End-Stage Poverty Is Killing People in Safety Net-Free America

Many Patients Don’t Survive End-Stage Poverty by Dr. Lindsay Ryan is a great/upsetting piece about how the poverty many Americans are subjected to in America is killing them. Many people die here in the world’s richest country not because they are sick but because they are poor and our systems of government, justice, business, and health care don’t do enough to help them (or, more cynically and perhaps truthfully, actively work against helping them).

This is one of those pieces where I want to quote every single paragraph, but I’ll start with this one (bold mine):

Safety-net hospitals and clinics care for a population heavily skewed toward the poor, recent immigrants and people of color. The budgets of these places are forever tight. And anyone who works in them could tell you that illness in our patients isn’t just a biological phenomenon. It’s the manifestation of social inequality in people’s bodies.

I have not been able to stop thinking about this phrase since I read it: “Illness in our patients isn’t just a biological phenomenon. It’s the manifestation of social inequality in people’s bodies.”

Medical textbooks usually don’t discuss fixing your patient’s housing. They seldom include making sure your patient has enough food and some way to get to a clinic. But textbooks miss what my med students don’t: that people die for lack of these basics.

People struggle to keep wounds clean. Their medications get stolen. They sicken from poor diet, undervaccination and repeated psychological trauma. Forced to focus on short-term survival and often lacking cellphones, they miss appointments for everything from Pap smears to chemotherapy. They fall ill in myriad ways — and fall through the cracks in just as many.

You should read the whole thing yourself (NY Times gift link). Her argument about the need to expand/shift the definition of what healthcare is (e.g. housing is healthcare) reminds me of this more progressive idea of freedom.

• death
• healthcare
• Lindsay Ryan
• medicine
• poverty
• USA