Racism is still here. Some places it is not as prevalent as others. Racism carries worrisome factors for everyday life that we do not always think about. Our babies, either born or still in the womb feel the pressure and stress that we feel when dealing with such a intense topic. As Americans both black white we expect our health care system to be one of the best, but this is not always true. Women who decide to be mothers are carefully  monitored by themselves, doctors, and family members to help ensure a healthy pregnancy and baby. When stress accompanies you during your pregnancy and it becomes to much it can wreak havoc on your body. complications can arise and can even cause low birth weight or premature births.

Premature birth can happen for many reasons and chooses to happen the most in African American women. African American women are three times more likely to have premature birth than a white woman. It is believed that  one’s upbringing, social standing, health, and education are all important factors. Other important factors include a persons environmental and political lifestyle as well. I would think that with how wary we are about our health system  that this would not be a great issue. Some people I’m sure would love to ignore this issue. But the is that it is real and that pregnant women or women wanting kids need to greatly relieve the stress in their lives as much as possible so that a healthier pregnancy is achieved.

–Health Equity Quiz: When I took the Health Equity Quiz I only got 50%. I knew a lot of the specific disparities, but I was unaware of most of the statistics about where the United States ranked among the world. I think the question that I got wrong, that I was most surprised about was the question about which ethnic group had the best overall health in the U.S. I had never heard of the “Latino Paradox”, and I think I would like to read up on that more, because that was quite an interesting statistic. On a side note, the statistic I found the most depressing was the one about the life expectancy of young Black men in Harlem. I answered that question correctly, but I still find it shocking and sad.

–Unnatural Causes- “Place Matters: I chose the “Place Matters” episode. This short film was about once prosperous communities in the Pacific Northwest, that have fallen on very hard times. This film discussed the prevalence of disease in these low income neighborhoods. A lot of these families, that left their home countries in order to make a better life in the United States, have found their health in actually worse shape than it was before. Many of the illnesses that are endemic in these communities are heart disease and asthma. The emotional stresses and the environmental stressors that many of the adults endure, cause them to have severe cardiac diseases, which can cut their lifespan by 30%. The children in these communities have such poor air quality, outside with pollution and inside with mold and other contaminants, that they are six times more likely to be hospitalized for asthma. And since most of these people are too poverty stricken to have proper health insurance, they end up in the ER for every episode. There was some community action to help rebuild the neighborhood of High Point into a multi-income community, but some of the poorest of the poor lost out again and were permanently displaced.

–Influences on Issues of Illness: There are many factors that affect the spread and treatment of illness, particularly in these impoverished, forgotten cities, like the one discussed in “Place Matters”. A lot of the community politics do not take into account the poorest residents and therefore they are under the radar and do not receive the services they are in need of. Also, the economics of a city fallen on hard times, causes those left there to be invisible to the surrounding communities, this is happening in parts of Detroit right now. Lastly, the environment presented in the film, shows that even if the residents are trying to take good care of their health and the health of their children, it is a lost cause, because they will still be exposed to the environmental hazards that make them ill in the first place. All of these factors lead to the constant spread of poverty and illness, which go hand and hand.

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 29^th 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.

I received a score of 5/10 on the Health Activity Quiz.  As a Public Health student, most of the statistics presented, such as our worldwide life expectancy ranking, the amount
we spend on healthcare, the life expectancy difference between counties, and the amount of park space in different neighborhoods, didn’t surprise me because these are areas that are consistently covered.  The statistic that did surprise me was that non-native Latinos have a better health outcomes on average compared to other U.S. populations and that within 5 years of immigrating to the U.S., their health begins to deteriorate and gets to the level of low-income Americans.

The case study that I chose was In Sickness and in Wealth.  This case study looks at
research presented by scientists on how the health of an individual is largely determined by their income.  The study looks at the lives of a CEO, lab supervisor, janitor, and an unemployed mother that all live in different counties within Louisville, Kentucky.  We get a small glimpse into the lives of each individual to get an  nderstanding of what life is like from their perspective.  We learn that each individual’s life expectancy varies by each county, the CEO’s 2 years more than the national
average, the lab supervisor’s 4 years less than the CEO, the janitor’s 6 years less than the CEO, and the unemployed mother’s 9 years less than the CEO.  Throughout the case study, we are presented with results of various researchers studies.  One such study looked at how the health of an individual decreases as you go down the social hierarchy, such as from the CEO to the unemployed mother.  We were also given the results of a study that showed people who have less stress in their lives have lower
levels of the hormone cortisol and were therefore healthier compared to those
with more stressfully lives.

Politics and economics can play a role in how much income a person has, which has an influence on the environment and culture that they live in.  If that happens to be a
low-income environment, it can have negative biological affect on that person’s
health.  If a large number of people live in an unhealthy environment, it can result in an illness spreading more easily with treatment possibly not being an option due to their income status.

• 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.

References

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.

