Health Citizenship in America. If Not Now, When?

On February 4th, 2020, in a hospital in northern California, the first known inpatient diagnosed with COVID-19 died.

On March 11th, the World Health Organization called the growing prevalence of the coronavirus a “pandemic.”

On May 25th, George Floyd, a 46-year-old Black man, died at the hands of police in Minneapolis.

This summer, the Dixie Chicks dropped the “Dixie” from their name, and NASCAR cancelled the confederate flag from their tracks.

Today, nearly 200,000 Americans have died due to the novel coronavirus.

My new book, Health Citizenship: How a virus opened hearts and minds, launched this week. In it, I track these events and the many forces transforming U.S. consumers, our homes, the healthcare system, and what we’ve learned in the first six months of the pandemic about all aspects of our health: physical, mental and emotional, financial, and societal.

The pandemic has been re-shaping all of us, beginning with the Great Lockdown compelling people to work-from-home when they could, learn from home, shop for food and hygiene supplies from home, repurpose homes as gyms, cook at home, and even pray at home at a distance from our churches, mosques, and synagogues. Consumers went through their personal digital transformations, across all of these life-flows. And without access to WiFi/connectivity in the pandemic, people couldn’t physically distance while reaching the apex of their personal Maslow Hierarchies of Needs.

These new work-and-life flows have changed our relationship with our personal doctors and local health care systems, pivoting us to virtual care and telehealth platforms. For many people, these new personal care experiences will be transformed for the foreseeable future, with many people, both younger and older, appreciating the opportunity to get health care away from brick-and-mortar clinics and exam rooms to avoid the risk of exposure to the very tricky and contagious virus.

In America, the pandemic has affected every person in some way: older and younger; urban dwellers earlier and then, by summertime, more rural communities.

The pandemic’s side-effects have impacted all aspects of American life:

Financial, resulting in declining productivity for the nation and job losses for millions of households, accompanied for many by the loss of health insurance tied to jobs

Mental and behavioral, impacting peoples’ emotional states, anxiety and depression, and nationwide stress

Societal, with the convergence of George Floyd’s murder, street-level protests, and growing risks of gun violence across the country along with increased sales of firearms in 2020.

Through this societal lens, the pandemic also clearly, dramatically, and tragically revealed the role of social determinants of health in the crisis: while roughly equal percentages of White and Black people in the U.S. knew someone who had contracted COVID-19, nearly twice as many Black people knew someone who died from the coronavirus.

In a June essay published in JAMA, Dr. Donald Berwick re-named these factors that underpin our health as “The Moral Determinants of Health.”

We must connect the dots between public policy for food security, safety, and accessible nutrition; WiFi as a social determinant of health; a clean environment and climate health; education; fair wages; and, of course, health security.

©Jane Sarasohn-Kahn

This is the call for Health Citizenship for people in America. While the pandemic has wreaked havoc on lives, livelihoods, and spirits, there is a gift in the moment: we can claim our health citizenship, bake health into public policies, and remember who we are as Americans: a community of people who, at the end of the day and this potential new beginning for a new social contract for health and a caring, mutual society.

You can access my book on Amazon Kindle here. It’s a data-packed and footnoted quick read on where we are right now in the pandemic, and how we’re at a moment to pivot toward health care as a civil right in America.

Health economist, advisor, communicator, and trend weaver. Find me at