Monday, May 26, 2014

How Being Poor Makes You Sick By Olga Khazan THE ATLANTIC


How Being Poor Makes You Sick

By Olga Khazan
When poor teenagers arrive at their appointments with Alan Meyers, a pediatrician at Boston Medical Center, he performs a standard examination and prescribes whatever medication they need. But if the patient is struggling with transportation or weight issues, he asks an unorthodox question:
“Do you have a bicycle?”
Often, the answer is “no” or “it’s broken” or “it got stolen.”
In those cases, Meyers does something even more unusual: He prescribes them year-long memberships to Hubway, Boston’s bike sharing program, for just $5 per year—a steep discount from the regular $85 price.
“What we know is that if we are trying to get some sort of exercise incorporated into their daily routine, [the bike] works better than saying, ‘Take x time every day and go do this,’” Meyers told me.
The bike-prescribing program is paid for by the city. For patients without bank accounts, Boston even puts up its own city credit card. Meyers thinks the two-wheeled solution tackles several problems at once.
A Hubway bike in Boston (Louis Oliveira/Flickr)
“Boston is pretty compact, parking is always a problem, and getting around on a bicycle makes all the sense in the world,” he said. Plus, doctors at Boston Medical Center use their electronic medical records to prescribe the bikes, and they plan to measure how patients’ use of the bikes tracks with their weight and health over time.
Meyers realizes that sedentariness is one of the many ills that afflict the poor to a greater degree than the rich. People earning less than $36,000 are far less likely to exercise than those earning $80,000 or more. Low-income people may live in dangerous areas, have little free time, lack access to parks, or some combination.
The bike program is one example of the various ways physicians are attacking a vexing problem that’s not in any medical handbook: Poor patients are sicker, and their poverty actually makes them sick.

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