I’m gonna talk to you all today about
healthcare and healthcare obviously is
something that is we’re right around a
election and health care is something
central to everybody’s concern in many
ways but I’m going to talk about it a
little differently than probably how you
think about it
most of the time you know we think about
health care we think about insurance
which is obviously important and we
think about getting our flu shot which
is important we think about getting our
annual checkup which is important you
should do all those things but I’m going
to talk about what’s known as the social
determinants of health and I’m gonna get
into that in a little bit greater detail
and in a second but when I when I start
I want you to think about health care as
a civil right and once again that’s
something we hear about a lot especially
around election time is you know as
health care is silver right or not what
I’m going to talk about right now is
that health care and we don’t think of
it very much
was part of the civil rights movement
and health care came directly out of the
civil rights movement in many ways our
current health care systems dr. King
talked about healthcare and we don’t
think once again about healthcare in
civil rights movement we think about
voting rights we think about
desegregation we think about schools but
health care was very central to what a
lot of the civil rights leaders were
talking about dr. King talked about it
Malcolm X talked about it fannie lou
hamer talked about the Black Panthers
Black Panthers created healthcare
clinics in Oakland and in many places so
health care was was very central to the
message of what was important to civil
rights and so you know this is not a new
thing when we talk about health care
being viewed as a as a civil right and
during the civil rights movement there
was a group of physicians black and
white northern and southern the group
called the medical committee for Human
Rights and what they did is they
traveled throughout the south mainly in
Mississippi and Alabama in 1962 1963
1964 1965 and they patched up the civil
rights workers you’ve all seen images of
civil rights workers getting beaten up
well doctors didn’t treat them in the
south
hospitals didn’t take them in you didn’t
we didn’t have a Good Samaritan law back
in the 1960s so they weren’t they were
not treat
so this group of doctors travelled
around the South patched them up took
care of these civil rights workers but
what happened as they were doing this is
they were traveling throughout the south
and they were patching up these civil
rights workers they got very frustrated
they saw the good work that these civil
rights workers were doing they saw that
they were fighting for desegregation
fighting for voting rights all the
things that we think of when we think of
the civil rights movement but they also
saw the deplorable conditions that the
black community and a lot of the white
community in the south was living in and
they these doctors literally sat around
at night in the hotel rooms they were
saying they’re saying what are we doing
you know what is what is this fight for
if people don’t have enough to eat if
people don’t have any adequate health
care people living in conditions that
are unhealthy and so they started to
think about what could they do and the
father of this movement is a guy by the
name of dr. H Jack Geiger and and Jack
Geiger was one of these physicians one
of the members of the committee a
medical committee on human rights and
Jack said we’ve got to think about not
just treating people not just trying to
make them better when they get sick but
it alleviate the conditions that make
themselves sick and so he talked about
the social determinants of health what
are the things that make people sick and
how what can we do to alleviate them
because what he saw were conditions as
he traveled throughout the south that
were making a making it a situation that
people couldn’t get better he said our
job isn’t just to get people better when
they get sick but to prevent them from
getting sick in the first place and so
he first with some of these other
doctors started a small clinic outside
of Jackson Mississippi that basically
did that out of their own back pockets
they said that’s inadequate that’s not
enough so then they went and they wrote
a grant this is during the the Great
Society and the war on poverty and they
got a demonstration grant to start the
first two community health centers in
the United States one in Mississippi and
one in Boston and we now have 2900
community health centers in the United
States it’s the single largest way that
people get health care in this in this
country 27 million I think people now
get health care through the Community
Health Center and it comes right out of
the civil rights movement and one of the
things that Jack wanted to do was deal
with the problems at the
grassroots level and the first one he
dealt with was poverty and when he was
in Mississippi he set up a the first
