A different approach to health

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I’ve never been a member of Commonwealth Care Alliance; I don’t think I’d ever even heard of them before a few months ago.  But I have been noticing their ads on the subway and bus, they’ve been getting my attention.  It’s that line at the bottom that seems to be the tagline for their whole campaign: “Healthy is harder for some.”

When I was looking at this particular ad on the bus tonight and reading that the tagline, it made me think of the health care experiences of friends and family of mine who have some pretty complicated health challenges.  One has celiac disease that had gone undiagnosed for years; another has endometriosis.  In both cases, these individuals have experienced years of pain and frustration, and in both cases they spent many of those years running through countless doctors who denied that their pain was real, or misdiagnosed their symptoms, or hesitated in providing the treatment that they needed to manage their illness.  Both individuals had to be vocal and persistent advocates for their right to receive competent, sensitive, and thorough medical care, and battled some ridiculous obstacles along the way – all while feeling really crappy a lot of the time.  Again, I don’t know anything about CCA, but I like to hope that people like my friends would find it easier to get the care they needed in a health system with this philosophy.

Interestingly, that ad was sitting right next to another health care ad:

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As it turns out, I am familiar with the Cambridge Health Alliance; I’ve received care from hospitals and physician’s practices that affiliate with them, and I know folks who work on their staff around community health issues.  They have a pretty good reputation – but this ad frustrated me tremendously.  I’m a 30-something woman … and I have diabetes, along with a collection of related endocrine system issues.  I certainly don’t think the intent of the ad was to judge anyone for their health status; they’re just trying to market themselves as good care providers for a particular segment of the population.  Unfortunately, saying what someone’s health status “should” be at a particular age has some implications that I’m not sure they realize.

The fact is that not all of us are perfectly healthy in our 30s – or at any age.  People develop health challenges in their earlier decades for any number of reasons: genetics, heredity, accidents, environment, and behavior.  Behavior can contribute to or cause some of these issues; at the same time, there are things that even perfect behavior can’t prevent.  And even if a particular set of behaviors caused a condition that someone has to deal with, they’re already dealing with the physical, mental and emotional consequences of those decisions in their health condition; they don’t really need to be judged  by other people for not being as healthy as they “should” be.

This is a sensitive topic for me because Type 2 diabetes is one of those “preventable” things that usually only happen to people when they get older.  I went through a lot of guilt when I was first diagnosed about how I had let this happen to me because of unhealthy eating and how I should have known and kept it from happening to myself.  And because I am considered overweight in a land of skinny people, I constantly deal with external pressures around whether I exercise and how much, what I eat and how much, what I have or haven’t tried to lose weight and “be healthier.”  It took a good while for me to get to a place where I could lose all of that nonsense and decide how I wanted to manage my health for the kind of life that I wanted to live, without guilt and without reference to who other people thought I should or should not be.

There are a lot of “should”s that follow me around as a woman in her late thirties – about my relationship status, my childrearing status, my homeownership status, my job status … on and on.  Again, I don’t know about the quality of medical care between these companies, so I can’t comment on which one a person with complex health issues should choose.  I just appreciated the affirmation from the Commonwealth Care Alliance ad that we are all different, we don’t start out in the same place and we don’t end up with the same needs.  Healthy is harder for some; and for those of us who find that true, it’s OK to be who we are.

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