Health and Disability

At an academic medical institution in Baltimore, several doctors examined a teenager. They were mystified by his rapid weight loss, an unusual and alarming condition for an otherwise healthy young man. As the boy shivered on the exam table, his doctors mulled which blood tests to order, metabolic tests to run, and potential diagnoses. A volunteer member of the primary care clinic’s extended care team wondered aloud, “Do you think he’s hungry?” One of the doctors replied, “He’s never said anything like that, but you can ask him if you want.” It turned out that the teen had recently moved out of his home, often didn’t have enough money to buy food, and simply went without.

Variations of this story play out across the country hundreds of times every day. Unmet social needs represent a disastrously overlooked, or ignored, underpinning of poor health, disability, and even death.

Doctors use the term comorbidity to describe the simultaneous presence of two or more chronic diseases or conditions in a patient. They readily include in this category high blood pressure, diabetes, obesity, depression, and others. It’s high time to include in the definition things like the inability to get enough food, not being able to refrigerate insulin because the electricity got shut off, not having safe and secure housing, and the like.