Despite new medical technologies and increasing knowledge about prevention of a host of diseases, the poor live shorter lives than the wealthy. That’s the upshot of an article in today’s New York Times.

Last spring, when I spoke about The Alabama Project at the American Association for Cancer Research Celebration of Hope, I talked about the necessity of access, Whatever knowledge we gain in medicine has to be made accessible to people, regardless of their circumstances. It seems cruel to have answers to health challenges that aren’t made available to the individual suffering. Of course, I recognize the impossibility of providing some of the most costly care to every American, given constraints on the health care system.

But there’s more to the story. Edwina’s family lives in a setting that isn’t conducive to good health. Generations of unhealthy lifestyles contribute not only to how Edwina, her siblings, and son live, but also to how they think about health care. When Edwina goes to Princeton Hospital or Cooper Green for emergency care, she hopes to have her immediate concern addressed–pain or trouble breathing. But she has no expectation that her overall quality of life or odds of living a longer life are part of the deal.

Edwina has witnessed relatives dying young, some from disease and many from violence. A long life isn’t part of the equation. I wonder sometimes if Edwina’s assumption that her life will be short is tied to the reality of her days–each one is a struggle.


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