Perspectives in Primary Care features writing from practitioners, activists, and community members representing organizations, practices, and institutions across the United States and around the world.


The Role of Advocacy in Primary Care

Primary care physicians are uniquely positioned to go beyond the immediate needs of their patients. Everything from writing a prescription to examining the larger, more daunting socioeconomic and environmental factors that affect their patients’ health and well-being falls within their scope of work. “When physicians have a trusting relationship with their patients, there are things that are disclosed between the walls of an exam room that many people would not disclose otherwise,” says

Air Pollution Is the New Radiation. It is Time to Act Like It.

In the not-so distant past, you may not have thought twice about your exposure to radiation. While Roentgen discovered the X-ray in 1895, it would not be until the early-mid 1900s that the general public—let alone the scientific community—would accept the malignant potential of an invisible, devastating force, powerful enough to pierce bone, burst cells, and warp DNA. It would take years of tragedy before we finally recognized radiation for what it was—a threat to human health. That begs the question, why aren’t we doing ...

Relating Place, History, and Neighborhood Context to Mental Health: A Baltimore Case Study

Mental health is a growing public health priority. While people from racial/ethnic minority groups generally report a similar prevalence of mental health conditions compared to the rest of the U.S. population, they have
Personal Perspectives

Seeking Medical Care in Fear: Transgender Millennials Open up About Fears, Mistreatment

One of the most beautiful aspects of my practice as a mindfulness teacher and coach is that it takes me into a wide range of communities. The goal is to meet people where they are rather than expect them to find me. I learn as much (or more) from the populations I serve as they may learn from engaging in the programs I offer. Much of my mindfulness teaching involves individuals and groups who are from diverse backgrounds very different from my own. A recent experience was no exception, as I was invited to teach an eight-week

Considerations for Primary Care Providers in the Diagnosis of Long COVID

Data on long COVID is evolving, causing diagnosis and treatment to be complex. Primary care clinicians must consider not only the preexisting conditions of each patient, but their environment (work, home, financial security). There are special considerations when caring for vulnerable patient groups affected by long COVID, including patients with disabilities, substance use disorder, and those who are immunocompromised. Who is at risk for long COVID? Long COVID is significantly associated with age and in some reports, has been

A Farewell Message from the Outgoing Editor-in-Chief

To our community of readers and contributors of the Harvard Medical School Primary Care Review: It has been the pleasure of a lifetime to serve as the inaugural Editor-in-Chief of the Harvard Medical School Primary Care Review from April 2020 through December 2022, and it is with mixed emotions that I step down from this role as I pursue further family obligations. Throughout the past 2.5 years, we have grown this publication to become a key Harvard-affiliated publication where community members ...

Our Right to Basic Public Health Amenities

I was born and raised in Mebane—a small town in North Carolina that is now primarily white with a large percentage of Black, Indigenous, and Latinx individuals today. My childhood was spent between my father, Jesse’s, side of the family in the West End Community of Mebane and the Hawfields community of dairy farms where most of my mother, Mary’s, side of the family lived. My father worked on dairy farms after his left arm was cut off in a Mebane sawmill accident, while my mother worked in textile mills that caused carpal tunnel syndrome and mini-strokes. Outhouse ...

Compassionate Release for Prisoners: Ensuring Dignity and Care

He is bedbound, unable to walk, unable to care for himself, unable to advocate for himself, and so confused that he cannot finish a thought, let alone a sentence. He has lost 90 pounds in the past year. He soils the bed multiple times per day. His legs and feet are so swollen and edematous that socks and shoes do not fit on his feet. The expectation is that he yells from his bed/cell if he needs something, has a problem, or even worse, he falls with the hope someone hears him in the hallway. There is no emergency call button or ...

P is for Period and P is for Power: Attending to Menstrual Hygiene in Rural India

“Can I take a bath during my period?” comes a feeble voice from one corner of the classroom. I struggle to put the words together but am afraid to ask again lest the enquirer retreat. “I missed my exam because I was on my period that day, and the cloth I use often leaks and soils my clothes,” someone else says from another corner. Slowly the entire room fills with questions that I never imagined existed. I wonder if we have different centuries for different people.
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