How did the tallest oak tree in the forest get to be the tallest tree in the forest? Did it grow from a seed that produces only tall, big trees? The answer to that question is no, according to the experts, as I am not a botanist.
Quercus, the oak tree genus, contains a diverse group of hundreds of species. All start from a tiny seed, an acorn. Hidden inside every acorn is the potential to be a fully complete tree if the conditions are right. If an acorn is planted in the right environment with sunlight, soil, moisture and is protected from damage (chemical or being eaten by bugs, deer, squirrels or mice), it will grow to be a normal oak. As noted by one expert, even fungal pathogens that cause various forms of root rot can infect and cause a tree to die a long, slow death, or it may become structurally unsound, with no outward symptoms. Acorns from the same tree planted in different environments will result in different trees or no tree at all. Acorns and growing trees that have full exposure to the most ideal conditions experience their full potential, these become the largest trees. Interestingly, the acorn creates none of these conditions for itself. It has no say over where it falls or is planted.
Not so different from people I believe. We have huge differences in health outcomes between different populations in the U.S., with infant deaths and diseases being significantly higher in minority populations. It is very easy to speculate about differences in health outcomes and behaviors of different populations and ignore some of the conditions that exist in the environment in which they developed. It’s very easy to assume that all populations have the same conditions for growth and that they have full control over those conditions. In public health, we are understanding more and more about how these environmental or social conditions affect health. Not all populations have adequate income and access to the resources to get healthy foods; safe, chemical-free and violence-free places to live; or exposure to healthcare and health information. We know now that in addition to biology, all these things matter and must be considered if we are to achieve the best health outcomes for all, or health equity. Yes, our vision is a forest where all acorns achieve their full potential as mighty oak trees.
