The Link between Justice and Health

…Our health is the launching pad which allows us to reach our full potential. Healthcare that actually improves health, protects access to the opportunity to participate in the economic, social, political, and personal lives of an individual’s community and world…

If you are new to the idea that health, healthcare, and justice are linked:  here is the fundamental reason we all need access to high quality healthcare:

Our health is the launching pad which allows us to reach our full potential.  Healthcare that actually improves health, protects access to the opportunity to participate in the economic, social, political, and personal lives of an individual’s community and world.

Beyond this, there are of course complicated, systemic and overt drivers that prevent communities from participating in the political, social, economic, and personal lives of their community and world.  I am not here to say that those aren’t  real, impactful and destabilizing for the individual.  But without health, those determinants play second fiddle.  With health, the engagement of identifying problems and solutions becomes a discussion and a possibility from within a community.

In today’s world where inflammation, insulin resistance and adrenal dysfunction are deeply tied to each other and the way we–or whether or not we manage to–integrate and recover from stress, this is more true than ever before.

Let’s look together at a dramatic example:  Before I knew to offer education for this, I watched immigrant women who had arrived in America in the year prior to their pregnancy, continue to eat the same diet they had in their home country with one exception.  The ingredients were American.  The flour refined and void of the fiber naturally found in the food they grew up eating.  These women disintegrated before my eyes and their health became almost exactly like the health of most women coming from whole lifetimes of American poverty and the “typical” American diet.  In fact, the occurrence of maternal child outcomes taking a nosedive within the first generation of arrival in America has been well documented, though not well explained. How is it possible that women arrive from developing, or even war-torn nations and their health declines?!

The women I saw developed persistent fatigue which made work a complete drag and engaging with their family a lost art.  Mostly, when asked, they ascribed it to the difficulty of being away from family.  But their sense of their vigor and their actual blood glucose levels told a different story.  Interestingly no one blamed pregnancy–they had all grown up where pregnancy was viewed as a normal, active, and healthy time in a woman’s life.

During a home visit, one of the families cooked us dinner and it was there that as I chatted in the kitchen with the mom while she prepared the food that I saw what I came to demonstrate in my practice as the one of the Real Culprits.  With guidance to find imported flours–and to eliminate the processed American foods–blood glucose levels returned to normal.  The extra belly fat melted away as the muscles could once again absorb the insulin being delivered by the pancreas instead of creating a toxic and hostile environment from which each woman was supposed to work full time, care for her family, establish herself in a new home with all of the stress that moving brings, and support the activities at her church or community center (or both).  This food was not so slowly and ever so surely poisoning these women and their babies, who often grew so big that despite well supported labor and best practices, were born by cesarean section at alarming rates.  This was true for first time moms who naturally carry a higher risk of cesarean birth, but also for 2nd, 3rd, and 4th time moms who had healthy vaginal births as part of their health history.

I combine catered education about nutrition with stress reduction strategies at each prenatal visit for every family.  Have a mom bring in a picture of her pantry if you can’t do a home visit.  Frame it is a starting point, not a place to drip shame, fear, and humiliation into her life.  Let’s learn together–have her teach you about her life, her stress, her nutrition, her loves.  Rich or poor, immigrant or 4th generation American. Everyone receives education that meets them where they are at and responds to their life in that moment.

One of the more important maternal/child health results of addressing these deep needs of mothers is that babies grew to be the right size for their mother’s body.  That is a reduction in healthcare costs in the tens of thousands per mother/baby. It reduces so many immeasurable personal costs and so very many short and long term healthcare costs.  A healthcare actuary could have some good solid fun with seeing the numbers all the way through.  It lends to the potential for each baby to be born to a mom ready to mother physically and engage mentally, because they feel good, they feel energized, they feel like themselves.  Even in a foreign country.  Even with a minimum wage job when they are actually qualified mathematicians, accountants, doctors, or teachers.  Even when they miss their family and are learning a new language. Even when they want to somehow muster the  capacity to attend night school to learn a new trade or earn a new certificate so that they can move into a life of opportunity for themselves and their children. 

**an interlude for all of you now fuming advocates from the world of the threat of a big baby  = cesarean birth.  Let me save you from skipping the rest of this article so you can leave an inflamed comment.  This is not that.  These babies are at real risk–their pancreas having been tested and pushed beyond its limits while en utero, they develop a lot of brown fat around the cheeks and shoulders, and are usually 1-4 pounds heavier than mom’s other babies.  These are not the robust babies who could have been born vaginally if mom had providers who knew to use positioning and time to aid in a healthy birth.  They look very, very different than a baby who is just born a big healthy baby.  None of those babies are included in this observation** [also, I love you for the work you do educating mothers about how to use their bodies to birth their babies and demanding that providers get with the program written so many thousands of years ago]

Back to the blog…

The model of healthcare delivery I offer is wrapped in listening and free from standard time constraints.  And still, I almost missed it.  It took listening, observing, and participation in the lives of the families I serve to find this connection.  It took nothing at all for me to apply the lesson to every pregnant woman who came through the door.

If we want to use our privilege as healthcare providers to launch families onto a platform where they can begin to see that opportunity funded by energy, vitality, and good health is different than opportunity funded by the massive domino effects of refined foods and stress without recovery–the disability of diabetes, cardiovascular failure, endocrine implosions, adrenal fatigue–well, we are in the perfect position to do so.

What do you do to offer healthcare that promotes justice?  Do you want to learn more about offering this kind of healthcare?  Are you a healthcare consumer who has or has not received personalized care?  Share your story!

Author: Midwifery

Jodilyn is a licensed midwife (WA, TN) and certified professional midwife. Recently relocated to Memphis, TN, and passionate about the intersection of social justice and perinatal healthcare. She owned Essential Birth & Family Center in South Seattle’s Seward Park neighborhood. She is co-founder of South Seattle Women’s Health Foundation, an organization dedicated to providing midwifery-led maternity care in a collaborative community-based setting and to increasing capacity within the community to support healthy birth and breastfeeding practices.