-2 and Omicron. As of last week, there’s only been seven confirmed cases in four countries, but we’re detecting it in wastewater, which means it’s spreading even if asymptomatically. Remember the three questions we always ask about new variants? Is it more transmissible, more immune evasive and more virulent? And the answer right now is, well, we just can’t know. But given the evolutionary leap it’s taken to get here, there is concern. We’ll watch, wait and let you know. A new study published in JAMA, the Journal of the American Medical Association with data from over 25,000 patients, found that pulse oximeters, which use light to measure blood oxygen, systematically overestimated the blood oxygen levels of Black patients with COVID 19, leading clinicians to miss worsening respiratory symptoms, delaying care and increasing the probability of readmissions. It’s a stark reminder that while technology itself may not actively pursue discrimination, the ways we design technology often frame shifts preexisting bias into that tech, rendering its outcomes racist af. And the challenge is that for too long, the assumptions about who a, quote, normal patient is have shaped the way we design around them. And guess what? Normal doesn’t usually include people of color, women, and so many other marginalized folk. Pulse oximeters could easily be tuned to better accommodate different skin colors. In fact, some of the earliest versions used eight wavelengths of light rather than just two. But the industry settled on these for the sake of expediency, and we’ve known that they systematically overestimate blood oxygen in Black people since at least 2005. But the industry argued that the consequences were, quote, “minuscule.” But minuscule for whom? It’s simply a matter of who we choose to pay attention to and whom we choose to ignore. Not that you should have watched it, but this happened last week. 


[clip of Bret Baier] Welcome to the first debate of the 2024 presidential campaign. 


Dr. Abdul El-Sayed, narrating: Basically, a bunch of folks got together to trade rather absurd talking points in an effort to be crowned king or queen of the [?] given that the frontrunner in the race was preparing for his arraignment at the Fulton County Jail following his fourth indictment, I can’t believe I just said that. Here are some of the lowlights. 


[clip of Vivek Ramaswamy] Let us be honest as Republicans. I’m the only person on the stage who isn’t bought and paid for. So I can say this. The climate change agenda– 


[unspecfied responder] Oh whoa whoa whoa whoa. 


[clip of Vivek Ramaswamy] –is a hoax. 


[unspecfied responder] That’s just ridiculous. 


[clip of Vivek Ramaswamy] The climate change agenda is a hoax. [fades out]


[clip of Bret Baier] But just to be clear. Governor, would you sign a six week ban federally? 


[clip of Ron DeSantis] I’m going to stand on the side of life. Look, I understand Wisconsin is going to do it different than Texas. I understand Iowa and New Hampshire are going to do different. But I will support the cause of life as governor and as president. 


Dr. Abdul El-Sayed, narrating: The debate was characteristically light on any substantive public policy, with the candidates opting instead for zingers and one liners intended to out trump one another. I can’t tell you who won, but I can tell you what lost. And those are two things we care a lot about on this pod. Science and Public Health. Imagine calling climate change a hoax, even as the waters off Key West have been literally as hot as a hot tub, literally decimating one of America’s most important natural resources in the coral reefs off of South Florida. That and the fact that a hurricane hit the wrong coast and temperatures hit 110 in Phoenix for a month straight last month. Imagine signing an abortion ban in your state that denies basic bodily autonomy to folks before they even know they’re pregnant and then trying to do the same damn thing nationwide. While I doubt anyone on that stage will be president in 2024. It’s a major indictment on our country’s future that one of two major political parties in our country is openly adopting such anti-science, anti-health positions and winning support from some corners of the electorate for it. It’s easy to watch something like that and throw in the towel, But remember, the only antidote to bad ideas spread hatefully, is good ideas spread lovingly. And that’s what we’re going to continue to do. Not just us here at America Dissected, but all of you in the conversations you have with your friends and family members, coworkers and neighbors. Have the courage to have these discussions and the courage to sit with the discomfort of disagreement. Remember, minds don’t usually change in the moment. It’s only usually long after those conversations have been had. So keep stepping up and stepping in. We’ll be right here with you. That’s it for today. On your way out, don’t forget to rate and review the show. It really does go a long way. Also, if you love the show and want to rep us, I hope you’ll drop by the Crooked store for some America Dissected merch. Don’t forget selected items are on sale for 15% off. [music break] America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producers are Tara Terpstra and Emma Illick-Frank. Vasilis Fotopoulos mixes and masters the show. Production support from Ari Schwartz. The theme song is by Taka Yasuzawa and Alex Sugiura. Our executive producers are Leo Duran, Sarah Geismer, Michael Martinez and me, Dr. Abdul El-Sayed, your host. Thanks for listening. [music break] This show is for general information and entertainment purposes only. It’s not intended to provide specific health care or medical advice and should not be construed as providing health care or medical advice. Please consult your physician with any questions related to your own health. The views expressed in this podcast reflect those of the host and his guests and do not necessarily represent the view and opinion of Wayne County, Michigan, or its Department of Health, Human and Veterans Services.