Wealth and Health: Why Black, Brown, and Poor People Are Dying of COVID19

In Sickness and in Wealth

Directed by Llewellyn M Smith (2008)

Film Review

It’s no mystery and doesn’t need yet more study. Epidemiologists have known since the late seventies that health and life expectancy directly correlate with income level, irrespective of genetics, lifestyle (smoking, exercise, diet, etc), or access to medical care. This documentary is a about a 2008 study that examined four Louisville districts with varying average income levels.

Residents in the wealthiest district earned incomes averaging $100,000+. Nearly all had college degrees and owned their own homes. Their average life expectancy was 80 years.

In the second most prosperous district, most residents had high school diplomas. Although a minority owned their homes, they considered themselves solidly middle class. They had an average life expectancy of 76 years.

In the third wealthiest district, fewer were high school graduates. Many had difficulty maintaining stable employment and lived in subsidized housing. Lacking in chain supermarkets or other access to fresh produce, the district is characterized as a food desert. The average life expectancy here was 74 years. In the poorest district, unemployment was double the national average, and many residents suffered from chronic illness and received disability benefits. Most had failed to complete high school. Thirty percent lived below the national poverty level. Their average life expectancy was 70 years.

The study reinforced prior research* indicating that neither genetics, lifestyle, nor access to medical care has as much influence on health outcomes as income and social status.

Scientists believe low social status leads to poorer immune function and adverse health effects due to the total lack of control poor people have over their lives. This absence of control tends to result in high chronic stress levels that contribute directly to high blood pressure, heart disease, obesity, and impaired immunity.

Overall African Americans had worse health outcomes than white residents regardless of income or social status. Scientists believe this relates to the chronic stress they experience related to racial slights and abuse in their interactions with white people.

More recent research indicates that growing inequality (ie tax and public spending policies that grants billionaires a larger and larger share of the wealth working people create) since the 2008 economic crash is worsening health discrepancies based on wealth and racial differences. The solution is no mystery, either. We will never end inequality so long as we allow private banks to create and control our money system. Contrary to popular belief, private banks presently create 97% of our money (out of thin air) when they issue loans.**

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*The film mentions 1967-1977 The Whitehall Study https://unhealthywork.org/classic-studies/the-whitehall-study/

**See The Battle for Public Control of Money

The full film can be viewed free at Kanopy by anyone with a public library card. Type Kanopy and the name of your library into your search engine.

 

The True Cost of Cheap Meat

Farmageddon: The True Cost of Cheap Meat

By Philip Lymbery with Isobel Oakeshott

Bloomsbury Press (2014)

Book Review

Farmageddon is about the false economy of industrial meat production. While the corporations that promote factory farming applaud themselves for producing “cheap meat” for poor people, when societal costs are counted, industrially produced meat costs society approximately 25 times the sticker price. So as not to infringe on corporate profits, the excess costs (for environmental clean-up and a myriad of health problems) are transferred to the taxpayer.

Lymbery, a long time organic farming proponent, provides an extremely thorough and compelling expose of the numerous drawbacks of raising livestock in concrete warehouses. The side effects of living adjacent to a factory farm include air and water pollution by toxic herbicides and pesticides, nitrates, pathogenic bacteria and arsenic; loss of songbirds, bees and other insect species; reduced life expectancy,* increased exposure to disease carrying mosquitoes, loss of earthworms (due to fertilizer-related soil acidification), increased incidence (by threefold) of childhood asthma; increased antibiotic resistance (due to routine feeding of antibiotics to factory farmed cows, pigs and chickens); reduced sperm counts and increased breast cancer and renal tumors related to Roundup, the herbicide used with GMO crops.

Lymbery also includes a section on industrially farmed fish and they risks they pose to the health of wild fish populations.

His final chapter includes a variety of policy recommendations that could facilitate a move away from industrial farming to safer, less environmentally destructive traditional farming.

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*Individuals who live adjacent to intensive dairy farms have a ten year decrease in life expectancy.

How Cuba is Revolutionizing Global Health Care

Salud! : What Puts Cuba on the Map in the Quest for Global Health

Connie Field (2009)

Film Review

Salud! Is about the global struggle to overcome health inequality and the vital role Cuba plays in this effort. Filmmaker Connie Field is totally open about her perspective that that health car is a basic right and not a commodity, as it’s viewed in the US.

In pre-revolutionary Cuba, only a small wealthy elite had access to health care. The poor, who comprised 90-90% of the population, died in droves of treatable conditions, such as malaria, respiratory infection, parasites and infantile diarrheal infections.

