Over the past three years, I have dabbled in gardening, growing a modest assortment of vegetables and herbs in the modest yard surrounding my apartment. My initial foray into producing my own produce occurred in collaboration with my friend and next-door neighbor, Julie, whose thumbs are inherently much greener than my own. (Mine are more of an olive drab shade, for some reason.) That first summer, we grew a couple of varieties of tomatoes, which we planted in the sunny perimeter of Julie’s yard. The spot was chosen because it offered more light and better soil than my own slice of yard. We tended to the plants throughout the summer and into the fall and were rewarded with a bounty of tasty tomatoes. Though Julie has since relocated to a nearby town, I have continued to garden in some measure. Unfortunately, my tomatoes have been more crap than crop, as they stubbornly refuse to flourish in the less favorable conditions of my yard. Go figure…
The health of any organism is, in no small measure, dependent upon its environment. Favorable conditions promote good health. Adverse conditions hinder good health. Organisms that are young and still developing are more vulnerable to adverse conditions. By virtue of their reduced size and output, my tomato plants communicated their distress at having to spend their formative months in a shadier and sandier locale. Similarly, children raised in environments that are toxic or inadequately nurturing communicate their distress by manifesting developmental delays and physical/mental disorders. Often, when this occurs, the first person to take notice—perhaps besides the parent(s)—is the pediatrician. As a health care professional, he or she can assess the circumstances, advise the parent(s), and prescribe treatment, if any is available. However, in many cases, the environmental issues that are harming the child are beyond the doctor’s purview. For example, situations of family conflict, unsafe housing, community violence, or loss of income cannot be remedied by medical treatment. So what’s an M.D. to do? A referral to an outside provider (better suited to addressing such matters) can be made, but there is no guarantee that the family will follow through or gain access to the services they need. Frequently, these are the families that have the fewest resources and are the most disempowered. It is a significant dilemma and a very real public health issue.
All is not hopeless, though, as evidenced by the following article in today’s New York Times:
It was not the normal stuff of a pediatric exam. As a doctor checked the growth of Davon Cade’s 2-month-old son, he also probed about conditions at home, and what he heard raised red flags.
Ms. Cade’s apartment had leaky windows and plumbing and was infested with roaches and mold, but the city, she said, had not responded to her complaints. On top of that, the landlord was evicting her for falling behind on the rent.
Help came through an unexpected route. The doctor referred Ms. Cade to the legal aid office right inside the pediatric clinic at Cincinnati Children’s Hospital.
Within days, a paralegal had secured an inspection that finally forced the landlord to make repairs, and also got the rent reduced temporarily while Ms. Cade searched for less expensive housing.
“It got done when the lawyers got involved,” Ms. Cade said.
Doctors and social workers have long said that medical care alone is not enough to address the health woes of the poor, which are often related to diet, living conditions and stress.
The pediatric clinic in Cincinnati is one of 180 medical sites around the country that now seek to address at least some of these broader issues by bringing lawyers and doctors — so often foes in the courtroom — together into a close partnership. [full article]
Maybe it’s time I consult a horticulturist.