Examining Poverty and Health Care

“The crisis of health care in America today is not how to transplant hearts, but how to transplant ordinary health care to the poor — the same kind of ordinary health care that the affluent take for granted.”
Sargent Shriver | Chicago, IL | December 15, 1967

Our Quote of the Week highlights a profound irony about health care in the United States: that we have mastered the most advanced procedures and refined some of the most groundbreaking technologies in health care, but that we have not bothered to extend the most basic care to those who are economically disadvantaged.

This is the first of a two-part series on health care. In this first part, we are focusing on health care in the United States. Next week, our focus will be global health care.

Sargent Shriver spoke these words at the first American Medical Association National Conference on Health Care for the Poor. He was speaking in his capacity as Director of the Office of Economic Opportunity (OEO), which managed the programs of the War on Poverty. In the speech, Shriver outlines the many ways in which being poor impacts one’s health in the United States. He mentions, among other issues:

  • that poor children go without medical and dental care and are much more likely to die before the age of one
  • that the poor are disproportionately affected, and have a higher mortality rate from certain diseases
  • that poor communities suffer from being what we would refer to today as “medical deserts,” i.e., areas that have no health care providers or facilities at all
  • that poor women using public hospitals have little or no access to prenatal care
  • that African American pregnant women in particular have a significantly higher mortality rate than White women

In short, to use Sargent Shriver’s own words: “for a poor person in America, poverty is not something you just feel in your pocketbook or wallet. You feel it in your body.”

To address the issue of health care during his tenure as head of the OEO, Shriver oversaw the creation of Neighborhood Health Centers (now known as the National Association of Community Health Centers), which expanded access to health care in poorer communities. Other OEO programs, including Community Action and Head Start, also incorporated health services into their offerings. While all of these services continue to exist today, the failings of the health care system that Sargent Shriver described persist, and are exacerbated by our health insurance system.

The COVID-19 crisis has been a stark reminder of the ways in which Sargent Shriver’s words remain true today. Throughout the pandemic, local maps of COVID-19 cases and deaths by zip code consistently show that poorer neighborhoods have had higher cases and mortality rates from the virus, and that African American communities and other communities of color have been disproportionately affected.

Inside this crisis, however, there lie opportunities to implement creative solutions that will bring equity to economically disadvantaged neighborhoods. For example, to accelerate the pace of COVID-19 vaccinations in every community in the US, the vaccination program was expanded in March to include more than 950 Community Health Centers around the country. Many communities have also joined the mobile vaccination unit program, bringing vaccines to underserved areas. These developments are wonderful examples, but much more can be done to ensure that, from infancy to old age, all people living in the world’s wealthiest nation can have easy access to the services they need to maintain good health, not just during a pandemic, but each and every day.

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Peace requires the simple but powerful recognition that what we have in common as human beings is more important and crucial than what divides us.
Sargent Shriver
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