Community Health Center in the south and
mound Bayou Mississippi and dealt with
basically sharecroppers in north Bolivar
County and he dealt with conditions like
this and you know this picture is is
very powerful it’s also very
illustrative because one of the things
that when Geiger set up his first
Community Health Center in Mississippi
he knew about he knew statistics
he knew that maternal and infant
mortality rates in Mississippi were
terrible in 1966 1967 1968 so he
recruited pediatricians he recruited
people to come down and do these things
but what he found out was that there
were other problems he had to deal with
and I said this picture is very
illustrative this is a if you can see
this is a stove this is a sharecropper
Shack as a stove is a stove made out of
a 55-gallon drum that was you know left
on the plantation that was the only sort
source of heat
the first winter they the health center
was open they had all these small
children that were coming in with burns
and they had they weren’t ready for
burns in Mississippi why are we getting
all these burns in Mississippi and it
turns out that this is how most houses
were heated and so kids were running
into it so they went out they said we
can’t just wait for people to come to
health center we got to get out into the
homes and so they started building
little fences around the little fences
around the stoves that eliminates a
problem right but then they said there’s
a lot of other problems
the roofs leaked we got this quote from
dr. Brown or it doesn’t do any good to
treat someone and send them back into an
environment when they’re gonna get sick
there were no screens on the windows
people were getting disease diseases
from mosquitos there were holes in the
floor boards that were snapped as snakes
there were rats that were getting in so
they set up a system just to fix up the
houses right because poverty has a
tremendous impact on someone’s health
and there are obviously lots of reasons
many of which we don’t have time to go
into but this is just kind of an example
and so this is the 1960s but today of
course
we still deal with poverty and poverty
still has a huge impact on people’s
health recent UN report on poverty in
the United States you know saw Alabama
as the most impoverished areas in the
country Lowndes County Alabama and we
look at some pictures in a minute where
people are dealing with some of the same
conditions that Jack Geiger saw a half a
century ago
in the Mississippi Delta and if you live
in extreme poverty it has direct effects
on your health it has effects on
obviously if you can afford health care
we live in a state where with medical
with Medicaid obviously if people say
well we have we have Medicaid in this
country well you have if you make more
than eighteen percent of the poverty
rate in Alabama you don’t qualify for
Medicaid so if you make if you make more
than four thousand dollars a year in
Alabama you’re too rich for Medicaid so
part of this is policy right part of
this is policy we need we need we need
change pause so you deal with those
types of issue but poverty’s today still
has a direct result on health one of
these issues that Geiger saw and we’re
saying it’s still relevant today is
sanitation one of the things that was
horrifying to him when he went into
Mississippi and and his sanitary
engineer was that there were towns where
the white side of town was Seward and
the black side of town was not the
sharecropper shacks we saw didn’t have
toilets they had sunshine privies open
per Beason and they actually got to a
point this is the late 1960s that they
were building outhouses building
sanitary outhouses because that was a
better solution than what they had and
was it was horrifying to them that they
were saying look why are we why are we
having to build outhouses you know we
should be building sewers but they
didn’t have the money to do that so
they’re building outhouses because up to
that point when you’d have you had rain
in cities like rosewood and alligator
Mississippi there would literally be
human waste in the black part of town
eventually that led to Supreme Court
cases Shaw versus United
you know once again we don’t think of
sanitation we don’t think of sewage as
being a civil rights issue
there were boycotts there were court
cases and Shaw versus Mississippi which
has finally decided in the early 1970s
is yes a municipality can’t decide to
provide basic services to one part of
town and not another part of town and so
you know that was a struggle that was
was won in the 1960s but we’ve also seen
deterioration of a lot of these
situations
this is Lowndes County Alabama 2018
there’s sewage in the streets sewage
bubbling up because that infrastructure
has gone out of working order and has
not been replaced so this UN report on
poverty issued a devastating indictment
of a lot of aspects of poverty in the
United Sates and if you haven’t had a
chance to read this you can google it
it’s not that long but it’s it’s very