I scored a 5 out of 10 on the Health Equity quiz, which was lower than I expected. I was incredibly surprised to find out that the US life expectancy is only  29^th in the world. I assumed that because we have had so many medical advancements and have vast access to health care and resources compared to many other countries that this ranking would be closer to the top ten or so. What I also found interesting was that the greatest difference in life expectancy between counties in the US was 15 years. I find this to be a better indicator of life expectancy because it is not as general and takes into account environmental and lifestyle factors. This statistic also played into wealth being the number one predictor of some ones health as there are many suburbs in America in which wealth is concentrated and other urban cities that are poverty stricken.

I chose to elaborate on the ‘Collateral Damage’ video. I find it ironic that we usually think of urbanization and globalization as indicators of wealth and prosperity, while in the Marshall Islands, disease and poverty are a direct result of these developments. In this nation of islands, Tuberculosis is 23 times more prevalent than in the US. This rampant disease, which spreads easily in densely populated areas, is the result of the overcrowding of the island of Ebon, which at one mile long is home to ten thousand people. Ebon is the perfect environment for tuberculosis to spread because with up to twenty people living in one house, if one person is sick more often than not everyone in the home will become sick. These conditions of poverty lower compromise the immune system, and the stress of poverty can contribute directly to this malnutrition.

To make room for nuclear testing during World War II, the US military resettled thousands of people on different islands, tearing apart their culture. The Marshallese community structure broke down and there were significant impacts on health through the stress of not being able to grow food, becoming diabetic through a western diet, and contaminated land. The Marshallese were not an urban group of people but we forced them to urbanize and infectious diseases such as tuberculosis took off with overcrowding. In order to eradicate tuberculosis, the Marshall islands need improved living conditions, alleviated crowding, and improved nutrition, which are all factors we imposed on them through US development and urbanization of the islands.

Politics: The island with the military base is home to many affluent white contractors that live there with access to medicine and grocery stores while Marshallese workers have to take a ferry home everyday to their dense, overpopulated living conditions.

Economics: The Marshallese cannot afford care for tuberculosis at hospitals and they have to rely on public health officials to provide them with medicine for the treatment of tuberculosis.

Culture: Many of the homes on Ebon do not have inside toilets so inhabitants have to travel to public restrooms that do not have sinks and are unable to wash their hands until they return home, which allows for the spreading of disease.

Biology: The treatment of tuberculosis involves a strict drug regimen and if not completed the disease can come back in a deadly drug resistant form that is very dangerous.

Individual choice: People of the Marshall Islands are ashamed to admit they have the disease and will not seek treatment for it, which in turn will further spread tuberculosis.

When I took the Health Equality Quiz I got a 7 out 10. The question which I found the most surprising was the one about the differences among life expectancy for various counties. There was a side note about the difference in a county in new jersey having a 33 year long life expectancy than another county in North Dakota. To me something that drastic shows just much inequality in health care we have here in the United States. Just because of affluence someone can on average live almost a generation longer than another is kind of ridiculous. I understand that class distinctions are necessary and common place but they should not have such a strong effect on an individual’s life.

The Case study that I found the most interesting was entitled “Not just a paycheck”. This segment focused on a major refrigeration company that closed down their American factory in order to move overseas. This resulted in lots of people being laid off a few years from retirement unable to receive their full pensions and stuck taking minimum wage jobs just to make ends meet. For many this caused them to live on fifty percent or less of their normal (prior to layoff) income. While many of these upper middle class families moved out because they could no longer afford the taxes, much of the lakefront property was being redeveloped into larger homes. No only did this clip give a view to the urbanization of the property but it also the effect that the psychological stress had on the laid off employees. Some struggled with depression, drinking issues, and even health problems from internalized stress such as headaches and jaw clenching.

The spread and treatment of a disease or illness incorporates many factors: politics, economics, environment, and culture. Policies development can lead to ordinances that require quarantines, or vaccines, or even provide general health care for citizens. By enacting these things the spread of disease is halted, or slowed down so that not as many can be infected. Politics also impacts which drugs are permitted for prescribed use. The economy can impact what policies would be passed. It can also affect drug development, if a company is worried about losing its patent on one of its major drugs they may redesign it to sell it under different circumstances, as was done with the drug BiDil. By spending time designing narcotics companies are missing opportunities to discover the cure for something else.

I got an 8/10 on the Health Equity Quiz. I took History of American and European Healthcare (HST 425) in the previous summer session, and that helped a lot with most of the questions. I was most surprised that recent Latino immigrants have the best overall health in the United States. I expected first generation immigrants to have lower overall health than U.S. citizens, or even second and third generation immigrants.

The case study that I am going to talk about is the Pima Indians and their water supply. Starting in the 1890s, irrigation projects on the Gila River upstream of the Pima Indians developed extensively. This brought a reliable water supply to the white farmers and ranchers upstream, and was quite beneficial for them. However, these projects caused the Gila River to drastically diminish downstream, severely crippling the Pima Indians who relied on the river to grow their own food. Winters v. United States did little to help the Pima Indians in 1908. With the Coolidge dam in 1930, the Pima Indian’s water supply increased somewhat, but not nearly as much as what was needed. It would not be until the Arizona Water Settlements Act of 2004 that the Pima Indians would gain water rights significant enough to bring a difference.

