M3.2 Vulnerable Populations

What makes us sick?

Dr. Manchandra raises some interesting points about our current healthcare system. The United States has a sick care system and not a health care system. As healthcare providers, we excel at intervening once a person already has a disease. However, we significantly lack the resources to prevent disease. He states numerous times that health begins where we live and work. Notably, scientists now believe one's health is more influenced by zipcode than genetic code. In fact, the first environment that we live in—the womb—can already predispose us to significant adverse health outcomes. Dr. Lanphear further explains that fetuses exposed to chemicals will have significantly altered health outcomes. For example, as a mother's PBDE or OP pesticide blood levels increase, the lower her child's IQ will be. This is demonstrated in a dose-response relationship. Additionally, the cumulative impact of multiple chemicals can have an extreme affect on the child's health and development. Dr. Miller poses that exposure to toxic chemicals is a human right issue as this is an unsolicited trespassing on our bodies and the bodies of our children. Unfortunately, those of lower socioeconomic status are at greater risk for exposure. Social determinants of health are often the root cause of disease. If we had more forward thinkers and those willing to address the "upstream" problems, we could start curing disease instead of treating symptoms.   

Public health professionals play an important role in addressing social determinants of health and creating policies to mitigate exposure. They look at the health of the whole person and of the community. Moving forward, we should create regulations that require companies to prove the safety and efficacy of chemical before putting them in products sold to the general public. It is outstanding that several chemicals known to cause harm are not even efficacious (example: PBDE or triclosan).