it’s very devastating and talking about
the the you know the raw sewage that’s
found in parts of Alabama and parts of
West Virginia also looked at Puerto Rico
and the problems there and the fact that
this is creating situations that health
conditions that had gone away are coming
back one of the most devastating was
hookworm hookworm was a hook woman is a
parasite it’s something that had
basically been eradicated by the 1940s
and 1950s in the United States because
if you have sewage systems you don’t get
hookworm it’s coming back and and it’s a
parasite that’s now being found again in
humans in Alabama and Mississippi
because of the the problems we have so
sanitation basic things that pretty much
everybody in here I assume takes for
granted that we have toilets these are
issues that are affecting health of our
you know our neighbors still today
related to sanitation of course is water
there’s another picture from the 1960s
we see another one of these drums you
can see there’s a little spigot on it I
always think this is a powerful photo
those shacks that dr. Geiger came across
and in the 1960s they didn’t have they
didn’t have sewers they didn’t have one
at running water either
and so what many people would
they would get these old 55-gallon drums
from the plantation and they would take
them into the city the music municipal
water supply and they fill them up
of course these drums had previously
held DDT and other chemicals on the
plantation right you don’t have to be a
doctor to figure out that that’s not
good for your health
so they fought and they got municipal
water supplies built once again the Shaw
case dealt with sewers it also dealt
with water sixty years later we have
Flint alright and Flint’s not the only
city in the United States where we’re
dealing with water issues it’s become
the most famous but there are lots of
places that are dealing with waters in
part because that infrastructure has
broken down and there’s not been the
political will to fix it and as if your
water is not good your Health’s not
going to be very good and like so we
have we have Flint there are cities
Baltimore New Orleans where the public
schools kids can’t drink the water out
of the taps out of the water fountains
because it’s not healthy it’s got too
much too much lead in it areas where
there’s fracking has there have been a
lot of problems with the groundwater
being contaminated coal ash ponds I said
a lot of these issues we hear we hear
about only when they kind of intrude
upon middle and upper-class societies
right you know when it just stays when
it just stays with the poor we don’t
deal with it but we’re seeing a
situation where with Flint with the
danger of coal ash ponds especially in
North Carolina with the recent
hurricanes the floods now this water is
getting into everybody’s drinking water
and then it becomes a crowd I was in
Austin Texas on on Monday talking about
a lot of these same things and we didn’t
have we didn’t have water when I was
there because of all the with all the
flooding and so Austin Austin was going
without water and so that was that was
causing a crisis there so water these
are issues that all of us have to deal
with and these are issues that are
directly related to health these the an
you know these social determinants of
another thing the Geiger dealt with when
he showed up in
Mississippi was massive malnutrition he
was horrified and this is a mountain
malnourished baby that he’s dealing with
with the extreme poverty and how that
related to people’s ability to get
proper food and Mississippi in the late
nineteen sixties of the Mississippi
Delta
like the Arkansas Delta like parts of
Louisiana like parts of missus arts of
Alabama like parts of the Appalachians
many of these areas actually saw hunger
getting worse in the late 60s from the
1930s to the early 1960s there was what
was called a commodities program a
program to deal with you know taking
excess commodities flour cheese we
different things and giving him to the
poor that gets replaced with the food
stamp program in the 1960s the idea
behind the food stamp program was one
who was gonna give people more variety
was also gonna be good for business
right you had to spend the food stamps
but the initial program you had to buy
the food stamps he had to pay about
twenty-two cents for every dollar where
Geiger was the average family made seven
hundred dollars a year do you make seven
hundred dollars a year twenty-two cents
to buy a dollars worth of food was more
than you could you could afford and he
saw nutrition getting worse malnutrition
getting worse in these areas and so you
know one of the things he did he he
actually he had a federal budget and he
started writing prescriptions for food
he wrote him out of his he wrote him out
of his his pharmacy budget you can
imagine when people in Washington found
out that he was writing prescriptions to
local grocery stores for milk and eggs
they went bananas they say you can’t do
this you know prescriptions are for
