Every clinical story has a social story. Learning these stories is more than the heart of medicine - it's the key to building a more healthy society.
This week I start my Northern Family Medicine residency in Labrador, serving my hometown and a vibrant population of Inuit, Innu, and settlers spread along the coast north of Quebec and south of Greenland. As I write, the people of northern Labrador are experiencing their fourth TB outbreak of the decade, revealing a pattern of prevalence that can teach us a lot about the conditions of everyday life in the North.
Globally, over 2 billion people - fully one third of humanity - are infected with Mycobacterium tuberculosis, the bacterium that causes TB. While anyone can be exposed to TB, our risk of infection, disease, and bad clinical outcomes is intimately shaped by our conditions of everyday life. Just as TB can teach us how housing, nutrition, and income are embodied as disease, it can help us learn to think upstream, and work together to build a more just and healthy society.
Upstream thinking draws on a helpful metaphor – instead of only waiting downstream to help all those drowning in a river, why not head upstream to learn why people fall in, solving problems at their source? In Canada, Inuit are not only the most affected by TB - they're leading the way in designing upstream solutions to improve northern health. To learn more, check out my new article Piliriqatigiingniq: Working Together to Stop Tuberculosis in Northern Canada.