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.

Seeing the Water: Seven Values Targets for Anti-Racism Action

You know the old saying, “It’s hard for a fish to see the water in which it swims?” That’s true! And in the United States, we are all swimming through a polluted ocean. More of us are starting to see the icebergs and reefs that structure our watery landscape, in part because we are starting to understand that the wreckage that they cause is not “natural.” But we have been slower to see the water. And we need to see both, because it is the very murkiness of this water in which we swim that makes it hard for us to see the structures that harm and divide us. We swim in an ...

Food Insecurity… Emerging Again from the Shadows of COVID-19

On first glance, COVID-19 appeared to be the “great equalizer,” particularly with reports of celebrities and world leaders infected and succumbing to the unruly virus. It seemed that income, race, ethnicity, and location were no longer protective factors. On second glance, though, we find COVID-19 is actually the “great magnifier.” It has shed light on the

The Impacts of Racism on the Health of our Nation

Dr. Martin Luther King, Jr. once said, “Our lives begin to end the day we become silent about things that matter.” The American Academy of Family Physicians (AAFP) has a legacy of being outspoken on issues that matter to our patients and the communities in which our members serve. We advocate loudly for our most marginalized patients, including those who are transgender, those with limited English proficiency, those with disabilities and, of course, people of color. It is in that spirit we issued a

COVID-19 and the Social Determinants of Health

The COVID-19 crisis continues to expose deep vulnerabilities in the U.S. healthcare system—from the dearth of personal protective equipment to the lack of surge capacity to fragile hospital financials. And yet many of the most concerning issues laid bare are ones that originate outside the system. Some have called this coronavirus the “great equalizer,” as all of us—in every corner of the country—are at risk. But although pathogens might not discriminate, our society certainly does. And with each passing day, patterns in COVID-19 morbidity and mortality are revealing the ...

COVID-19 Exacerbates Food Insecurity in Latino Children & Families

COVID-19 has exacerbated long-standing health disparities that continue to affect Latino families, and further, the pandemic has revealed that many Latino families are struggling to put food on the table. Food insecurity affects 37 million Americans, including 11.2 million children—and this is especially urgent within the Latino community. Prior to COVID-19,

The State of the South

I refuse to write another state of emergency article. I have no more words to say about the epidemic of anti-Black violence and white supremacy’s murderous impact on Black bodies. I’ve lost count of how many names we’ve typed of siblings murdered by police officers. We’ve screamed at our computer screens about the disproportionate impact of COVID-19 on Black communities, and for so ...

Social Mission Now: The Role of Health Professions Education in Addressing Health Equity and Social Justice

The racial equity movement and COVID-19 are bringing needed public attention to the structural racism and inequities that underlie social and health disparities in the United States. The police killings of George Floyd and so many other Black lives have brought about increasing calls for police reform. In Minneapolis, where George Floyd’s killing occurred, the City Council recently approved a

Beyond the Symptoms: How & Why Medical Providers Can Address Police Misconduct

Many of my teachers and fellow students feel that to be good healthcare providers, we must separate ourselves from our political opinions and the issues outside the walls of the hospital. That impulse can be helpful. We don’t want to mistreat our patients because they hold different opinions from us or see the world in a different way. At the same time, I think it limits the degree to which we can fully understand and address the problems our patients face. It is difficult to understand the injuries caused by violence or the illnesses caused by chronic stress ...

Medicare-for-All in the COVID Era: A Path to Healing

As physicians in the intensive care unit (ICU) at Cambridge Health Alliance, a safety-net hospital in the Boston area, our patients regularly fall victim to the intersection of the social determinants of health and the failures of our dysfunctional healthcare financing system. We frequently treat patients whose health problems have been thrust upon them by structural forces: a Black man spiraling into ketoacidosis because he couldn’t pay for insulin at ...
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