medicine and he said he said the
medicine for Mount malnutrition is food
and of course they couldn’t argue with
that and they set up they started
setting up a new program where the worth
it was going to be a food relief but of
course that doesn’t solve the problem in
the long term that only solved immediate
problems we deal with malnutrition today
we deal with malnutrition in many
different ways
fifteen percent of the American
population is food insecure
forty million
Americans 40 million Americans are food
insecure six and a half million children
are food insecure in this country and
when we talk about malnutrition today we
talk about certainly not having enough
tea but we also deal with the issue of
having the wrong things to eat one of
the physicians that was in the original
Delta health center one of doctor
Geiger’s colleagues Aaron surely was a
fascinating guy was a just a hero of the
the medical community in in Mississippi
dr. Shirley said in the 1960s people
were dying if not enough to eat he gives
in the 2000 they’re dying of the wrong
things to eat and we deal with what many
of you have probably heard about it
things called food deserts right where
if you live in an urban area or you live
in a rural area there may be a place to
get food but it’s a gas station and you
can’t get nutritious food but it’s also
an issue of poverty a two liter of coke
cost dollar fifty a gallon of milk cost
350 people are buying coke instead of
milk for their children and so
malnutrition is another one of these
social determinants of health and
something that is not going away right
we still we do have food assistance all
right we and the food stamp program has
been adjusted since it was in the 60s
but it is something that you probably
all know is constantly under attack
right constantly being limited on who
can who can qualify for it and of course
it’s important remember it’s not just
people who are unemployed that need food
assistance most big public universities
now have food banks for their students
half of all children of the Armed Forces
active Armed Forces their children
qualify for free or reduced meals
alright if you work a 40-hour week at
minimum wage you still qualify for food
assistance so all of these issues I just
want you to think about as you leave
today you know think about health beyond
just my health insurance my flu shot my
my
weekly by month my yearly visit but
think about all these other social
determinants of health thank you very
much [Applause]
healthcare and healthcare obviously is
something that is we’re right around a
election and health care is something
central to everybody’s concern in many
ways but I’m going to talk about it a
little differently than probably how you
think about it
most of the time you know we think about
health care we think about insurance
which is obviously important and we
think about getting our flu shot which
is important we think about getting our
annual checkup which is important you
should do all those things but I’m going
to talk about what’s known as the social
determinants of health and I’m gonna get
into that in a little bit greater detail
and in a second but when I when I start
I want you to think about health care as
a civil right and once again that’s
something we hear about a lot especially
around election time is you know as
health care is silver right or not what
I’m going to talk about right now is
that health care and we don’t think of
it very much
was part of the civil rights movement
and health care came directly out of the
civil rights movement in many ways our
current health care systems dr. King
talked about healthcare and we don’t
think once again about healthcare in
civil rights movement we think about
voting rights we think about
desegregation we think about schools but
health care was very central to what a
lot of the civil rights leaders were
talking about dr. King talked about it
Malcolm X talked about it fannie lou
hamer talked about the Black Panthers
Black Panthers created healthcare
clinics in Oakland and in many places so
health care was was very central to the
message of what was important to civil
rights and so you know this is not a new
thing when we talk about health care
being viewed as a as a civil right and
during the civil rights movement there
was a group of physicians black and
white northern and southern the group
called the medical committee for Human
Rights and what they did is they
traveled throughout the south mainly in
Mississippi and Alabama in 1962 1963
1964 1965 and they patched up the civil
rights workers you’ve all seen images of
civil rights workers getting beaten up
well doctors didn’t treat them in the
south
hospitals didn’t take them in you didn’t
we didn’t have a Good Samaritan law back
in the 1960s so they weren’t they were
not treat
so this group of doctors travelled
around the South patched them up took
care of these civil rights workers but
what happened as they were doing this is
they were traveling throughout the south
