Is inequality making us sick?
This is the telling question asked in a video series produced by California Newsreel and shown by PBS a couple of years ago. As a public health nurse I use this series often to draw attention to the wide gap between people and neighborhoods that exists when it comes to health. It seems that our zip codes have more to do with our health than our genetic code. This is a serious indictment. While we hear about the “widening gaps” between rich and poor and the problem with distribution of wealth, rarely does anyone drill it down to diseases people get, life span, and all the other factors that go into overall wellness.
All of us, regardless of our station in life, interact with the world around us. And it is in this world that our health is created. So if we live in a neighborhood that has clean air, wide sidewalks, well-lit streets and play grounds, along with affordable farmers markets for fruit and vegetables, we have a far better chance at health than the person who has none of these things. Turns out that person is far more likely to struggle with asthma, lack of physical activity, obesity and poor nutrition.
As debates on health and healthcare continue it makes sense to focus on these most basic things, termed in the public health world as the “social determinants of health“. The World Health Organization explains these determinants this way: “the conditions in which people are born, grow, live, work and age, including the health system”. Paying attention to these determinants would change outcomes to a degree that any costs incurred would be covered through reduced rates of diabetes, high blood pressure, heart disease and the list could go on and on. Transforming neighborhoods does as much or more to increase health and wellness as diet and exercise.
Nancy Krieger, an epidemiologist from Harvard School of Public Health says this: “We interact constantly with the world in which we are engaged. That’s the way in which the biology actually happens. We carry our history in our bodies, how could we not?”
The question becomes how can we, how can I, be a part of changing the communities where we live world-wide? While I believe governments, both state and federal, can help with policies, they aren’t the ones who can create communities that care. Only people who live within those communities have the capacity to do that. So as we bicker about politics and point fingers we’re wasting a lot of time. Time that could be spent in helping to transform.
Take a look at the introduction to the series and see what you think.