Tag Archives: CDC

Why adoption and the rights of adoptees must be seen as public health issues

The Centers for Disease Control and Prevention provide this model to explain how a public health approach addresses problems and promotes population health.

My memoir, You Don’t Know How Lucky You Are: An Adoptee’s Journey Through the American Adoption Experience, will stand apart from most books and memoirs that focus on adoption and adoptees’ stories.

Unlike other works this field, You Don’t Know How Lucky You Are describes the American adoption experience through a public health lens, and it is written as a “public health memoir.” Please see the CDC Foundation’s definition of public health if you are not sure what public health means or how it approaches health issues.

In terms of policy, You Don’t Know How Lucky You Are will show how the institution—past and present—and the status of being adopted both constitute legitimate public health areas of interest that can be improved by changing outdated and discriminatory laws and policies. This will require the active collaboration of health and public health groups. Both have a moral obligation to advocate for the well-being of all adopted Americans as a population. Both also have a responsibility to correct their past historic roles creating system that denies adoptees rights and also health information that could potentially be life saving for some.

These are some of the public health issues my memoir will address:

  • It will show that being adopted can be measured in long-term health impacts (there are anywhere from 5 million to 9 million U.S. adoptees, and that imprecision is part of the larger problem of counting them, and thus ensuring they count in all public-health decision-making).
  • It will show how and why health and public health professionals need to be involved in policy changes that improve the health for this diverse but large group of Americans, including advocating for legal changes to harmful adoption-records-secrecy laws now used in most U.S. states. Giving more adoptees access to their records will allow them to know their health and family ancestry—something recommended by nearly every leading health and scientific expert.
  • It will show how public health professionals today, namely in state vital records offices, contribute to legal inequality in the treatment of adopted persons seeking equal treatment by law and their family ancestry and medical history.
  • It will show how implicit bias against illegitimately born people—adoptees are viewed that way, even if that is not acknowledged—is seen in longitudinal health outcomes. There are tragic and meticulous historic and current data on mortality and morbidity of those born outside of marriage, which should be of interest to anyone in public health and health who thinks that bias matters in the treatment of people/groups.
  • It will show how doctors and social work professionals from the late 1940s through the 1970s promoted practices that separated infants and their birth families without any peer-reviewed or demonstrable evidence documenting how this would provide a long-term benefit to millions of Americans, namely the relinquished infants and their mothers/birth families. Those impacted were usually vulnerable, young, and powerless women who had few advocates for maintaining family relationships.
  • It will show how the United States’ state-level adoption records laws promoting records secrecy are out of alignment with most developed nations that allow adoptees to access birth records, and all without any evidence of harm. This discussion will also highlight how this represents another form of “American exceptionalism” in health issues, such as the United States’ lack universal health care, and how the GOP in promoting adoption as a Christian/moral “alternative to abortion” has promoted this exceptionalism that harms adoptees as a population.

Health professionals have professional responsibility to help adoptees change state laws

Yesterday, I visited a medical specialist for a routine visit. Like every office of doctors and dental professionals I have seen for well over three decades, this office asked for background about my medical history. Such information can be helpful as shown by nearly all peer-reviewed science to offer information to help patients receive appropriate and responsible health care. 

For the majority of American adoptees, however, this simple process can be insulting and demeaning. It is another reminder how laws in most states deny potentially life-saving information to them because they are adopted. No other group in the United States is denied this critical health information based on status of birth alone. I devote a chapter to practice and problem in my forthcoming book, You Don’t Know How Lucky You Are (Chapter 8: Who Am I?).

The National Institutes of Health highlights why every person needs to know their family history–it can be a matter of life and death with cancer.

Health professionals more than any other group are aware of the role genetics and family history play in determining a patient’s likelihood for disease, health problems, and risks from illness. I wrote at length about his in my post from March 20, 2016, when I was advocating to get my original birth certificate from the State of Michigan (I won that battle three months later). I noted, “Adoptees like all other Americans should by legal right be entitled to this potentially life-saving information. The National Institutes for Health reports there are more than 6,000 genetic and rare diseases. These afflict more than 25 million Americans, and about 30 percent of early deaths can be linked to genetic causes.”

Yet there is almost no support from anyone in all of the health professions or groups like the Centers for Disease Control and Prevention with the rare exception of the American Academy of Pediatrics, which has taken a public stand advocating for this at the national policy level as a matter of science and public health. (Note, this group also was among many health experts who advocated in 1960 for adoption as a social-engineering policy decision that relinquished hundreds of thousands of infants–a little-known and controversial position I explore at length in my forthcoming book [Chapter 2: The Most Suitable Plan]}.

To my surprise, the office I visited did ask if I was adopted or if I did not have access to my family medical history. I was astounded. This was the first time I have ever seen any health facility acknowledge adoptees and that adoptees may not legally have access to their family health history as a matter of legal discrimination denying them their original birth records. 

When I completed my intake forms, I noted this fact and specifically wrote on the form saying it was the first time any health provider acknowledged the existence and reality of an American adoptee. When I completed my exam, I thanked my doctor for this evidence-based protocol and told her it acknowledged millions of Americans may not have their medical history at no fault of their own. She told me her practice absolutely needed to know a patient’s background because many of the health problems they address have genetic precursors. 

I also told her that my forthcoming book would be examining this topic at length. She was excited to hear about this and told me she would like to see the book. That conversation also told me many doctors may also like to know about the issue linking health, public health, and adoption and that my book can reach a large audience of readers who could become advocates for legal reform to change discriminatory state laws.

My immediate proposals to address this are two-fold. For anyone who is an adoptee, I encourage them to tell all of their health providers to change their intake forms to acknowledge health history is a legal issue that adoptees cannot change alone, and that medical professionals have moral and professional responsibilities to issue statements supporting birth record access for all adoptees, without exception. For medical professionals, I encourage you to become familiar with state laws that seal adoptees’ records and explain to the public how this undermines public and human health. This is within your range of practice to encourage healthy lives for everyone. Public health practitioners also need to be part of this, including the CDC.