Map of life expectancy at birth from Global Education Project.

Monday, April 11, 2005

Regional politics

So okay, you may ask, why is there a New England Minority Health Conference in the first place? Is New England a real concept? Yes it is. The U.S. is a big country -- I'm not sure most of the people who live here entirely grasp the scope and scale of this place. The state borders are largely arbitrary, the result of all sorts of historical accidents from ancient land grants, to surveryors' expeditions, to, yup, wars of conquest. But while historical accidents make for less than meaningful political boundaries in most cases, combined with climate and ecology and patterns of economic development, they make for geographic regions with common interests and cultural commonalities.

New England did develop a north-south divide in the 19th and early 20th century as the southern states -- Connecticut, Rhode Island and Massachusetts -- urbanized and industrialized much faster than Vermont, New Hampshire and Maine, and their industrial cities then became ethnically diverse. But that's changing, and we're reunifying. As you drive from New Haven to Portland the cities still thin out, and the farms and woodlands grow more extensive, but most strangers would be surprised how much of the latter remains in southern New England. If you pull off the turnpike in Manchester, New Hampshire today, the first thing you'll see is a botanica -- a store run by Dominicans that sells medicinal herbs and religious and ceremonial supplies. Vermont is still the whitest state but Burlington is now a good place to find Indian food and more and more Latino migrant agricultural and forestry workers are settling down now in small towns in Vermont and New Hampshire.

Those of us who want to eliminate health disparities recognize that the federal government isn't going to do a damn thing that's any good for the foreseeable future. If we want to accomplish anything we are going to have to work at the state level, and the states and their activist citizens can be a lot stronger and a lot more effective when they join forces. In the coming days I'll talk about state public health and health care policy and what we can accomplish in spite of the march in Washington D.C. back to the 15th Century. The North will rise again!

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