InfrastructureBridges and roads as important to your health as what’s in your medicine cabinet
Two seemingly unrelated national policy debates are afoot, and we can’t adequately address one unless we address the other. Health care reform has been the hottest topic. What to do about America’s aging infrastructure has been less animated but may be more pressing. What if a solution to bridging both the political and sectoral divides between health care and infrastructure was, literally, a bridge? Sure, bridges are core elements of infrastructure, but what do bridges have to do with health care? As it turns out, a lot. Moving the health care debate to a discussion on infrastructure might accomplish two vital needs. It might advance the health care debate by both walking away from the current gridlock and approaching the destination from a fresh perspective. It might also advance public health by making America’s highways, neighborhoods and water systems safer, mediating the risks of health care and bridge collapses.
Two seemingly unrelated national policy debates are afoot, and we can’t adequately address one unless we address the other.
Health care reform has been the hottest topic. What to do about America’s aging infrastructure has been less animated but may be more pressing.
Yet even as cracks in America’s health system and infrastructure expand, political divides between parties and within parties have stalled efforts to develop policies and implement solutions. Problematically, debates over health care reform and infrastructure projects remain separate.
As a professor of architecture who also studies health equity – the establishment of systems, laws and environments that promote fair access to health care – I believe we have reason to be concerned.
What if a solution to bridging both the political and sectoral divides between health care and infrastructure was, literally, a bridge? Sure, bridges are core elements of infrastructure, but what do bridges have to do with health care?
As it turns out, a lot.
Abroad, substandard infrastructure kills
We have seen the negative effects of poor infrastructure most in poverty-stricken countries.
In October 2016, Haiti saw the importance of bridges. Still reeling from the devastating 2010 earthquakes, the poorest country in the Americas was struck by Hurricane Matthew.
Torrential rains led to contaminated food and water supplies, and, subsequently, a cholera outbreak. They also washed out the bridge over the River La Digue. The collapse broke a link in the primary highway connecting the capital of Port-au-Prince to the southern peninsula of Haiti, the area worst hit by Matthew.
Without road access, medical supplies, water and food rations, community-education programs, and equipment to repair water and sanitation systems could not be delivered. Disease spread further.
Disasters are not the only situations where fractures in infrastructure impact health.
In Uganda – a country with a high prevalence of preventable and treatable illnesses, such as respiratory infections – the “last mile” of the supply chain is a matter of life and death. While effective, low-cost treatments exist, the leading causes of childhood mortality include pneumonia, malaria and diarrheal diseases.
As in the U.S., rural children in Uganda are at a greater risk of death than those living in cities. In fact, children living in the rural northeast region of Karamoja die at more than double the rate of children living in the capital region of Kampala. The health literacy of parents is one factor; access to health facilities is another.