and they were patching up these civil
rights workers they got very frustrated
they saw the good work that these civil
rights workers were doing they saw that
they were fighting for desegregation
fighting for voting rights all the
things that we think of when we think of
the civil rights movement but they also
saw the deplorable conditions that the
black community and a lot of the white
community in the south was living in and
they these doctors literally sat around
at night in the hotel rooms they were
saying they’re saying what are we doing
you know what is what is this fight for
if people don’t have enough to eat if
people don’t have any adequate health
care people living in conditions that
are unhealthy and so they started to
think about what could they do and the
father of this movement is a guy by the
name of dr. H Jack Geiger and and Jack
Geiger was one of these physicians one
of the members of the committee a
medical committee on human rights and
Jack said we’ve got to think about not
just treating people not just trying to
make them better when they get sick but
it alleviate the conditions that make
themselves sick and so he talked about
the social determinants of health what
are the things that make people sick and
how what can we do to alleviate them
because what he saw were conditions as
he traveled throughout the south that
were making a making it a situation that
people couldn’t get better he said our
job isn’t just to get people better when
they get sick but to prevent them from
getting sick in the first place and so
he first with some of these other
doctors started a small clinic outside
of Jackson Mississippi that basically
did that out of their own back pockets
they said that’s inadequate that’s not
enough so then they went and they wrote
a grant this is during the the Great
Society and the war on poverty and they
got a demonstration grant to start the
first two community health centers in
the United States one in Mississippi and
one in Boston and we now have 2900
community health centers in the United
States it’s the single largest way that
people get health care in this in this
country 27 million I think people now
get health care through the Community
Health Center and it comes right out of
the civil rights movement and one of the
things that Jack wanted to do was deal
with the problems at the
grassroots level and the first one he
dealt with was poverty and when he was
in Mississippi he set up a the first
Community Health Center in the south and
mound Bayou Mississippi and dealt with
basically sharecroppers in north Bolivar
County and he dealt with conditions like
this and you know this picture is is
very powerful it’s also very
illustrative because one of the things
that when Geiger set up his first
Community Health Center in Mississippi
he knew about he knew statistics
he knew that maternal and infant
mortality rates in Mississippi were
terrible in 1966 1967 1968 so he
recruited pediatricians he recruited
people to come down and do these things
but what he found out was that there
were other problems he had to deal with
and I said this picture is very
illustrative this is a if you can see
this is a stove this is a sharecropper
Shack as a stove is a stove made out of
a 55-gallon drum that was you know left
on the plantation that was the only sort
source of heat
the first winter they the health center
was open they had all these small
children that were coming in with burns
and they had they weren’t ready for
burns in Mississippi why are we getting
all these burns in Mississippi and it
turns out that this is how most houses
were heated and so kids were running
into it so they went out they said we
can’t just wait for people to come to
health center we got to get out into the
homes and so they started building
little fences around the little fences
around the stoves that eliminates a
problem right but then they said there’s
a lot of other problems
the roofs leaked we got this quote from
dr. Brown or it doesn’t do any good to
treat someone and send them back into an
environment when they’re gonna get sick
there were no screens on the windows
people were getting disease diseases
from mosquitos there were holes in the
floor boards that were snapped as snakes
there were rats that were getting in so
they set up a system just to fix up the
houses right because poverty has a
tremendous impact on someone’s health
and there are obviously lots of reasons
many of which we don’t have time to go
into but this is just kind of an example
and so this is the 1960s but today of
course
we still deal with poverty and poverty
still has a huge impact on people’s
health recent UN report on poverty in
the United States you know saw Alabama
as the most impoverished areas in the
country Lowndes County Alabama and we
look at some pictures in a minute where
people are dealing with some of the same
conditions that Jack Geiger saw a half a
century ago
in the Mississippi Delta and if you live
in extreme poverty it has direct effects
