Message-Id: <199610091909.OAA07144@medicine>
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Date: Wed, 09 Oct 1996 14:07:12 -0400
To: socgrad@csf.colorado.edu,
        Sociology Graduate Students -- International <socgrad@csf.colorado.edu>
From: ghougham@medicine.bsd.uchicago.edu (Gavin Hougham)
Subject: Re: foot doctors
At 11:10 PM 10/8/96 CDT, Jean Czerlinski wrote:

>In Hyde Park I have the impression that a lot of foot-doctor
>ads are directed toward the poor.  Why is this?  Are there
>more foot problems among the poor?  Why?  Is it directed more
>toward the working poor or the unemployed... [stuff deleted]

Well, there are a number of things going on, but here's what I have picked
up on this issue (and remember, I'm no physician).  As far as I understand
it, there are serious periperal sensory neuropathies (nerve disorders in the
extremities) associated with some forms of diabetes and lead poisoning,
among other things.  The nerve damage in the feet causes a multitude of
cascading problems (if you can't FEEL an ulcer or corn developing, or an ill
fitting shoe, it gets worse, for example).  Diabetes and lead poisoning tend
to be overrepresented in the poor for a host of other reasons (maybe
nutritional deficits, restricted or late access to health care services,
housing deficits, whatever...).  So, what you are observing with respect to
what seems like mass advertising of podiatric services to the poor is
coincident with targeted advertising to folks with lots of foot problems
due, in part, to complications attendent with high incidence of diabetes,
etc, etc.  Your other observations on how the working poor might have jobs
that expose their feet to excessive risk is also plausible and testable.
Another hypothesis you'd have to rule out the geographic propensity of
health care providers to cluster, and as Hyde Park is the race and class
integrated neighborhood surrounding the Univ. of Chicago's Medical Center
complex, this is also a possibility. 

I am not SURE I am right on this, but this would be a start...  Fun with
epidemiology.

Gavin H.

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Gavin Hougham, Ph.D. (cand.)
The University of Chicago Medical Center
Section of General Internal Medicine and
Department of Sociology
5841 South Maryland Ave. (MC 6098)
Chicago, IL 60637

(312) 702-6735
ghougham@medicine.bsd.uchicago.edu
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