Inequality is Unhealthy

PHF's own Stephen Bezruchka recently paid a visit to Democracy Now! In a segment especially pertinent during this time of recession, Stephen explains how inequalities in wealth have contributed to America's poor health outcomes. As President Obama tries to "fix" both our health care and economic systems, what would you suggest he do to help America make a comeback as a contender in the Health Olympics?

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Happy, Happy, Joy, Joy

The results of a new well-being survey were recently released. Gallup, in partnership with with Healthways and America's Health Insurance Plans, conducted the survey. The top three states: Utah, Hawaii and Wyoming. The bottom three: Mississippi, Kentucky and West Virginia. Rankings by congressional district are also available. The story and nifty map feature are found here. (Read full post)

Place Matters

One of the most frequently presented arguments against systematic changes is that of individual agency. An initial response to this may be that, ideally yes, an individual has the potential to overcome any sort of adversity present in her or his life. Unfortunately, a large and ever growing body of evidence is showing that policy- (and ideology-) induced inequalities and disparities are stacking the deck against most individuals and especially individuals of certain populations. One of the most compelling manifestations of this is racial minorities that live in concentrated geographies (e.g. that are affected by deliberate and incidental housing, zoning, and economic policies). Below begins a list of damning evidence...

(check back for updates, feel free to post other studies through comments)

Zenk SN, et al. “Neighborhood racial composition, neighborhood poverty, and the spatial accessibility of supermarkets in metropolitan Detroit.” American Journal of Public Health. 2005; 95:660-667.

Summary of findings:
Statistically significant increases in distance to supermarkets were found in poorer neighborhoods when there were medium and high percentages of African Americans. Contrarily, distances to supermarkets were relatively consistent regardless of income for neighborhoods with low percentages of African American. The disparity of access between low percentage A.A. and high percentage A.A. poor neighborhoods were extreme, with an average of 1.10 to 1.15 miles greater distances to supermarkets.

Interpretation:
It's much harder to make the "healthy choices" in a poor African American neighborhood than in white neighborhoods. Why is this? Implicated, intertwined, and reinforcing factors include historically racist / exclusionary zoning policies ("redlining"), poverty dispersal or urban renewal factors, resultant deterioration in social environment, lack of political will or power, lack of employment/economic power, loss of tax base.
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An Inspiring Evening

Tonight the Population Health Forum was thrilled to be the guests of Meaningful Movies, a weekly community event organized by Wallingford Neighbors for Peace and Justice (link to their website)! We were able to screen a segment of the film Unnatural Causes... Is Inequality Making Us Sick? with over one hundred attendees. We had wonderful, engaging, and inspiring conversations after the film. Here are some helpful links for those who attended and want to learn more (or those who missed the event!)


Unnatural Causes Website: Summary of the series, video clips of each segment, toolkits for action in your community, and much, much more.

Several people asked about the graphs we displayed that showed where the U.S. stands compared to the rest of the world in terms of income inequality, health care spending, child poverty rates, and life expectancy (i.e. the "Health Olympics"!). The graphs were also from the Unnatural Causes website, but a direct link is here. They also have several other interactive activities and resources you should take a look at.

Thanks for a wonderful evening!
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Let Them Eat Soup

It is easy to understand that wealth in America is unevenly distributed among the few and many, however, it can be difficult to comprehend the magnitude of this income inequality. To help us comprehend the the income disparity in the United States the Working Group on Extreme Inequality developed the following video.

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Health care technology -- not the savior everyone perceives it to be!

In the New York Times Health Blog Well, Tara Parker writes about the need for both patients and physicians to move away from the framework that the most expensive and latest treatments are "best." She notes that technology has played a "surprisingly" small role in improving health outcomes - only 1 in 160,000 Americans have had their lives extended or saved because of recent improvements in health care technology. "The real gains in health, experts say, have come from lifestyle changes like smoking cessation and seat-belt use or from public health improvements like vaccination, a cleaner water supply and increasing access to primary care." Hopefully this is one more step towards getting the word out!
Read the full article here. (Read full post)