on your health it has effects on
obviously if you can afford health care
we live in a state where with medical
with Medicaid obviously if people say
well we have we have Medicaid in this
country well you have if you make more
than eighteen percent of the poverty
rate in Alabama you don’t qualify for
Medicaid so if you make if you make more
than four thousand dollars a year in
Alabama you’re too rich for Medicaid so
part of this is policy right part of
this is policy we need we need we need
change pause so you deal with those
types of issue but poverty’s today still
has a direct result on health one of
these issues that Geiger saw and we’re
saying it’s still relevant today is
sanitation one of the things that was
horrifying to him when he went into
Mississippi and and his sanitary
engineer was that there were towns where
the white side of town was Seward and
the black side of town was not the
sharecropper shacks we saw didn’t have
toilets they had sunshine privies open
per Beason and they actually got to a
point this is the late 1960s that they
were building outhouses building
sanitary outhouses because that was a
better solution than what they had and
was it was horrifying to them that they
were saying look why are we why are we
having to build outhouses you know we
should be building sewers but they
didn’t have the money to do that so
they’re building outhouses because up to
that point when you’d have you had rain
in cities like rosewood and alligator
Mississippi there would literally be
human waste in the black part of town
eventually that led to Supreme Court
cases Shaw versus United
you know once again we don’t think of
sanitation we don’t think of sewage as
being a civil rights issue
there were boycotts there were court
cases and Shaw versus Mississippi which
has finally decided in the early 1970s
is yes a municipality can’t decide to
provide basic services to one part of
town and not another part of town and so
you know that was a struggle that was
was won in the 1960s but we’ve also seen
deterioration of a lot of these
situations
this is Lowndes County Alabama 2018
there’s sewage in the streets sewage
bubbling up because that infrastructure
has gone out of working order and has
not been replaced so this UN report on
poverty issued a devastating indictment
of a lot of aspects of poverty in the
United Sates and if you haven’t had a
chance to read this you can google it
it’s not that long but it’s it’s very
it’s very devastating and talking about
the the you know the raw sewage that’s
found in parts of Alabama and parts of
West Virginia also looked at Puerto Rico
and the problems there and the fact that
this is creating situations that health
conditions that had gone away are coming
back one of the most devastating was
hookworm hookworm was a hook woman is a
parasite it’s something that had
basically been eradicated by the 1940s
and 1950s in the United States because
if you have sewage systems you don’t get
hookworm it’s coming back and and it’s a
parasite that’s now being found again in
humans in Alabama and Mississippi
because of the the problems we have so
sanitation basic things that pretty much
everybody in here I assume takes for
granted that we have toilets these are
issues that are affecting health of our
you know our neighbors still today
related to sanitation of course is water
there’s another picture from the 1960s
we see another one of these drums you
can see there’s a little spigot on it I
always think this is a powerful photo
those shacks that dr. Geiger came across
and in the 1960s they didn’t have they
didn’t have sewers they didn’t have one
at running water either
and so what many people would
they would get these old 55-gallon drums
from the plantation and they would take
them into the city the music municipal
water supply and they fill them up
of course these drums had previously
held DDT and other chemicals on the
plantation right you don’t have to be a
doctor to figure out that that’s not
good for your health
so they fought and they got municipal
water supplies built once again the Shaw
case dealt with sewers it also dealt
with water sixty years later we have
Flint alright and Flint’s not the only
city in the United States where we’re
dealing with water issues it’s become
the most famous but there are lots of
places that are dealing with waters in
part because that infrastructure has
broken down and there’s not been the
political will to fix it and as if your
water is not good your Health’s not
going to be very good and like so we
have we have Flint there are cities
Baltimore New Orleans where the public
schools kids can’t drink the water out
of the taps out of the water fountains
because it’s not healthy it’s got too
much too much lead in it areas where
there’s fracking has there have been a
lot of problems with the groundwater
being contaminated coal ash ponds I said
a lot of these issues we hear we hear
about only when they kind of intrude
upon middle and upper-class societies
