I got a 4 out of 10 on the Health Equity Quiz. The answers to these questions were really eye-opening, both about the success of the U.S. medical system compared to other countries, as well as about how much wealth and social class determine health. Considering how much we Americans invest in our healthcare, I had expected us to be better than 29th in the world in terms of longevity! I was also surprised by how much the health of individuals in the U.S. depends on class level, versus other factors like smoking or exercise.
When the Bough Breaks documents how the effect of racism against African Americans—which many Caucasians think is a thing of the past—is still powerful enough to severely increase the rate of premature births for African American mothers. Even correcting for education and wealth, which usually predict the health of newborns, African American women are three times more likely than white women to birth premature or underweight babies. Researchers have shown that this risk is not due to any genetic basis from African heritage. In fact, the rates of premature birth rates in African immigrants to the U.S. are equal to those of white Americans. This trend stops after the first generation of immigrants, however. After that, the immigrants’ future generations suffer from the same high risk of underweight babies as African Americans.
This prompted researchers to consider how the chronic stress of racism across a woman’s life might impact her pregnancy. Since stress hormones play a natural role in triggering labor, women with constantly high levels of these hormones are more likely to go into early labor. Stress can also limit bloodflow to the placenta and cause inflammation inside the uterus, both limiting fetal growth and prompting premature delivery.
Social structures like racism, as well as economic, environmental, and political forces can contribute to the health of individuals. While I generally focus on the biological and lifestyle factors that influence health, these other aspects can be very important. For example, political action and the environment both influenced the spread of disease in North Africa when government initiatives built dams on the Nile River. Bringing water sources close to new populations increased the prevalence of a parasitic disease called schistosomiasis, which thrives in water snails. The culture of these affected areas determines who develops the disease, and how it has progressed. Since many women in this area are Muslim and do not swim, the disease mostly afflicts fishermen and young boys. Since a symptom of the disease, blood in the urine, is interpreted as a rite of passage for boys, few of the afflicted individuals recognize it as a sign of illness and seek treatment.