This article is from the archives of the UB Reporter.

Hospital experience sets life’s course

Denial of emergency room care seals Street’s professional fate as a sociologist

Published: June 30, 2005

Contributing Editor

Debra A. Street arrived in northwest Florida feeling very much like "a fish out of water," a feeling she welcomed rather than reviled.


Debra Street, a new member of the faculty of the Department of Sociology, looks forward to continuing her research on aging and long-term care, topics that are among the strategic strengths identified by the UB 2020 institutional planning process.

"That helped me to look at society in ways I might not have had I remained in Canada," recalls Street, an assistant professor in the Department of Sociology in the College of Arts and Sciences.

A native of tiny Fort Erie, Ontario, Street found the upper part of Florida—"lower Alabama" as the locals call it—more like the deep South than the rest of the state, with an abundance of religions, as well as residents willing to openly discuss their places of worship.

"Canadians tend to be very reticent about asking people's religious beliefs," Street says. "They regard that as a private matter, and here religion is much more of a public experience. So many people in the south asked me where I went to church and that just doesn't happen in Canada."

Street enrolled in a course on the sociology of religion at the University of West Florida, mostly to help her understand the distinctions between various sects of churches in the south.

But she was left incredulous over a second difference she found between Canada and the U.S. While in Florida, she was turned away by a hospital emergency room because her health insurance policy hadn't yet kicked in.

"I was denied care at the for-profit hospital," Street remembers. "They suggested that if I needed care without group health insurance, that I might more happily go down the road to the charity hospital. For a Canadian, access to health care in an emergency is a birthright. Everyone's entitled to it. So you don't have to be lucky. You don't have to have a rich father to get a liver transplant when you need one. And you don't have to have a fish fry when your kid gets sick to try to raise money."

The incident sealed Street's fate as a sociologist.

"It was probably what made me most interested in sociology. It was a personal experience, but it was a personal experience writ large in terms of inequalities in the United States," Street says.

"And that is the core, substantive focus of sociology—understanding inequalities of various types. It could be inequalities in access to health care, inequalities in income and wealth—why do rich people seem to be significant and poor people insignificant—gender and race/ethnic inequalities. That's what sociologists want to understand."

One bachelor's degree, master's degree, doctoral degree and a post-doc later, Street has enjoyed a busy career in sociology, the latest stop of which brought her last fall to UB.

"I really did not ever plan to finish up more than a B.A. in the subject, but then a professor—a very interested, engaging professor—asked me where I was going to graduate school. And I wasn't entirely sure what graduate school was," Street says with a laugh.

"I'd come from a working-class family: my dad was a carpenter, my mother was a homemaker. And we didn't have any family knowledge about it. I might not have even been sure at that point which came first—a master's degree or a Ph.D. I knew you got both of them, but I didn't really know very much about it."

Street's interest in inequalities led her first to coauthor a book about the differences in retirement plans for women around the world. "Women, Work and Pensions: International Issues and Prospects," published in 2001, revealed the lack of a fair pension policy for female workers in most countries. One exception: New Zealand, which recognized unpaid work, i.e. having and raising children, "as socially useful and necessary" and so offered both men and women a flat-rate pension based on residency.

"Motherhood carries a big cost for women in terms of later-life income," Street notes. "If you have to take time out of work to bear a child and care for a child, that's time away from work when you're not generating any wage income or pension credits, and it can be very difficult to catch up. There's no pension penalty in terms of late-life outcomes for a man becoming a father, but there is a penalty for a woman becoming a mother. So it's not a parent penalty in terms of pension income, it's a mother penalty. There are ways that government pension systems can compensate for that."

Street is wrapping up research she conducted in Florida on aging and long-term care and plans to continue the same topics of study here in Western New York.

"I'm interested in any public policy that influences a person's health or economic well-being. For older people, no one gets up in the morning and says, 'I can't wait to get into a nursing home,'" Street says. "I'm studying residents who are already in long-term care, working backwards from there to find out what was the tipping point for them that they had to leave their own homes. It's fascinating, finding what it is about people's lives that led them to avoid or acquire chronic conditions as they get older."

Street is looking forward to continuing her research at UB because aging and chronic disease are areas of study that are among the strategic strengths identified by the UB 2020 strategic planning process.

To be effective, sociologists work to identify solutions that can be used by the general population, Street says, adding that Western New York is "a natural laboratory" for anyone looking at issues of aging.

"There are lots of people aging in place here. The population is older here in comparison to the rest of the United States, with 14 or 15 percent over age 65," she says. "I'd like to figure out ways to intervene at the population level because those are probably going to be the only solutions that we can afford. For a health-care intervention to work realistically, it's going to have to be one that is fairly low tech and broadly applicable."

For example, hailing from Fort Erie, Street is well aware of Buffalo's need to develop and maintain its downtown waterfront. Why not make it one of several appealing destinations that people would want to walk to? Like Iowa, where a recent statewide initiative is aimed at getting folks up and walking, just walking, Street would like to see the city adopt a similar program to boost better health, along with jobs and economic growth.

"If you could get 5 percent of a state's population walking that isn't doing it now, the health improvements and health-care cost savings could be potentially staggering," Street says. "The trick is to motivate an entire population, possibly by creating destinations where people can walk to. In North American society, there aren't many places to walk to. People walk around in a circle or walk around their neighborhoods, so they walk for the sake of walking, but don't walk to a place. Link public transportation that's attractive and affordable to places where people will want to spend time, and then people would probably get up and walk."