right you know when it just stays when
it just stays with the poor we don’t
deal with it but we’re seeing a
situation where with Flint with the
danger of coal ash ponds especially in
North Carolina with the recent
hurricanes the floods now this water is
getting into everybody’s drinking water
and then it becomes a crowd I was in
Austin Texas on on Monday talking about
a lot of these same things and we didn’t
have we didn’t have water when I was
there because of all the with all the
flooding and so Austin Austin was going
without water and so that was that was
causing a crisis there so water these
are issues that all of us have to deal
with and these are issues that are
directly related to health these the an
you know these social determinants of
another thing the Geiger dealt with when
he showed up in
Mississippi was massive malnutrition he
was horrified and this is a mountain
malnourished baby that he’s dealing with
with the extreme poverty and how that
related to people’s ability to get
proper food and Mississippi in the late
nineteen sixties of the Mississippi
Delta
like the Arkansas Delta like parts of
Louisiana like parts of missus arts of
Alabama like parts of the Appalachians
many of these areas actually saw hunger
getting worse in the late 60s from the
1930s to the early 1960s there was what
was called a commodities program a
program to deal with you know taking
excess commodities flour cheese we
different things and giving him to the
poor that gets replaced with the food
stamp program in the 1960s the idea
behind the food stamp program was one
who was gonna give people more variety
was also gonna be good for business
right you had to spend the food stamps
but the initial program you had to buy
the food stamps he had to pay about
twenty-two cents for every dollar where
Geiger was the average family made seven
hundred dollars a year do you make seven
hundred dollars a year twenty-two cents
to buy a dollars worth of food was more
than you could you could afford and he
saw nutrition getting worse malnutrition
getting worse in these areas and so you
know one of the things he did he he
actually he had a federal budget and he
started writing prescriptions for food
he wrote him out of his he wrote him out
of his his pharmacy budget you can
imagine when people in Washington found
out that he was writing prescriptions to
local grocery stores for milk and eggs
they went bananas they say you can’t do
this you know prescriptions are for
medicine and he said he said the
medicine for Mount malnutrition is food
and of course they couldn’t argue with
that and they set up they started
setting up a new program where the worth
it was going to be a food relief but of
course that doesn’t solve the problem in
the long term that only solved immediate
problems we deal with malnutrition today
we deal with malnutrition in many
different ways
fifteen percent of the American
population is food insecure
forty million
Americans 40 million Americans are food
insecure six and a half million children
are food insecure in this country and
when we talk about malnutrition today we
talk about certainly not having enough
tea but we also deal with the issue of
having the wrong things to eat one of
the physicians that was in the original
Delta health center one of doctor
Geiger’s colleagues Aaron surely was a
fascinating guy was a just a hero of the
the medical community in in Mississippi
dr. Shirley said in the 1960s people
were dying if not enough to eat he gives
in the 2000 they’re dying of the wrong
things to eat and we deal with what many
of you have probably heard about it
things called food deserts right where
if you live in an urban area or you live
in a rural area there may be a place to
get food but it’s a gas station and you
can’t get nutritious food but it’s also
an issue of poverty a two liter of coke
cost dollar fifty a gallon of milk cost
350 people are buying coke instead of
milk for their children and so
malnutrition is another one of these
social determinants of health and
something that is not going away right
we still we do have food assistance all
right we and the food stamp program has
been adjusted since it was in the 60s
but it is something that you probably
all know is constantly under attack
right constantly being limited on who
can who can qualify for it and of course
it’s important remember it’s not just
people who are unemployed that need food
assistance most big public universities
now have food banks for their students
half of all children of the Armed Forces
active Armed Forces their children
qualify for free or reduced meals
alright if you work a 40-hour week at
minimum wage you still qualify for food
assistance so all of these issues I just
want you to think about as you leave
today you know think about health beyond
just my health insurance my flu shot my
my
weekly by month my yearly visit but
think about all these other social
determinants of health thank you very
much [Applause]
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