Inauguration Day in the USA

I hate to break it to you, but things are not getting better for the urban poor.

Everyday brings me some new and compelling evidence of this harsh reality. You can see it everywhere in the city if you pay attention to poor folks.

Ironically, we are getting better at responding to the growing pain. But what sort of person could find even a shred of comfort in that assessment?

We do medicine where I work. Since 1990, we have offered some level of medical outreach to the poor who live around us. This past year was our best ever in terms of what we delivered.

Unfortunately, our hard statistics tell an even harder story about the health of the poor in inner city Dallas. Services are scarce and growing scarcer. Health continues to decline.

In 2003, we cared for 2,962 patients. During 2004, that number almost doubled to a total of 5,758.

One of our target disease sets is diabetes. During 2003, we treated 220 diabetic patients. This past year we provided a medical home for 564 people in their chronic battle with the all to common malady. Diabetes runs at epidemic proportions here, as do hyper-tension, cardiovascular disease, asthma and depression.

Our dental practice--poor people between 21 and 65 have little or no access to dental care--grew from 571 patients in 2003 to 822 in 2004.

Then there are the children. We don't treat many little ones. Most of them have some access to public health services--though with substantial cuts to the Children's Health Insurance Program (CHIP) the need among kids is growing. Our practice reflects the need trend. We provided a consistent medical presence for 252 children last year as compared to 123 in 2003.

I could go on, but I'll spare you. Except to say, we operate a relatively small medical clinic.

I guess my point here has to do with the state of the nation's health, but even more important to me is the state of our "national heart."

As you take in the inaugural events of this special day, think about where we really are in this country.

Remember the poor. Maybe, just maybe, if enough of us do that things will change.