BY: MARY ANN STEINER
Come early April, it's time to make my annual pilgrimage to the old cemetery where several of my beloved are buried. It's a private trek on a midweek lunch hour, 12 minutes down the highway before exiting into an area of the city most people avoid. Each time I go, I note the changes along the route, the people whose paths I cross, the steady decline of the cemetery grounds.
The man in the verge at the end of the exit ramp limps over to ask for money. A different man from last time, but he, too, blesses me before returning to his little patch of turf, littered as it is with fast-food debris, plastic bottles and the other detritus of drive-by trash disposal. In the four blocks to the cemetery gates, there are now 11 houses boarded up, and the yard with piles of tires shows a spotty greening of hardy weeds. A young man leads a young boy pulling a young puppy down the sidewalk. Three women share a big bag of chips on a front porch, while several men dump used motor oil in an empty lot. A birds-eye view of four city blocks in the landscape of the poor and vulnerable.
Or take a much longer perspective and consider four large states. Kentucky, Tennessee, Virginia and West Virginia are home to the mountains, valleys and coves of Appalachia. Surface mining began there around World War I (as opposed to underground mining, active since prehistoric times). In the 1970s, a more insidious procedure called mountaintop removal began, producing much more coal with much less manpower. Huge machinery and tons of explosives blast the top off a mountain, scrape all the timber to burn pits and inject the newly raw platform with multiple rounds of explosives to uncover rich deposits of coal. The landscape is desecrated, the air polluted with dirt and ash, the rivers and groundwater poisoned with toxic sludge. Miners are left unemployed due to the efficiency of new processes, and the vistas and habitats of whole communities are ugly and impoverished.
The environments we live in determine the quality of life and status of health more than any other factor, including heredity and individual behaviors. Naming the social, economic and environmental determinants of health is a first step in the practice of population health. It is also a piece of the care of creation that Pope Francis is calling for: mercy toward every fellow human being, justice in the policies of governments and practices of corporations, and humility about our role in and responsibility to all creation.
Our country has been blessed with a series of prophets who have denounced our sins against the environment and proclaimed the majesty as well as the vulnerability of nature — Henry David Thoreau, John Muir, Rachel Carson and Wendell Berry, among them. A new generation of environmental prophets is addressing what health care contributes to climate change and toxic waste, and they are proposing that health care move from human dominance over nature, to stewardship of nature, to care for nature, to communion with nature.
Fortunately, some of those prophets who can describe the damage done and the urgency to reform health care have written for this issue of Health Progress. We are grateful to each of them and to Sr. Kathleen Popko, SP, our guest co-editor, who helped us shape the topics and articles. Their insistence on binding the care of the environment with the care of God's people makes them prophets of hope rather than prophets of doom.
As prophets of hope, they know bringing about better relationships between health care and the environment depends on action. They are calling on leaders of Catholic health ministries to parlay the urgency of the moment with perseverance and planning for the long term. Can health care save the planet? Not on its own. But it can — with leadership committed to innovating and implementing green practices — embrace its fertile opportunities for healing God's people and the Earth they share with all creation. We all pray that it will.
Copyright © 2016 by the Catholic Health Association of the United States
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