By Madeline Drexler, Harvard Public Health, Winter 2020
In 2007, pediatrician Nadine Burke Harris, MPH ’02, set out on an idealistic mission: to deliver quality medical care to one of San Francisco’s poorest and most underserved neighborhoods—Bayview-Hunters Point, in the isolated southeastern corner of the city. Before Burke Harris arrived on the scene, only one pediatrician was serving the neighborhood’s 10,000 children. The community’s plight was starkly apparent in its ZIP code. In 17 of 21 other ZIP codes in the city, ischemic heart disease was the leading cause of early death. In three ZIP codes, HIV/AIDS was the leading cause. But in only one ZIP code—Bayview-Hunters Point—was violence the top killer.
Burke Harris founded the Bayview Child Health Center with the goal of tackling disparities in access to care, immunization rates, and asthma hospitalization rates. But she quickly discovered that the challenge was more deep-rooted than standard public health statistics would suggest. Her young patients often didn’t fit conventional diagnostic criteria. A 7-year-old named Diego, for example, had stopped growing at age 4, for no apparent reason. He also suffered from asthma, eczema, and behavior problems. Probing further, Burke Harris learned that Diego had been sexually molested at the age of 4—the year his normal growth came to a halt. The discovery made her stop in her tracks. Could all of Diego’s ostensibly separate medical problems be traced to a single early trauma?