By: Paul DeMuro, Ph.D., J.D., M.B.A., CPA and José Szapocznik, Ph.D.
In today’s America, people live in two distinctly different worlds. Dr. Garth Graham, President of the Aetna Foundation, points out that “life expectancy in New Orleans can vary as much as 25 years between neighborhoods just a few miles apart.” If a physician sees two patients, one from a well to do neighborhood in New Orleans and the other from one of the poorer neighborhoods, both of whom present with Type II diabetes due to overweight and a sedentary lifestyle, and that physician prescribed the exact medications and the exact lifestyle changes, will these two patients have the same outcome?
One of them, if she chose to, will be able to get a trainer to come to her home, and buy plenty of the best fresh produce, but the other will not. One will be able to arrange her schedule to arrive at work an hour later or leave an hour earlier to make it to her exercise class, whereas the other, an hourly employee, will not. And when the patient living in the poor neighborhood gets home, she won’t be able to go for a walk in her neighborhood because it might be too dangerous. There was a time when neighbors used to walk the sidewalks in poor neighborhoods, but now as crime has increased, residents are afraid to be outdoors. Actually, when Dr. Szapocznik asked mothers from an inner city neighborhood about their children’s play, they told him that after five in the afternoon, the mothers make sure that all the family is indoors because it is too dangerous to be outside.
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