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.

Well-Being of LGBTQI+ People in the United States Today

More than 11 million lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) people live in the United States today, but we know far too little about their overall health and well-being. For LGBTQI+ people, we do know that some aspects of life are better than they once were. Whereas LGBTQI+ people were once viewed negatively by many ...

Diversifying the Healthcare Workforce is Key to Addressing Health Inequities

When we improve the health of the most marginalized, we improve the whole nation’s health. Brian Stevenson, Executive Director of the Equal Justice Initiative, noted in the American Public Health Association (APHA) 2020 Annual Meeting, “the health of our communities must not be judged on how well the powerful and privileged are doing, but by the health and well-being of the most vulnerable ...

Reframing Research on Racial Inequities in Oral Health

Race has long been at the core of oral health research. In 1851, The Lancet published a seminal article arguing that “civilized men” and “barbarous races” could be distinguished from each other only by examining the shape of their teeth and dental arches. Since then, race has served two main purposes in oral health research and practice: To recommend specific dental procedures based on racial ...

Tribal COVID-19 Response Among Indigenous Populations

The COVID-19 pandemic presents American Indian and Alaska Native communities with the biggest public health crisis since the 1918 influenza pandemic. Tribal communities have experienced many major pandemics since European contact, some unintentionally spread, and some, like smallpox, intentionally used to wipe out our people. Because of this shared history, tribal communities in the United States have taken a hard line to protect tribal members and reservation residents from COVID-19. At

Practice Optimization Amidst COVID-19: A Note from Our Patient Partner

The impacts of the COVID-19 pandemic continue to be felt across the United States, and this includes the ways in which we interact with the healthcare system. As the mother of a daughter with complex medical needs and a diabetic patient myself—what many would refer to as “super-users” of the medical system—we had to quickly adjust and adapt to the ways we’d need to manage our health conditions throughout the pandemic, as COVID has not stopped our need for ongoing care management. So, when I was asked to serve as faculty for the Harvard Medical School Center for Primary Care

Relational Organizing Key to Addressing the Political Determinants of Health & Health Equity

As the world has watched with bated breath, the 2020 United States presidential election has unfolded into a paradigm shift marked by apprehension and anticipation. The American people—more civically engaged and politically informed than ever before—have mobilized in a historic show of democratic involvement. As American communities from all walks of life have been galvanized, a single factor has risen to ...

Here’s Why the US is Failing to Thrive

Americans die younger than people in other high-income countries. With a life expectancy of 78.5 years in 2018, Americans die 5.7 years younger than people in Japan, the global leader. They die 3.4 years younger than their northern neighbors in Canada. And they die 2.7 years younger than their

Promoting Health Equity through Voter Registration & Mobilization

It’s a warm September day. I neatly arrange my voter registration materials at a small table outside of the Somerville Urgent Care entrance. Sitting on a cool granite bench, I watch as a young girl and her mother approach. They are linked arm-in-arm, speaking Portuguese. “Hello! Are you registered to vote?!” They can’t see it, but I’m smiling behind my mask. The young girl’s face lights up, and, like many who visited my table before her, she begins to share her story. In just five days, she’ll turn 18. She’s finally old enough to vote ...

Child Care and Early Education is a Social Determinant of Health—For Children and Adults

More than six months into the COVID-19 pandemic, child care solutions for families remain scarce. A high-stakes problem typically confined to parents with children younger than five, lack of child care has now become a near-universal challenge, with remote K-12 learning upending care infrastructure for families with school-aged children as well. Consistent failure to provide public funding to the child care and early education sector—both traditionally and in this moment of crisis—is taking a heavy toll: