Our health depends on justice and equality

Working in functional medicine, a form of medicine that examines root causes and dedicated to a holistic vision of wellness, it is not enough to talk about nutrition, exercise, meditation, and gut health. I would be negligent as a practitioner to dismiss the broader forces inequity, discrimination, and socioeconomic status have upon the wellness of individuals and communities.

Mainstream medicine continues to be driven by insurance and pharmaceutical companies forging a narrow path by which “healthcare” must take place. This forces healthcare institutions to play the game of profit and economic stability, which results in rushed office visits, unending paperwork, too much red tape, burnout, and patients not feeling heard. This can result in the very place that should be making you feel “well” resulting in disempowerment and even trauma.

I do prescribe pharmaceuticals. Yes, medication can sometimes be a worthwhile tool. And yes, I often feel like I am medicating societal shortcomings rather than actual pathology.

In the era of COVID and the horrific circumstances of George Floyd’s murder, the realities of inequities and gross discrimination that continue in both subtle and overt ways to pollute our Constitution and cause division, have been ushered to the forefront of our national conversation.

While I like to think I am a proponent of social justice and advocacy, in recent days, I have been convinced of the gravity of my own privilege and how it has veiled me in many ways from confronting the hardships and injustice impacting so many. My tendency is to want to compartmentalize the hate, to escape to the luxury of denial, to tear up and express brief bouts of anger without lasting action, to voice opposition to discrimination, but rest easy in my white, upper middle-class comforts.

The wounds of our country will never heal with the thin Band-aids representing short-lived motivations from a rally, supportive sentiments without action, and promises not upheld. Change must come with a national reckoning of our failures to uphold the Constitution, apologies married with sustained, systemic action, and the emotionally charged work of confronting our personal narratives that uphold the often quiet and subconscious, but oh-so-powerful schemas that allow for discrimination, inequity, and hate to exist too often without penalty.

True, restorative justice has become more and more elusive.

My best definition of justice is that it is the intersection between grace and accountability. Under this definition, justice allows grace for the complexities behind certain actions and behaviors, while also making clear how certain actions harm ourselves and others. Locking a man up in a cell without addressing roots of trauma, fractured self-worth, and missed opportunities is “justice” without grace. This breeds resentment and mistrust. In our broken criminal justice system, wealth and power have too often allowed for criminal acts to be baptized free without regard to accountability. This allows for entitlement and reinforces perceived superiority.

While we may reminisce about the pre-COVID days when things were “normal,” in my home state of Oregon alone, suicide had become the greatest killer among youth ages 10-24, over 500,000 residents had food insecurity, we placed No. 44 out of 50 among national public school rankings, had one of the nation’s leading rates of homelessness — over two times the national average, and despite stereotypes of progressivism, Oregon’s history has deep roots of racism that continue to haunt the present day.

Native Americans and African Americans have the highest rates of poverty by race (25.4 percent and 20.8 percent respectively) followed by Hispanics, Whites, and Asians. The emotional stigma and burden of poverty is significant on its own. Poverty often comes with limitations to accessing quality healthcare and implement healthy behaviors. Accessing healthy food, finding reliable transportation, funding medical care, finding a safe place to exercise, taking time away from work for appointments, social and geographical isolation, and facing stereotypes and bias within the healthcare system are all potential barriers.

With the time demands on mainstream medicine, healthcare providers rarely have the time to address or even acknowledge such complexities and they are pushed further downstream from the driving factors of illness. It has created a flood of chronic illness and a scourge of mistrust and hopelessness. We keep throwing down sandbags when we really need to turn off the hose.

We must look towards a model of care that reinforces healthy communities, thereby acknowledging individual wellness is intimately intertwined with the wellness of a community.

To untangle the roots, we must take time to come together, listen, share stories, allow for vulnerability, hold each other accountable, and support one another. Especially in mental health where privacy is understandably a mandate, we must also recognize how keeping our struggles in isolation from one another may be reinforcing stigma, stress, and fear. In some ways, a culture of too much privacy can limit the healing that can take place when we allow for connection.

For our individual and collective wellness, we must continue to mobilize, to innovate, to advocate. The mass protests and desperation of COVID is not simply what is now, but a buildup of what has been for far too long. Ultimately, as isolated as we may find ourselves these days, we continue to be interconnected. Your struggle has a ripple effect beyond yourself. Your neighbor’s struggle has a ripple effect that may impact you. True wellness will never be solved in your 15-minute doctor visit, but by the security of human-human connection.