Probing Poverty and Health

In her California practice, a physician and Harvard-trained public-health scholar studies why poor people are sicker.

The March 21 issue of the New Yorker has a profile of Nadine Burke, M.P.H. ’02, who founded a clinic in San Francisco's impoverished Bayview-Hunters Point neighborhood.

"Seeing the same patterns of trauma, stress, and symptoms every day in many of her patients," Burke reached a turning point. One day, seeing a young female patient with a long list of physical ailments, Burke began to wonder: "What if [the patient's] anxiety wasn't merely an emotional side effect of her difficult life, but the central issue affecting her health?"

Since then, Burke has transformed her practice to go "beyond the typical boundaries of medicine" by considering the physiological effects of what typically are considered social issues.

The article uses Burke's story as a window into cutting-edge research on the role of "adverse childhood experiences" (ACEs), including parental divorce, physical and sexual abuse, and emotional neglect, in later health outcomes. (Burke studied these issues at the Harvard School of Public Health; a 2008 Harvard Magazine feature article, "Unequal America," explored Harvard researchers' work on the connection between income and health. The New Yorker article also mentions Harvard's Center on the Developing Child, and center director Jack Shonkoff's work on the academic and health impact of childhood adversity—the subject of another Harvard Magazine feature article, "The Developing Child.") "If we trust the data, and we want to prevent heart attacks," writes author Paul Tough (whose previous work includes Whatever It Takes: Geoffrey Canada's Quest to Change Harlem and America), "it makes as much sense to try to reduce ACEs, or counter their effects, as it does to try to lower cholesterol."

Read an abstract and find links to the full article, which  is available to subscribers on the magazine's website, and to all on the magazine's iPad app.

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