Think for a moment of poverty as a disease, thwarting growth and development, robbing children of the healthy, happy futures they might otherwise expect. In the exam room, we try to mitigate the pain and suffering that are its pernicious symptoms. But our patients' well-being depends on more, on public health measures and prevention that lift the darkness so all children can grow toward the light.
Those words were written by Dr. Perri Klass, in the NY Times Well Blog on May 13.
Do you believe them?
I also believe that part of the problem is us.
I was once at a local community group meeting to talk about the things we do at Carilion Clinic Children's Hospital. During the course of the presentation folks started asking questions about why it is so much harder for a children's hospital to be self-sustaining than for hospitals who only care for adults. Among other issues, we talked about how big a discrepancy there was between Medicaid and Medicare in payments to both hospitals and doctors. We talked about how many more children were dependent upon Medicaid for their health care coverage. We talked about the fact that more children born into poverty tend to be born early, due to limited or no access to prenatal care for the mothers, who may be unwed, and may be teens. We talked about many things that contribute to this situation, and how we, in the children's hospital provide care to all if they are in need.
While this discourse did seem to lead to an outpouring of empathy and understanding from the group, one man in the room seemed to think that by making healthcare accessible we were inciting more teens to give birth to babies they could not care for, inducing more "undocumented" immigrants to seek care, and all over, just ruin the complexion of our city, county and state. Luckily for me, one of the person's colleagues asked him to sit down. And so he did. But of course he still believes what he believes. He will never see the value in what we do for those who cannot climb out of the cycle of poverty on their own.
Children who live in poverty are limited in their likelihood to become healthy, self-sufficient adults. They are much more likely to be obese, suffer from diabetes, succumb to substance abuse, mental illness, or become victims as well as perpetrators of child abuse.
Toxic stress induced by poverty can cause damage that is not only able to last an entire lifetime, but is also able to transform genes, and lead to inheritable changes in mental capacity, physical health, and emotional stability.
I believe that pediatricians are capable of curing poverty.
Well, we need help. We need help from politicians, from businesses, from the population at large.
We need to push, as Dr. Klass extols us, to engage in treating the population. We need to stop pretending that it doesn't matter. WE need to do at least as much for our children as we have done for our elderly.
We need to see the effects of poverty as symptoms of a disease that is rampant in our country.
How do we do it?
We start by making health care available for every child. Then we take it one step farther and one step farther and one step farther. We invest in the child and the family. We help young working parents find affordable SAFE childcare. We provide access to fresh food in poverty stricken areas, that now only have access to fast food and rotten produce. We educate our young. We keep kids in school. We enable our teens to stop having babies that will only extend the poverty spiral. We stop increasing the discrepancy between the haves and have-nots. WE CARE.