- I scored 6/10 on the Health Equity Quiz. One of the statistics I found most unexpected was that the greatest difference in life expectancy observed between U.S. counties was 15 years, and that these differences are intensified when comparing subgroups. Intuitively, I would think that variables such as health insurance, heredity, social support, and psychological resiliency would be the primary predictors of health. However, upon further evaluation, zip code is correlated with income, access to healthy and affordable options, safety and sanitation infrastructure, exposure to stressors, coping resources, job security, and crime rate, which in turn affect life expectancy. In particular, it is disturbing that position on the class pyramid is the most potent indicator of health, as evidenced by a health-wealth gradient. I was also astonished that chronic illness costs the U.S. $1.1 trillion in lost work productivity; given this economic burden, it is surprising that more people do not endorse state-sponsored health care, due to its potential to enhance preventative medicine measures and preempt chronic illness (only 48% of registered voters supported ‘Obamacare’ in a July 1 Reuters/Ipsos poll, according to the Huffington Post).
- Unnatural Causes 3, “Becoming American,” addressed the Latino Health Paradox, the phenomena that new Mexican immigrants to the United States possess better health (in terms of lower rates of obesity, heart disease, diabetes, etc.) than their native-born American counterparts, including those of higher socioeconomic status and education. The longer immigrants live in the United States, the more they adopt an Americanized lifestyle (poor diet, sedentary activity levels, occupational stress), are exposed to discrimination, and their health begins to resemble other Americans. The buffering effects of being a new immigrant are attributed to cultural variables such as family cohesiveness, social support, and affiliation with cultural identity, which are eroded with longer duration in America and disappear in successive generations. The video suggests that providing opportunities for community involvement, decent housing, jobs, and wages, and retaining traditions of the culture of origin can extend the protective effects to health.
- According to the ecological approach viewed through the lens of political ecology, at a macro-level of analysis, historical, economic, social, and political transformations of populations bear directly on disease origination, frequency, distribution, and dissemination. As McElroy cites, “fluctuations among, or disruption of biotic, abiotic, and cultural subsystems,” when exceeding human adaptive capacity, can lead to “environmental degradation, loss of resources, population decline, changes in trophic (feeding) relations, and disease”. For instance, shistosomiasis development in North Africa in the 1950s and 1960s was a consequence of dam construction as part of Egyptian economic policy, which perturbed ecological niches and caused disease emergence. By the logic of cultural ecology, culturally entrenched beliefs and practices can disturb fragile human-pathogen equilibriums and hence create or spread disease. For example, a 1988 study by the Mulls examined how rural Pakistani mothers rejected oral rehydration therapy on the grounds that diarrhea was a ‘hot’ illness necessitating ‘cold’ treatment, a category under which Western did not fall according to their ethnomedical model. Here, cultural beliefs and individual choice about employing a treatment modality precluded their use of ORT and perpetuated morality from diarrheal illnesses. Furthermore, biology can influence disease prevalence by adaptive mutations conferring selective advantage, as is the case with heterozygosity of Sickle Cell alleles which engenders malarial resistance.
Mull, J.D., & Mull, D.S. (1988) “Mothers’ concepts of childhood diarrhea in rural Pakistan:
what ORT program planners should know”. Social Science & Medicine, 27(1), 53-67.