Kent State Online

Imagine a town that wants to improve access to its public buildings. Theoretically, the citizens of the town could appeal to their elected officials for the change and maybe vote on a ballot measure. Once that measure has passed, officials could craft a policy addressing the need for improved access, and then allocate the funds...and then things get a little tricky.

Throughout the mid-19th century, clinicians noted the impact of socio-environmental factors on healthcare. From unusually high incidences of breast cancer in Italian nuns to cancers that only seemed to affect chimney sweeps in Great Britain, medical literature of the period carefully traced the connections between cultural background and wellness. This led some physicians to theorize that disease was strongly related to societal dysfunction and inequality, and that improving schools and working conditions could help to alleviate disparities in mortality across social classes.

It can be easy to take for granted the comforts that most of us have in our homes. Indoor plumbing, running water, heat, a safe place to sleep, food—even the people fortunate enough to enjoy these amenities will periodically fall ill. Yet they can maintain their cleanliness, get adequate rest and most likely have access to reputable health care. Now, take all of that away. Suddenly, an alarming range of bodily and psychological impediments can arise.

We’re all familiar with oceanic tides, which cycle roughly every 12 1/2 hours based on the relative positions of the earth and the moon. Some places have greater ranges than others, based on the local configuration of the coastline. Every couple of weeks, when the sun, earth and moon all line up, we have “spring tides,” in which the tidal fluctuations are stronger than normal.