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 29th 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.