A superpower nation like the United States of America has always been regarded not only as a country of opportunity but also a country that takes pride for its exceptional education, social, healthcare and human services. For many immigrants, it is a dream to live in an industrialized country that has the resources to protect its citizens and assure them of a better quality of life.
The early part of the documentary film has caught my attention. It is surprising to know that a progressive country with the highest gross national product spends two to three trillion dollars per year on medical care that do not address the medical and healthcare needs of its citizens. With the huge health dollars spent each year, we would expect the United States to be among the industrialized nations with the highest life expectancy. Ranking in the 30th position and being in the bottom among the economically developed countries in terms of life expectancy is a painful reality. How could a great number of infants die before their first birthday? What is America doing to reverse this situation? Is it a curse to be born poor and African American? These were the nagging questions that run through my mind as I view the film.
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Economic Status and Health
It is a common knowledge that people with better socio-economic status have the resources to purchase healthy meals and other food supplements that is beneficial for their health. At the first sign of illness, they can go to the hospital and seek medical attention since they have better health and medical coverage. However, maintaining a healthy lifestyle largely depends on individual behavior and self discipline. Being the richest and highly educated person in the world is not an assurance that one would be spared from illnesses and diseases that are caused by smoking, unhealthy diet and lack of exercise. Hence, I do not agree that access to education and income, which are regarded as the social determinants of health, can largely influence a healthy lifestyle. We have the power to know what is right for our health and we have the power to reconfigure ourselves in ways that would benefit our health.
The film has focused on Louisville, Kentucky and compared the mortality rate of people living in various council districts that are often determined by social class and economic environment. Excess death, the indicator of population health is an alarming time frame predictor of how many people in a given population will die. Death is inevitable and oftentimes unpredictable. This is what we were made to believe in. However, experts in Louisville, Kentucky can successfully predict the life expectancy rate based on the place of residence, high school graduation rates, and income of their population. Hence, people who are living in a council district for the affluent have a higher life expectancy rate than those who are residing in a council district for the marginalized people. The prevalence of criminal activities may be greater in communities for the low income group. Lack of security and an increase in crime rate may also influence mortality rate. With this in mind it would be beneficial to compare the results of the Louisville study with other states in the US before a conclusion can be made that socio-economic status is a good predictor of life expectancy.
The research made by Sir Michael Marmoth and his team on how social influences affect disease erases our common belief that unhealthy behavior often lead to illness and death. We are aware that the combination of smoking, blood pressure, cholesterol, overweight and sedentary lifestyle can contribute to heart disease and other illnesses. Marmoth found that heart disease among smokers who are poor is higher than a wealthy person who is smoking. His study also revealed that among business executives, the lower the rate of employment the higher the rate of heart disease and every major cause of death. Hence, the second from the top have a better health condition than those who are third from the top. If we are going to use these findings, we could only conclude that it is unfortunate to be born poor and belong to the lower socio-economic class. This may also give a person living below the poverty line a helpless feeling as one’s life seems to be sealed with a destiny filled with unfortunate illnesses, diseases and shorter life expectancy as a result of being born in the United States.
Stress and Health
While stress is in every workplace, educational setting, sports competition, and in many homes, it is a factor that contributes to sickness and death especially if one is a victim of social subordination. Stress hormone such as cortisone is released when the brain perceives a threat. As cortisone floods the bloodstream with glucose, this causes the heart rate and blood pressure to increase. When this happens on a daily basis and the person does not have the power and resources to control them, the body system will work overtime and produce too much cortisone that will impair the immune function, inhibit memory and cause areas of the brain to shrink. It also affects the body’ ability to handle insulin and glucose; thus, increasing the risk of diabetes and heart disease. Shannon Collin, a psychologist made a study that has linked educational attainment and socio-economic status to the release of cortisone. He stated that people with more education and income release less cortisone during the day. He added that a higher socio-economic status leads to less stress and less stress means better immune function. In a similar cold virus study, it was discovered that children whose parents own their homes when they were kids tend to have better immune system when they are adults. With these findings, I am beginning to wonder if the government should create a program to help people manage stress. This program must be introduced to the grass root of society to help those who are living below the poverty line cope with the stressors of life. It may benefit more if it can be integrated in the public school program for the kindergarten, elementary and high school level. Although the program may not eliminate the stressors that are caused by their economic circumstances, it may help prevent or lessen stress related illnesses arising from other sources, e.g. racial discrimination.
Racism and Health
Learning about the huge number of death among African American babies due to premature deliveries and low birth weight is alarming. African Americans have settled in the US for many years and amidst the contributions that they have made in many fields, they are still suffering from unequal treatment in American society. Studies have shown that persons who are higher in socio-economic status have more income, better education and better jobs. People with more wealth tend to live longer and have fewer health problems than those who are lower in socio-economic status. However, these findings do not apply to African American women in US as infant mortality rate for this race group is about 10 per 1,000 births regardless of their socio-economic status. Chronic stress resulting from being an African American has taken a toll on women’s system and affected pregnancy outcomes. Stress can constrict blood flow to the placenta which could limit fetal growth and lead to premature delivery. Stress during pregnancy is not the only problem. The experiences of the mother over the course of her entire life referred as Dr. Lu’s life course perspective hypothesis contributed to infant mortality. The lifelong racial discrimination that is often experienced by African American women is a problem that must be addressed by our society at the soonest possible time. It is not enough to know the problem. It is time to create a concrete action plan to put an end to racial discrimination if we value the life of every human being.
The film is a wake up call to reach out to the poor and those who are suffering from any form of discrimination. It is time to empower every citizen in our community to do what is best for their health. We should not depend solely on our government. Let us do our share in eliminating or minimizing life threatening stress for the future of our country.