HEALTH CARE/Joan Retsinas

Beyond Virginia Woolf, the Tyrones and the Rest of Us: The Health Mess

Think of the family-breakdowns you see on stage: Edward Albee’s Woolfs, Eugene O’Neil’s Tyrones, or the current phenom: Branden Jacobs-Jenkins’ Lafayettes. As clans disintegrate in three acts, we sit riveted. But when the curtain falls, we return to our lives; the characters stay cemented in misery. There is no theatrical Act Four.

This election has plunged us into real-time family mayhem. As the candidates’ rhetoric has grown more vicious, we the electorate have taken sides, cheered, ridiculed, lambasted. Both sides have predicted doom.

Now comes, in real-time, Act Four, as we all – once warring – unite to clean up the mess left in this campaign’s wake. Unlike the fictive clans, we can’t stay cemented in discord. In this Act, we must gather up our brooms, psychic and real, to solve the quotidian problems of our republic.

On the health front, a few tasks demand our joint efforts.

First, tuberculosis is rising. The Centers for Disease Control and Prevention charted the first rise in the United States 23 years. Although the numbers remain small – 9,563 cases in 2015 – the spike is troubling. Most cases occurred in California, Florida, New York and Texas. Although many patients have immigrated here, physicians are seeing cases in native-born children. We have antibiotics – some as old as 50 years – to treat this airborne bacterial disease, but treatment is long, expensive and often requires surveillance. Once upon a not-so-long-ago time, public health officials dreamed of eliminating tuberculosis in the United States. Years of funding cuts have cancelled that dream. Whether you like government or loathe it, whether you see Uncle Sam as the savior or the scourge, only a concerted effort — in short, government – can stem this uptick.

More troubling numbers: the cases of sexually transmitted diseases have also risen. For the first time since 2006, the venereal trifecta – chlamydia (1.4 million cases), gonorrhea (350,062 cases) and syphilis (19,999) – is inching up. Young people are especially vulnerable; and, since a young woman may not recognize symptoms until years later, when she tries to have children, screening is crucial to let people know they are infected. Since the Great Recession of 2008, some states have cut funding for STD clinics. As with TB, to reverse the uptick, we must restore funds.

Obesity – pardon the pun- is expanding. Currently more than one-fifth of American adults are obese (many more are “overweight”). Of the states, Louisiana ranks as the fattest, with 36.2% of adults “obese,” Colorado the lowest, with 20.2%. Over the past year, rates in Minnesota, Ohio, Montana and New York declined; rates rose in Kansas and Kentucky, stayed the same in the rest of the nation. Presumably, adults are free to eat their way to diabetes – libertarians as well as conservatives would argue for their right. But, crucially, children are also weighing in as “obese.” The consequences include heart disease, cardiovascular disease, and diabetes. Across the political spectrum, Americans can accept childhood obesity as a public health crisis. And the strategy to slim our youth down must be multi-pronged, from taxing soda and junk food, to mandating that restaurants list calories, to instituting “healthy” school lunches, to expanding physical education classes. Government, moreover, need not morph into a bureaucratic nanny: parents hold the power to say “no” to empty calories.

Finally, opioids are killing Americans – 47,000 lethal overdoses in 2014. “Opioids” encompass not just heroin, but the pharmacopeia of legal drugs for pain, including oxycodone (OxyContin), hydrocodone (Vicodin), and morphine. Ignoring the epidemic will not make it disappear. We need action from government at all levels, physicians, medical societies, public health departments, and families.

In theatrical, as well as real-life family mayhem, people sometimes throw dishes – a catharsis. But afterward, the parties-at-war must clean up the shards.

This election has left a lot of shards. But if we can put aside the hot button issues like abortion, the Affordable Care Act and Medicaid, maybe we will agree on pragmatic solutions to tuberculosis, venereal disease, obesity, and opioids. An optimistic beginning for Act Four.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, December 1, 2016

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