When it comes to public health, it’s not just how you live, it’s where you live

John Snow in 1854 didn’t know what caused cholera, but he stopped it because he learned who was getting sick and where. We can do better.

I'm a doctoral candidate in the Doctor of Public Health program at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen

One thought on “When it comes to public health, it’s not just how you live, it’s where you live

  1. Around a decade ago, we lived in Southwest Philadelphia. We lived there for over 20 years, raised our children there as well.
    As you said, at night, people didn’t go out. We had drug dealers in the park, who intimidated and even injured people who weren’t interested in doing business with them.
    After one attempted robbery, while I was crossing that park one evening shortly after we had moved in, I began taking evening strolls around the neighborhood. The armed robber did not enjoy our communication, as after I had him on the ground and stomped heartily upon his genitals, I disassembled his firearm, throwing spring, follower and barrel around the park and the slide and lower receiver impacted his head. I then completed my journey home with the beer that I had purchased at the bar on the other side of that park.
    Strolls, where I carried a cane. Beneath my winter jacket was my Army issued Kevlar vest.
    There is a branch of martial arts that uses a plain, old fashioned cane.
    A few dislocations, contusions and concussions later (not in regards to myself), our merry gang of thugs made the mistake of setting up an ambush for me. I saw it and went home to bring the dog with me. He was a Dutch Shepherd, who really, really disliked drug dealers. We had quite a fine time dismantling that ambush. I’m entirely uncertain that at least two of those men may never have the use of their fingers again.
    After that, people started sitting out at night, they’d even walk in the park. They started a townwatch.
    Unfortunately, most neighborhoods in our cities don’t have a former SF medic living amongst them, so people end up stuck inside of their homes, in literal fear of their lives.
    Two years after I deployed overseas, the neighborhood went back to where it was when I first got there.

    Today, my wife can’t go for walks, her herniated disc and narrowing spinal canal prohibit it. I’m getting close to the same, as I have degenerative disc disease of long standing.
    So, exercise is out of the question.
    Our genetics work against us as well, as both of our families tend to run large in body mass. Diabetes, high cholesterol, hypertension, coronary artery disease, heart disease, stroke, all in our genes.
    I eat a lot less and keep the weight off and am only pre-diabetic. My wife hasn’t been able to keep the weight off and is diabetic. I will say, I’m the *only* male in my family that is not diabetic by age 50 and I’m 53 now, so I’m doing fairly well in that department. Cholesterol, no luck there. Statins send me straight into rhabdo. Once my BP is under control, the next project will be to figure out what alternative medications will work to get my cholesterol lower than that of a whale.

    Upside, there is one exercise that is effective and doesn’t cause neural havoc on my lower back, swimming. Summer is coming and after brief conditioning, I have been known to tread water for hours on end.

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