by James Parks, Mar 25, 2008
Americans spend more money on health care than any other country, but the benefits of our health care system are distributed unequally. We know 47 million Americans have no health care and the health care system is broken. Ninety-five percent of the 26,000 people who responded to the AFL-CIO/Working America 2008 Health Care for America Survey released today (click here) say the system needs fundamental change or to be completely rebuilt. Now, a growing body of research finds the social conditions in which Americans live, work and are born into also affect our health and how long we live.
A groundbreaking new PBS documentary series shows that economic and social inequality play a significant role in the nation’s health. The documentary, “Unnatural Causes: Is Inequality Making Us Sick?” airs nationally March 27 at 10 p.m., but check your local listings to find out exactly when the series will air in your area.
The series makes the case that U.S. life expectancy grew in the mid-20th century not only because of new drugs and medical technologies, but also because of reforms such as the eight-hour workday, child labor laws, universal high school, civil rights laws, a progressive income tax, Social Security and the right to form unions that ensured benefits from economic growth were shared more widely.
Then the leadership of the nation changed direction. In the midst of a recession, the Reagan administration cut taxes on the rich, slashed social programs and deregulated business—and in doing so, placed a disproportionate burden on the middle class and the poor. The Bush administration exacerbated the situation by expanding the tax cuts and actively attacking the vehicles that reduced inequality such as unions and living wages.
As inequality grew, the U.S. life expectancy ranking dropped—down from the top five in the 1950s, and lower than even a few years ago, as more countries surpass the United States with improved health.
Larry Adelman, creator and executive producer of the four-hour TV series, says in a Point of View column on the AFL-CIO website that “the single best predictor of one’s health is not diet, exercise or even smoking but class status.”
But it’s not only the poverty-stricken who are afflicted—after all, what would be so surprising about that?—but the middle classes as well. At each descending step down the class pyramid, from the rich to the middle to the poor, people tend to be sicker and die sooner. Top executives have, on average, better health than managers, managers fare better than supervisors and technical personnel, supervisors do better than line, service and clerical workers, and the unemployed have the worst health of all. High school dropouts die, on average, six years sooner than college graduates. In other words, it’s not CEOs who are dying of coronary heart disease but those who work for them.
The PBS series points out that much of what can improve health lies outside an individual’s control: better land use, transportation and business investment; neighborhoods that include green space so people can walk, jog, bike and play; and quality schools. Another key component of a healthy life comes from benefits that usually are part of a union contract, such as guaranteeing paid vacations, paid family leave and living wage jobs.
In the documentary, Harvard sociologist David Williams says:
There is an Axis of Evil of inequality, of racism, of poverty, of economic deprivation that is adversely affecting the health of the American people. As a nation, we can address the racial and economic inequalities that increase our risk of disease now, or we can pay to repair our bodies later.
Public health agencies and more than 100 other groups are organizing screenings of the series, which also will be shown at town meetings and policy forums around the country over the next year. You can join in the discussion and download video clips, lesson plans and other resources, including an events calendar, by clicking here.
The first of the seven episodes chronicles the struggles of Eboni Cochran and her neighbors in the Rubbertown section of Louisville, Ky., who have organized to demand that chemical companies in their area do a better job of monitoring and containing hazardous materials that seep into the soil and air (see video above). Across the country, polluting industries are concentrated in communities where the poor and people of color live.
Other examples of the health results of inequality from other episodes include:
- In western Michigan, a factory moves to Mexico for cheaper labor, undercutting the lives—and health—of a white, working-class community. In Sweden, where the parent company is based, a similar plant closure has a very different impact on workers because of protective government policies.
- In Kennett Square, Pa., the “mushroom capital of the world,” Mexican immigrants arrive healthier than native-born Americans but discover that the longer they are here, the harder it is to maintain their health.
- In Atlanta, an African American lawyer delivers a premature baby despite making healthy choices and having the advantages of social status—like so many other middle and upper income black women. Researchers wonder if the cumulative wear and tear of a lifetime of racial discrimination imposes an added health risk during pregnancy and beyond.
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