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.

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 ...

My Patient Anna, and Millions of Others Like Her, Are on the Ballot in November

Meet Anna. She’s a 47-year-old woman with diabetes and high blood pressure—that is, hypertension. When I first met Anna three years ago, she’d recently moved to Massachusetts and obtained health insurance for the first time in two decades. During her first clinic visit, Anna’s blood sugar was wildly uncontrolled—a clear indication of diabetes. She felt dizzy and fatigued, but this was her baseline. We spent over an hour, during a visit scheduled for 20 minutes, working with the pharmacist and health insurance company to find an insulin prescription for which she could ...

A Health Equitable COVID-19 Response Starts with Housing Justice

It’s the middle of the month, and rent is almost due again. An estimated 30-40 million people are at risk of eviction in the next several months—and

Moving Beyond Empty Promises on Making #BlackLivesMatter (Part 2): How can our cities, companies, and other institutions dismantle structural racism?

Part 1 of this blog post discussed some of the empty promises in the United States to make #BlackLivesMatter, as well as the types of policy changes needed to move beyond surface-level action. Today, we’ll focus on what specifically cities, companies, and other institutions can do. What can our cities do to dismantle structural racism? There has been a fair amount of coverage ...

Moving Beyond Empty Promises on Making #BlackLivesMatter (Part 1)

As we seek justice for the deaths of Breonna Taylor, George Floyd, Ahmaud Arbery, and the long list of Black victims of police violence; as we grapple with the disproportionate impact of COVID-19 in Hispanic, Black, and Indigenous communities; and as we acknowledge the tremendous toll of

COVID: He Didn’t Have to Die

He’s young. Just 49 years old. A long life ahead of him. He was hospitalized a week ago and doing okay initially on the medical floor. After his saturations were consistently in the 80s on the highest level of supplemental oxygen, he needed to be intubated. We asked him if he wanted to call his family before intubation, just like we do with all our COVID patients… because we know it might be the last time. He declined, said he’s not in touch with his family and has no friends to call. He was adamant that he didn’t want his estranged parents or brother contacted for updates while ...

My Moral Responsibility as a Physician: Addressing the Political Determinants of Health

A while back I was invited to attend a panel discussion on primary care at an area medical school. For 45 minutes the other two primary care doctors and I shared a lighthearted conversation about why we love primary care, interspersing various plugs for why the students should consider the field for themselves. After several stories about the satisfaction we derive from our jobs and the joys in the relationships we form with our patients, a student raised their hand to ask a question about how the current political climate was affecting our practice. “I’ll take this ...
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