By Robert S. Kahn, Associate Director, Division of General and Community Pediatrics; Cincinnati Children’s Hospital Medical Center
MY FATHER HAD a saying, “a rich man’s house burns as quickly as a poor man’s house.” He was no firefighter, but he and my mother both had a commitment to civic duty. That family-driven sense of duty is part of what has led me to the work that I do as a pediatrician at Cincinnati Children’s Hospital Medical Center.
The medical community knows from experience that simply caring for a child’s immediate ailment and sending them home can be a revolving door in many cases—particularly for patients of low socioeconomic status. The child may be better for the moment, but if they return to substandard housing circumstances, for example, it is extremely likely we will see them again for the same issues. By thinking about social determinants of health and collaborating with devoted organizations in our community, Cincinnati Children’s has been able to create an approach that goes beyond our clinical care, to include public and social well-being in addressing health issues.
Looking at the example of asthma, my research team has found that African American children are more than twice as likely to be readmitted for asthma. Household socioeconomic status and strain explain a significant portion of this disparity. Using hospital data, we are able to pinpoint geographic areas and neighborhoods that seem to be asthma hotspots. We can then work with community partners—lawyers, local organizations, and community leaders—to improve conditions in those specific areas and address some of the exact issues that are impacting asthma rates and the health of children.
So, why should someone not impacted by such disparities or not living in sub-standard housing care about this? That can be answered in two ways. The first has to do with efficiency and value in healthcare. When we reduce preventable health problems in underserved and minority children, we are saving money and producing better outcomes for all. If we are able to reduce the number of avoidable visits a given minority family makes to an emergency room, that can translate to greater efficiency, including more time and resources to provide in-depth service for every other family in need of care at that emergency room.
In the end, though, I prefer the second answer, which relates to personal values. It goes back to my father’s saying. What I think he meant is that there is a point where society is so fractured and fragmented that people do not understand who their neighbors are and the struggles they face. As you lose any sense of what it is like to walk in their shoes, you wind up with a society that none of us would really want to live in. That’s why minority health is a priority for me, and should be a priority for all.