The Castro regime responded to this health crisis by training tens of thousands of doctors. At present, Cuba has 60,000 doctors for a population of 11 million, making their health system one of the best resourced in the world.

Ending Diseases of Poverty Worldwide

Cuba has been extremely generous in sharing this resource with other poor countries, especially in Africa and Latin America. Since 1963, over 100,000 Cuban health professionals have worked overseas. As well as performing direct patient care, they also train foreign health care professionals.

The film profiles their work in South Africa, Gambia, Honduras and Venezuela. In all four countries, the Cuban doctors have helped local health professionals establish community-based health delivery systems that focus on health promotion and disease prevention. This contrasts to health care in the industrialized north, which waits for patients to get sick and fights one illness at a time.

Cubans Healthier than Americans

Thanks to their phenomenal workforce and this common sense approach, Cuba is one of the few developing countries that has virtually eradicated malaria. Moreover Cubans experience better overall all health status than Americans. On average, Cubans live longer: 79.07 years compared to 78.74 years for Americans. Cuba also has a lower infant mortality (4.70 per 1,000 live births) than the US (6.2 per 1,000 live births).

In Honduras and Venezuela, Cuban doctors have played an essential role in setting up clinics in barrios and rural areas that are poorly served by Honduran and Venezuelan doctors – both for financial (their barrio patients can’t afford to pay them) and “lifestyle” reasons. Despite their refusal to serve these communities, local doctors responded to the presence of Cuban doctors with mass protests claiming the Cuban medics were threatening their livelihood.

Free Medical Education for International Students

In 1999, Cuba set up the Latin American Medical School, which offers free medical training to low income students from all over the world. In collaboration with the Congressional Black Caucus, they have also opened this medical school to African and Hispanic students from low income US communities.

Income Inequality: The Real Cause of Poor Health

Contrary to popular belief, the primary determinant of your lifelong health status and life expectancy has nothing to do with your weight, fitness level and whether you smoke. According UW epidemiologist Dr Stephen Bezruchka, the most important determinant of your adult health status is your mother’s income level when you were born. Lifestyle factors (including smoking) only account for 10% of illness.

More than fifty years of epidemiological research bear this out. Yet it’s only in the last decade scientists have learned why this is – thanks to the new science of epigenetics. The term refers to changes in gene expression caused by external influences.

The stress of poverty causes an increase in maternal stress hormones, which causes variations in the way genetic code is transcripted into proteins and enzymes. These, in turn, can predispose the fetus to insulin resistance, obesity and immune problems, as well as emotional instability and mental illnesses.

The Link Between Income Inequality and Poor Health

The most important research finding, according to Bezruchka, is a more pronounced effect in societies plagued by income inequality. Study after study bears this out. In other words, a poor person’s health will be worse in a society with a wide gap between its rich and poor residents.

The US, which has the most extreme inequality, is near the bottom of the charts for indicators that measure a nation’s overall health. In life expectancy (according to the CIA), the US ranks 50^th, just behind Guam. In infant mortality, it ranks 174^th, between Croatia and the Faroe Islands.

A Mindset Driven By Social Service Cuts

In Sick and Sicker, Dr Susan Rosenthal notes a 30 year trend for policy makers – both conservative and liberal – to make sick people “take responsibility” for their illnesses. Epidemiological studies – as long as scientists have been doing them – have always shown a correlation between poverty and poor health. Even in Dicken’s time, it was taken for granted that the undernourished poor people living in cold, damp, overcrowded tenements were far more prone to illness than their middle class counterparts.

Rosenthal believes this shift to a “blame the victim” mentality has been deliberate – to justify aggressive social service cutbacks (by both Republicans and neoliberal Democrats like Clinton and Obama) that came into fashion with Ronald Reagan’s election in 1980.

The Role of Oppression and Exploitation in Illness

Although the link between poverty and inequality is unequivocal, epidemiologists have yet to explain why the effect is poor pronounced with extreme income inequality. Bezruchka puts it down to people in egalitarian societies looking after one another. I like Rosenthal’s explanation better. She relates it to high levels of oppression and exploitation in societies with extreme income disparity.

She points out that minimum wage workers aren’t just poor. They also work in exploitive, arbitrary and often punitive job settings which they feel powerless to change. Enduring this massive stress on a daily basis takes an enormous toll on the human body and psyche.

photo credit: AJC1 via photopin cc