Best form of prevention: Health education in the schools

AMA Leader Commentary. By J. Edward Hill, MD. Jan. 6, 2003.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from J. Edward Hill, MD, chair of the AMA Board of Trustees.

On July 20, 1969, our great nation was changed forever, and so was my life as a physician. That day in history, Neil Armstrong took his great leap forward for humankind -- and I took a first step forward for the public health.

That morning in the Mississippi Delta, a woman almost hemorrhaged to death after giving birth at home. Her blood pressure had plummeted so low that I couldn't even record it when I arrived on the scene. A single unit of blood, which I hung from a nail in the wall, saved her life -- but just barely.

Later that day, I watched Neil Armstrong navigate the rocky terrain of the moon. But I couldn't stop thinking about my patient. Our country could put a man into space. Yet we still couldn't provide a poor, pregnant woman with basic medical care.

I knew right then that we had to see change -- profound change. Not long after, my partner and I, along with the Mississippi Health Dept. and the University of Mississippi Medical Center, began a program to address maternal and child health in the Delta. As part of that program, we trained local women, none of whom were high school graduates, to do home visiting and to provide health education to pregnant women, many of whom were just children themselves.

The results were astounding.

The incidence of eclampsia essentially disappeared. Mortality rates for infants dropped, not just below the Mississippi average, but below the national average, where they remained. The program was a living testimony to the power of preventive medicine -- and to health education.