When I was asked to serve on the New London Community Center Task Force, I doubted that I could bring any special expertise to the group. I’m a family physician who works at the Community Health Center in New London. I don’t have any special knowledge about building community centers, recreational programming, financing, or siting such a facility.
Then I thought about the patients I see. How often I want to tell patients with low back pain to go to a swimming pool to swim or even just to walk waist-deep in water, but realize that New London residents don’t have a year-round swimming pool to go to.
Or to advise obese patients with diabetes to exercise, but who don’t have a gym membership.
I contrast the lack of community recreational resources to what I had seen when I was working on a medical education project in Dundee, Scotland. The city had a beautiful community recreation center − complete with a swimming pool − that every citizen could access. This was not unique to Dundee. Most communities in Scotland of any size have a community center. The same is true throughout Europe.
Developed countries around the world, other than the United States, recognize that good health means more than doctor visits. In fact, the illness care system in which I work actually contributes only a small part of what determines a person’s health, perhaps as little as 10 percent. Your biology is the biggest factor, and since we can’t pick our parents, there is little we can do about the genetic hand you were dealt. Nevertheless, lifestyle and behavioral choices can improve even a high-risk biological profile. That’s where access to resources like a community recreation center fit in.
Other factors outside the health care system also make a big difference, such as a healthy diet, safe neighborhoods, clean air and water, and good housing. These benefits to good health are tied to where you live. Neighborhoods in which poor people live often are bereft of grocery stores, plagued by violence, devoid of good housing, and polluted by toxin-spewing industries. The average life expectancy of people living in a certain poor neighborhood in Chicago is 20 years less than those living a short bus ride away in an affluent neighborhood.
Being poor accounts for much of this disparity in average life expectancy, but not all of it. Even when income is controlled as a factor, Black men and women suffer a lower life expectancy. It isn’t race that’s the problem, it’s racism. The constant stress of living in a racist society exacts a physical toll, leading to earlier disease, disability, and death.
As a physician, I want my patients to have the best our expensive, high-tech medical care system has to offer. I’m angered by the fact that many of my hard-working patients don’t have health insurance and can’t afford the drugs they need, the tests I order, or even the ability to come in for a visit. Even those with health insurance through Husky can’t get to see certain specialists in our area because those well-paid doctors refuse to see patients on Medicaid. Health care should be a right, not a privilege for only the more affluent. Every other developed country in the world offers universal health care to its citizens; why can’t we?
Beyond just my patients, I also want better health for my community. That’s why I’ve come to realize that serving on the community center task force and pursuing the opening of a recreation center makes sense for me. It’s one step — one long overdue step — that we need to make for the better health of all those who live in New London.
Dr. Stephen R. Smith lives in New London. He is a lifelong resident of the city, a former city councilor, and a professor emeritus of family medicine at the Warren Alpert Medical School of Brown University.