Class and race lead to health disparities

Conventional wisdom says that people’s health depends on two things: access to health care and healthy behaviors like eating a balanced, nutritious diet, exercising, not smoking, etc. But there is a growing body of research that finds another factor that’s equally, and perhaps even more, important–social factors like class and race.

About a year and one half ago, a PBS series entitled Unnatural Causes: Is Inequality Making Us Sick explored the impact that class and race have on health. Among other things, it reported that health outcomes varied significantly among different social class.

“The series reveals a continuous health gradient tied to wealth,” reads a media statement issued by the series’ producers. “At each step down the socioeconomic ladder—from the rich to the middle class to the poor—people tend to be sicker and die sooner. The least affluent die, on average, six and a half years earlier than the rich. But even middle-income people die more than two years sooner than those at the top. Poorer smokers face higher mortality risks than rich smokers.”

Unnatural Causes shows how lack of resources and power affects people’s lives in communities across the US. One of those communities is Greenville, Michigan a town hit hard by plant closings. In 2006, the town’s largest employer, Electrolux a multi-national company based in Sweden that made washing machines in Greenville, closed its Greenville plant putting 2,700 out of work.

Shortly after the plant closing, the local hospital saw a spike in the number of people it treated for depression, attempted suicide, and domestic abuse. Two years before the plant closed, it treated about 80 people a year for these pathologies. After Electrolux closed, the caseload nearly tripled.

“These external life events (like layoffs) do get under the skin,” said Rick Price, a psychologist who has studied the consequences of job loss on workers’ lives. “They do create changes in the way our psycho-physiological system operates. They create elevated stressors–stress responses that ultimately lead to both acute and chronic health problems.”

Stressors like job insecurity, low pay, unemployment, and lack of a voice on the can job lead to increased heart disease, stroke, diabetes, and cancer. But the impact of these stressors can be mitigated by making people’s lives more secure.

Take for instance Amador Bernal, an immigrant from Mexico who works on a mushroom farm in Kennett Square, Pennsylvania. Bernal has lived in the US for 25 years and has never been sick enough to visit a doctor. According to the series, Bernal’s good health is related to the fact that he is protected against some of the stressors that other workers endure.

He has a low-paying job, but becasue he belongs to a union, the pay is higher than most farmworkers, he has job security, and he has access to health care for his family. Just as important, he lives in a community with an extensive support system. His network of friends and extended family play an important role in making his life more secure, and the town where he lives, which was founded by Quakers, also provides services like after school child care and tutoring and a free health clinic that help Bernal deal with the common stressors of working class life.

The stress that affects the health of working people, is much worse among African-Americans, even those with high incomes. The incidence of chronic and life threatening diseases among African-Americans is higher than among their white counterparts, and this health disparity is much more pronounced among very young African-Americans.

Among all developed countries, The US has the highest death rate for children one-year old or less. For African-Americans, the rate is double that of whites. African-American mothers are also more likely to deliver a premature baby, which contributes to their high infant mortality rate.

Neonatonologists James Collins and Richard David assert in a research paper that the stress of racism, not some innate biological characteristic, is responsible for this disparity. The paper shows that immigrants from Africa on average have babies with higher birth weights than African-Americans, but this advantage disappears after one generation as first generation African-Americans are exposed to racism.

Other researchers like Michael Lu agree that chronic stress caused by racism triggers anxiety, which cause the release of stress hormones that create an overload during pregnancy and premature births.

Unnatural causes concludes that “Americans not only need universal health care to treat illness, but also better and more equitable social and economic policies that can protect and promote health in the first place. Social policy is health policy.”


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