Barbara Starfield in Venice, Italy for the 23rd Patient Classification Systems/International Conference November 8, 2007. Photo is courtesy of the Alan Mason Chesney Medical Archives
Staring up at the 76 boxes in Barbara Starfield’s collection occupying an entire wall of shelving—or 91 cubic feet—in the Alan Mason Chesney Medical Archives, I immediately wondered how I would ever be able to piece together the life’s work of a world-renowned researcher and academic. As a rising senior majoring in international studies, however, I quickly realized the daunting task of beginning the archival process would be an eye-opening experience due to exposure to Starfield’s groundbreaking work in the areas of primary care and health inequalities. Skimming through the boxes, I started to get a feel for the enormous scope of her collection through refoldering, inventorying the boxes, and reading the carefully annotated notes left by Starfield pertaining to research but also more personal details such as knitting during meetings and her opinion on women’s increased role in the medical field. The collection encompasses her fifty-year career from the early 1960s until her death in 2011 and contains everything from political cartoons to the sophisticated data sets of internationally recognized studies.
Primary care was a largely undervalued field when Starfield’s career first began. She became its major champion, working alongside fellow primary care legends such as Kerr L. White. The world has only recently started to catch onto the need for strong primary care, making Starfield’s work extremely relevant in today’s political discussions. I was particularly impressed with the timeliness of Starfield’s work, and am constantly reminded of her work when hearing reports of rising medical costs and barriers to medical access. While the national health care debate is still waging a war for the hearts and minds of the American public, the United States is realizing that its health care system can no longer claim to be the best in the world, an issue Starfield covered extensively.[1] Starfield long warned that United States’ doctors were becoming too specialized, due to high costs of medical education and fee-per-service incentives. Indeed, she was right; by 2025, it is estimated that the United States will face a shortage of nearly 150,000 doctors, including 50,000 general practitioners.[2] Her work demonstrates the need to provide an all-encompassing primary care system that is both good quality and affordable.
The breadth and depth of Starfield’s collection illustrates how tirelessly she worked to reduce health inequalities that exist due to socioeconomic status in the United States and abroad. Her work has a broad international dimension, especially as she sought to create a unified framework for researching access to care across a variety of countries, which makes it fascinating for a student of international relations. As I consider my senior thesis, Starfield’s work has inspired me to blend public health with an examination of legal rights. I plan to examine the health and human rights inequalities that exist for groups on the fringe of society, such as asylum seekers and migrant workers. Once fully archived, the 76 boxes in Starfield’s collection will be enormously beneficial to researchers hoping to get not only a better understanding of the concepts behind primary care but also a glimpse into the life of this amazing person.