The Environmental Health Clinic at NYU is a clinic and lab, modeled on other health clinics at universities. However the project approaches health from an understanding of its dependence on external local environments; rather than on the internal biology and genetic predispositions of an individual.
The clinic works like this: you make an appointment, just like you would at a traditional health clinic, to talk about your particular environmental health concerns. What differs is that you walk out with a prescription not for pharmaceuticals but for actions: local data collection and urban interventions directed at understanding and improving your environmental health; plus referrals, not to medical specialists but to specific art, design and participatory projects, local environmental organizations and local government or civil society groups: organizations that can use the data and actions prescribed as legitimate forms of participation to promote social change.
As with traditional healthcare, the responsibility ultimately is managed by you. Attending the Environmental Health Clinic – and following up – is entirely voluntary. You decide whether or not to address an issue; you formulate the concerns, ask the questions, and come to the clinic only if you are interested in addressing these concerns. You draw on the clinicâ€™s resources and expertise to help develop a reasonable course of action, which you can follow through or not. You are the one driving, as with traditional health care where you decide whether to smoke, exercise, or fill the prescription: you bear the costs and benefits of changing environmental health.
This inversion of health as an external phenomenon is not just a thought-experiment, but a growing concern. Take Pediatricians, for example: trained to diagnose and treat bacterial and viral disease, monitor for malnutrition and administer vaccinations. Pediatricians actually spend most of their office hours treating – according to Landrigan and the National Academies report – Asthma; Developmental Delays and Disorders (including Autism Spectrum); the increased rate of childhood cancers (an alarming 400-fold increase in some rare cancers); and increasingly now, obesity. All the conditions pediatricians spend their time on are ones in which the environment is implicated, yet this is not represented in medical curricula, or at least not proportionately to the time medical professionals spend, addressing these issues professionally.