“Th[e] denial of health services is not the fault of the doctor—not the fault of the hospitals—not the fault of the medical schools. They have all done a magnificent job of creating the technology, the arts and sciences of healing by which disease may be cured. The trouble lies in a national failure to develop adequate delivery systems to bring this skill and care into the forgotten regions where they are needed most.”
Our Quote of the Week reminds us that when it comes to health care, the United States has a wealth of resources. At the same time, our systems prevent many from accessing those resources, leaving people at risk for disease and poor health.
This week, we’re reflecting on Sargent Shriver’s 1967 Speech at the Annual Meeting of the Academy of Medicine. In the speech, he focuses on the subject of Neighborhood Health Centers, showing how these community clinics opened up access to health care during the War on Poverty. Shriver also stresses how a lack of health care affects poverty, making the point that poverty is much more than a lack of funds.
“What is poverty?” Shriver asks his audience of physicians.
“We used to think it was just being without money. And so we had various charities—that provided clothing for unfortunate children—odd jobs for the unemployed man—and a Christmas turkey to maintain the pauper’s faith in the goodness of the rich. Today, we know that poverty is far more complex than the mere absence of money. And is far more widespread than we once believed.”
He then says:
"[P]overty is not just being without money. It is a lack of education. It is not having a marketable job skill. It is not having access to a lawyer or a doctor. It is living in the darkness of an urban slum. It is being a child in the ghetto. It is being a Mexican-American along the Rio Grande. An American Indian on a Navajo reservation. An American Negro in Hough or Harlem.”
Shriver also makes clear the importance of addressing each aspect of the life of someone dealing with poverty, listing how each individual War on Poverty program—Head Start, Job Corps, Community Action, Legal Services, Foster Grandparents—can provide the opportunities and resources needed to help lift someone out poverty.
In this context, he says of Neighborhood Health Centers:
“Why a neighborhood Health Center? Because that is what the people of the community thought they needed more than anything else to help them out of poverty. [...] The people themselves—the poor people and the representatives of all segments of the community recognized that among all the other needs —for jobs, for housing, for better schools—bad health and inadequate medical facilities were undermining their capacity to possess the rest. I am sure I don’t have to rehearse for you the grim statistics of the health gap that exists between the poor and all other groups in our society.
- you know that one-half of all women who have their babies in public hospitals have received no pre-natal care at all.
- you know that 60% of poor children receive no medical care, never see a dentist.
- you know that adults in poor families have several times more disabling heart disease, arthritis, or mental illness than in families that are not poor.
- you know that the chance of a child dying before the age of one is 50% higher for the poor. And the chance of dying before reaching the age of 35 is four times greater for the poor.
It stands to reason that poor diet—illiteracy, unsanitary living conditions, filth and rodents, absence of regular or pre-natal care —all go towards the compounding of a poverty and health disaster.”
Looking back at the War on Poverty today, it is clear that our advancements in understanding the nature of poverty, and of recognizing the importance of health care in addressing it, were a breakthrough for the time. Unfortunately, we are currently on a much more regressive path when it comes to health care, one that sees us cutting funds for community health centers and to other programs like Medicare and Medicaid. To make matters worse, regulations for everything from the Environmental Protection Agency (EPA) to the Food and Drug Administration (FDA) have been weakened, which make us more vulnerable to disease and outbreaks. And political attacks on established medical experts like Dr. Anthony Fauci also play a role in weakening our ability to prepare and respond to public health crises.
Sargent Shriver’s observation that it was our systems and not our resources that prevented us from providing robust health care for all continues to hold true. We must keep this in mind as we chart the course for public health going forward.
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