The first task of the physician is to alleviate the suffering caused by the immediate symptoms of a disease — but you can eliminate the symptoms and not affect the cause. Unless that doctor also treats, neutralizes or eliminates the underlying disease, the patient will continue to suffer. Or die.

What if, in improving educational outcomes, promoting health, sheltering the homeless, and addressing other crises that prevent achievement of the American dream, we’re actually only treating the symptoms, rather than the underlying diseases? If this is the case, we need to significantly change what we have been doing, name the diseases, and develop interventions to treat them.

So, what are these diseases? I think there are at least three of them:

  1. Structural racism: The disproportionality by race of the symptoms related to educational failure, health disparities, housing instability, and homelessness is striking.
  2. Extreme Income Inequity: The toxic stresses exacerbated by poverty affects education and health, increases race and gender inequalities, and puts the American Dream further and further out of reach for far too many Americans.
  3. Gender inequality: The overwhelming majority of homeless families are headed by single moms. The reasons for this aren’t hard to identify: As long as women continue to earn significantly less than men for the same jobs, as long as family planning is expensive or inaccessible, and as long as access to educational opportunities is interrupted by parenthood combined with the high cost of childcare, single-parent households, predominantly headed by women, will continue to struggle economically.

Read the full article on structural barriers to healthcare by David Wertheimer at Medium.