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, stands apart from most books and memoirs that focus on adoption and adoptees’ stories.
Unlike other works in 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 shows 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the status of being adopted both constitute legitimate public health areas of interest that can be improved by changing outdated and discriminatory laws and policies.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 a 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 addresses:
- It shows 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 shows 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 shows 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 shows 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 shows 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 shows 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 also highlights 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.
(Published Jan. 16, 2018; updated July 27, 2019)