By SUSAN ADELMAN, MD
Physicians are used to seeking practical answers to definable problems. We do this in our clinical work and in our research. Perhaps this physician might suggest a useful approach in a time of worldwide demonstrations over racism. Normally in medicine, we try to break down a larger problem into its component parts, which need to be definable issues that can be addressed effectively to create real change.
Just as occurred in Detroit after the 1967 riots, we need civic leaders to join with leaders of affected neighborhoods, identify the issues that would be the most productive to work on, seek the people who need to come together for each project and prioritize the efforts. Working groups need to figure out what possible solutions would be realistic and would solve more problems than they will create. Then they need to coordinate with the political establishment and with sources of funding, in order to move forward.
The enthusiasm is here. The timing is now. We need to turn all of this turmoil into real change, change that will help. We understand that there are police who need more discipline. Then we need to work on this, not blow up the whole police force, which would have the effect of leaving honest merchants in minority neighborhoods bereft of protection for their businesses and homes. Stress already has a major deleterious effect on health in these neighborhoods.
Schools in minority neighborhoods are notoriously bad. What needs to be done to fix them? Since education is the key to the future of the entire community, we need practical, nonpolitical reform, informed by data, and monitored for results. It should not be about teachers’ unions or any other factors that are unrelated to preparing these kids for higher education and for productive careers.
The health of minorities still lags behind the health of wealthier suburbanites; we need to know how and why. A lot of work has been done and a lot of ink has been spilled in an effort to correct disparities in health care, but to get into the details, those with the most experience need to go back to the drawing board. What has received less attention though is the effect of disparities in life style. These too need study and may need specific educational programs. Dr. Charles Vincent used to tell his pregnant teenage patients that “You can’t make a baby out of potato chips.”
Drugs are important problems in the inner city. We need to tailor the war on drugs to fit the inner city environment. We must figure out who should be in charge of this effort, what laws need revision, and what alternate activities will attract inner city youth away from the drug culture.
And there is so much more.
Marching is exciting. It makes us feel good. It shines a bright light on the issues, but it will change nothing unless there is follow-up that is specific, practical, focused and sustainable. That is the real challenge.
Susan Adelman MD, is a Past President of the Michigan State Medical Society.