Sick neighborhoods raise sick people

I live and study public health in Baltimore, a city in which one-third of its children live in poverty, another two-thirds live in single-parent families, and more than a third of students drop out of high school.

Not coincidentally, Baltimore has an infant mortality rate nearly twice that of the nation, its teen birth rate is higher than the national average, and people here live shorter lives, especially minorities and low-income residents, than their counterparts just a few miles away in the suburbs.

This is a sick city. Literally blocks of houses are boarded up – dead and rotting with crime, hopelessness and fear. If you think I’m being melodramatic, watch the HBO drama The Wire. It’s a pretty accurate portrayal.

<a href="http://www.buzzdash.com/index.php?page=buzzbite&BB_id=122624">Are health connections to poverty &amp; education adequately recognized?</a> | <a href="http://www.buzzdash.com">BuzzDash polls</a>

On The Health Care Blog, we spend a lot of time talking about the
health system, what it’s lacking and how it should be fixed. This is
important, but as Maggie Mahar points out in her post on a new Robert
Wood Johnson Foundation report that demonstrates the undeniably strong
connections between poverty, education and health, “Many experts have
concluded that medical care and genes actually play a relatively minor
role compared with the influence of the physical and social conditions
in which children grow up.”

I haven’t figured out why talking about the detrimental effects of
poverty and poor education never seems to be taken seriously in health
reform debates. Maybe the issues are too large and daunting. I also
don’t understand why efforts to improve the economic status and
well-being of underprivileged Americans always seem to get labeled as a
liberal causes.

Maybe, someday I’ll figure it out, but in the meantime, vote in our poll and read Maggie’s excellent post.

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9 replies »

  1. I think we can all agree that our health care system is pretty backwards. How we live in the richest country but people sleep in the streets with their kids just doesn’t make sense. Personally, I’d rather be called a “bleeding heart liberal” than walk around blind to the fact that the poor are only getting poorer and that low-income communities are getting the cold shoulder. I wonder how many low-income parents know that they can get their kids free immunizations? I know vaccinating is not a solution to all of the disease and health problems many people are facing, but it would help with infant mortality and keeping kids healthy enough to finish high school. Infants and children are already so susceptible to numerous preventable diseases, but poor nutrition, unkempt conditions, and in many situations under-educated parents mean these kids don’t have a chance.
    Today we’re discussing the importance of vaccinating, both kids and adults, and where to get free vaccines. Like I said, it’s not a solution but a piece to a puzzle that no one seems to want to put together. You can read this post at http://current.pic.tv/2008/10/29/its-time-to-talk-vaccines/

  2. When I worked in the Baltimore city schools, I was struck by how many kids had health problems that were utterly foreign to me and everyone I grew up with. Lead poisoning was rampant – the parents I worked with were sadly conversant in the jargon of lead measurements and treatments. Some kids had never seen a dentist. Just like on “The Wire,” a few kids didn’t have anyone to wash their uniforms or make them take a bath, so they developed skin rashes and in one memorable case, hair loss.
    I think most people are aware of the nutritional challenges, parental substance abuse and other mainstream public health issues facing poor city kids, but truly the health challenges go even deeper than that.

  3. the big reason why we have sick people is because the government and FDA in many countries especially in USA is trying to reduce the population by feeding people with white sugar, hydrogenated fats, colorings and similar deadly ingredients. These ingredients totaly mess up your imune system and your brains.
    If you want to know more about what is healthy and what is not then go here: http://seekthat.net/blog/2008/10/17/health-intro/

  4. Sarah-
    Thanks for focusing on this topic.
    You write: “I haven’t figured out why talking about the detrimental effects of poverty and poor education never seems to be taken seriously in health reform debates. Maybe the issues are too large and daunting. I also don’t understand why efforts to improve the economic status and well-being of underprivileged Americans always seem to get labeled as a liberal causes.”
    I’m afraid that, at some point in the early 1980s, our compassion for the poor just wore out. Ronald Reagan
    managed to persuade too many people that the poor were con artists “welfare queens,” etc, with anecdotes made up out of whole cloth.
    Also, as our society became more materialistic in the 1980s and 1990s, the upper-middle-class and middle-class became less willing to share–by paying taxes to support public education and social programs for the poor.
    Also, during this period of time, as the poor got poorer and the rich got richer, the gaps between classes widened. Few upper-middle-class and even middle-class people even know any poor families. They live in different neighborhoods, go to different schools, shop in different store . .. The poor have become invisible.
    I find this especially true for people who came of age in the 1980s and 1990s. By then the classes were very separate. (Before that, upper-middle-class kids met and worked with poor people when they took a summer job doing construction working in a factory, waitressing or working =an ice-cream shop. Now upper-middle-class kids spend their summers doing “internships” or traveling. They don’t take blue collar jobs.
    You could see what was happening in the 1980s when jokes about “bag ladies” and homeless people became acceptable, both among affluent young people and on shows like Saturday Night Live. To people who laughed at these jokes, the homeless just weren’t real.
    Meanwhile over the past coupole of decades, anyone who talked about the poor came to be labled a “bleeding heart liberal”. (Just as, in the 1990s, anyone who questioned the Gulf War–and later the invasion of Iraq, was labeled a “Peacenik.”
    But today, as we head into a Depression, I think perhaps we’ll see a little more social solidarity. We’re ready for–and need–a new War on Poverty.
    In terms of the nation’s health, that would do more good than all of the health insurance in the world.
    I wish more healthcare reformers would rally round the idea.

  5. As an immigrant from Europe, I don’t say this to be smug or condescending or whatever, I love the US and I do live and work here, but it needs to be said:
    some regions of the US approach 3rd world standards (homelessness, poverty, poor public schools, economic segregation), and I believe that this is mainly due to ineffective government (on state- and federal level) which has been further weakened by the right shift over the last decade. Sure, you have your immigrant ghettos in Europe as well ( I personally know that they exist in France and Germany) … but the situation doesn’t seem to be as dire as in some parts of the US.

  6. I went to Baltimore a couple of years ago. I have never seen so many street people in a city before, and I’ve been to some large cities.
    Unfortunatly the size of the problem has been allowed to grow so big (like other problems in America) that it will take huge investments to make much of a dent. Maybe Henry Paulson can do it.

  7. Sarah – Another great post! I think you have figured it out. Bigger societal issues are definitely spilling over into the healthcare system and those issues are too daunting for most to handle. However, they cannot be ignored if we are going to have sustainable reform.
    I don’t think efforts to improve the well-being of the underprivileged is a liberal cause, unless the efforts amount to nothing more than handouts.