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Healthcare Reform Requires A Recognition Of Socio-economic Inequities

I was part of the USC Annenberg School of Communication and Journalism’s “Health and the Blogosphere” conference/brainstorming session last week.  Bloggers and other health writers were invited to give input on a new professional training program, and I was honored to be a part of that group.

I took away so much more than I contributed. An unexpected focus (for me) was the idea of taking the blogosphere dialog about our own health (”my health”) and expanding that into a discussion about the health of our communities (”our health”).

But haven’t we’ve been doing that for the last year, health care reform having been debated ad nauseam?

Well, no.

We talk about access, the medical home and affording medical care. From screening to vaccinations to treatments for illness and the cost of prescriptions drugs, it’s all about keeping the individual healthy.

We are talking trillions-with-a-capital-T to reform our health care system.

With health care reform, access and education, life expectancy will increase and health disparities will be a thing of the past.



Well, no.

Our health care system looks to remedy problems. Fix them. Change behaviors. Treat illness. Educate.

Reform will mean that everyone is equal. Everyone has access. Everyone covered.

No more health disparities.

A noble and worthy goal.

But it doesn’t address the root cause of the majority of those disparities.


It matters where you live.


All the health care in the world means nothing if your housing is sub-standard, dilapidated and full of lead-based paint.

In neighborhoods full of empty lots and garbage.

All the health care in the world means nothing if you don’t have the means to purchase food (healthy or otherwise) because your job, if you have one, pays nothing and there are no grocery stores in your neighborhood, just liquor stores and fast food joints.

All the health care in the world means nothing if the crime rate in your neighborhood qualifies it as a war zone and you take your life in your hands just walking down the street.

And you can’t get a decent education because what little teaching actually goes on in your underfunded, understaffed neighborhood school is hard to retain when you are going to school hungry. Or watching your back.


It matters where you live.

We will never have true health care reform unless we deal concurrently with social inequities, specifically poverty.

It’s like putting a band-aid on a deficient immune system.

It looks good, but it isn’t really doing much for the patient.


For the record, this is not bleeding-heart “save the world” banter.

I’m not talking hand-outs and welfare that goes on for generations.

I’m talking about providing the basics, the tools that can help raise people out of poverty, the cause of health disparities.

Social justice.

Believe me, I’m all about “pulling yourself up by the bootstraps”.

But shouldn’t we make everyone has a pair of boots, first?


The inspiration for this post is a direct result of a presentation given at USC by Anthony Iton, M.D., J.D., MPH, Senior Vice President of Healthy Communities for the California Endowment: “Beyond Disease: Blogging on Obstacles to a Healthy Society”. Dr. Iton had been the director and county health officer for the Alameda County Public Health Department until September of 2009. I thought this slide was particularly impressive, so I’m including it here:


It Matters Where You Live

*This blog post was originally published at Emergiblog*

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One Response to “Healthcare Reform Requires A Recognition Of Socio-economic Inequities”

  1. bobbcat says:

    Don’t you think it’s important to address the issues that are related to what is behind what causes poverty in the first place, such as th sharp disdain for the notion that having a good education is a must and that hard work is the right road to personal success, that indulging in the drug trade is the way to go. Until this issue is addressed head-on, I don’t see a way out for the people involved.

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