There are a lot of ways in which politics and economics can influence the development and spread of treatments and medical improvements. The most significant is the financial cost of expanding infrastructure to support new treatments or to supply medicine, in my opinion at least. For example, an area with a high rate of poverty is unlikely to have many hospitals or physicians. Caring for the poor does not generally pay well, and for many in the medical field money is the bottom line. The environment can also have a drastic effect on one’s health. In the case of the Pima Indians, the loss of their primary source of water dealt a huge blow to their health. Without water, the Pima were unable to sustain themselves with their own crops, and many had to subsist on government surplus, which was generally not very healthy.

1. I thought I would have done a lot better on the health equity quiz but I honestly did pretty terrible. The statistics that I found most surprising was that Latino immigrants have better health when they arrive to the U.S. and then their advantages disappear. I thought this was interesting because I would have thought that the U.S. if anything would improve their health, but it makes sense because health care is so expensive here. Also I thought the fact the the top 1% of American families own more wealth than the bottom 90% combined. That is just terrible and is not right at all, it honestly just makes me sad because it just shows how they have so much unnecessary money.

2. The case study I chose to watch was “Not Just a Paycheck.” I was about a company Electrolux from Greenville Michigan closed and moved to Mexico. The workers in Michigan received $15 an hour plus health benefits while in Mexico they were able to pay the workers made $1.57 an hour. Many people were laid off but the company had to do what was best for them. It added $1 million a year to the company. It goes on to examine the consequences of job loss, which prove to be enormous. It shows that it is not just a lost job the stresses of money bring people sleep loss, nausea, anxiety, depression. It brings people to overeat and lead to obesity and with obesity comes all sorts of health problems. It adds such a stress on these people it is so sad. Some people just don’t know how to cope with the issues of being laid off. It was interesting too because it showed that after Electrolux closed at the nearby hospital the cases for depression increased so much. It shows that even with areas of development, urbanization, and globalization circumstances happen like loosing a job and because money is so important by means of survival here it creates all kinds of health problems.

3. Politics influence the development and spread, and treatment of illness because with their help politics can completely help a population, with advances in who is able to get medical care. Economics can influence because it has to do with the amount of wealth a person of area has so they more wealthy it is able to help the spread of illnesses, and allowing people the ability to get treated. Environment plays a big part as well because a more undeveloped environment might not have the necessary medical devices to treat illnesses which cause them to spread. Cultures can perceive illnesses differently. This could mean that a culture is about a holistic or spiritual approach which could lead to the spread of an illness because they aren’t getting treated as how someone in our culture would see fit. In biology some people may develop illnesses easier then others and also could have been given a genetic disease which keeps the disease spreading. Individual choice is your own beliefs and by certain choices a person can put themselves in positions to get illnesses like smoking can lead to cancer. Some people may even make the choice to not get treatment for an illness.

I have taken a lot of classes in the past concerning health and health care so I expected to do decently well.  I got 6 out of 10 correct.  Most of the questions I got wrong were concerning statistics and my answers were close.  The question that I was most surprised about was the one about health care spending in the U.S. I was not aware that we were spending so much more on health care.  One of the questions I got right but was still surprised about was the fact that recent Latino immigrants have better health than the average American.  In another class I learned that each generation of a family has worse health outcomes the longer they have been in the U.S.  To me that really says something about the American lifestyle.

One of the videos I watched was “When the Bough Breaks”, which concerned the drastic disparities in infant mortality rates between black and white women.  Researchers originally have attributed this to differences in socio-economic factors such as wealth and education levels.  When these were factored out the gap in infant mortality rate widened, rather than shrunk.  It was determined that college educated black women had higher infant mortality rates than white women who did not complete high school.  Researchers are now working under the assumption that the everyday stress of racism felt by black women is leading to poor health outcomes in infants, putting them at risk of death before age one.  This everyday stress affects the baby in utero through decreased blood flow and can lead to premature birth, which was the case for Kim Anderson.  The conclusion is that nine months of pre-natal care is not enough.  Things need to start changing so that black women do not feel this stress and this cycle can end.

The development, spread, and treatment of illness is affected by several different areas, as we learned this week in lecture.

Politics: Politics can be influential in regards to health care policy.  This includes how a government reacts to an epidemic to how health care is made available to the people

Economics: One example of how economics can affect the spread of illness is the case of shistosomiasis along the Nile River.  It was because of economic development and the building of the dams that interrupted the homeostatic balance between humans and parasitic disease, bring the parasite closer to local villages.

Environment: The environment can become either a breeding ground for disease or prevent it by being an unlivable environment for things like bacteria and parasites.

Culture: Culture effect come from how people understand disease and their behaviors, which can increase or decrease the likelihood of infection.  In the case of shistosomiasis, cultural norms surrounding water affect who gets infected.  Fishermen and young boys have high risk of contracting it because they spend a great deal of time in the water.  Muslim women, on the other hand rarely contract it because they do not enter the water.

Biology: Biology can affect disease in terms of peoples susceptibility.  One example of this is the case of malaria and sickle cell anemia, where being a carrier of the sickle cell gene prevents malaria .

Individual Choice: One example of the effect of individual choice is the decision to participate in risky behaviors such as drinking, smoking, and engaging is unsafe sex practices.