Sunday, March 16, 2008

Unnatural Causes: In Sickness and In Wealth

Beginning March 27, PBS will be airing a mini documentary series called Unnatural Causes. While you may be right in thinking none of the Presidential candidates have a useful solution to the health care crisis in the US, this series would tell you even if we had universal, single payer care, that would not be enough. A person's health is completely tied with social status, as this series will show. I haven't seen Sicko, but I'm sure you'll see that, and more, and more proof, in these.

How do I know? I already saw the first one, and you too can get a preview in cities across the US. Check that website for related materials as well. At least you can supplement your viewing when it does come to PBS. Here in Portland, the Multnomah County (yay my employer) is partnering with the library and with other community centers to show each of seven parts, several times. See the schedule here.

Not only is the Health Department showing this, and giving out FREE FOOD, the County is treating this as the beginning of a three year project to work on health equity. Go Multco! After the show, community discussion. The audience is in effect a focus group. The audience at the showing I went to last Monday was woefully small. We need more people there, and we need more people who don't come with their own AGENDA about what they think the solution is. One guy rattled on and on about people needing to get more involved in community, completely missing the point that the disenfranchised people who are too tired from too much poverty to even come, or even know about it because they don't/can't look at websites, can't go to such meetings and spend their time listening to windbags like him.

Sorry to be so disrespectful about a young white guy so gung-ho about people needing to get involved, but really, he needs to learn to shut up, and actually hear what the issues are. And get a clue as to why the few people there had the luxury to be able to attend this meeting. Most were in the health field. Some in the community activist field.

So right now, Portlandians, you can see this amazing series. It will open your eyes as to the complexity of the American crisis, and that we do not have guaranteed national health care only makes our ability to deal with the complexity that much worse.

Review of Part 1: In Sickness and in Wealth
Note that while I saw the last showing at a Multnomah County Library, there is still one showing in Portland. (Saturday, March 29 :: New Columbia Education Center, 12 p.m. - 2 p.m) If you care about SPOILERS, even in documentaries, proceed with caution.

One of the experts introduces the subject by saying "we carry our history in our bodies. How could we not?" Karma folks. Any Buddhist who's done a few go-rounds in meditation retreats could tell you that. Such psychic wounds that cause physical ailments, they are there. When I stopped dieting, and thus stopped feeling bad about every bit of food I ate, my blood pressure went down. Hmmm.

One person was a medical sociologist. I wrote it down so I could look it up. It "examines topics such as the social aspects of physical and mental illness, physician-patient relationships, the organization and structure of health organizations and the socio-economic basis of the health care system. Sociology majors who focus on medical sociology develop research and analytical skills to address issues facing health care providers and those needing health care."

Also, epidemiologist. Something to do with epidemics, but more than that? Ding ding!

From, Sci-Tech encyclopedia:

Epidemiology examines epidemic (excess) and endemic (always present) diseases; it is based on the observation that most diseases do not occur randomly, but are related to environmental and personal characteristics that vary by place, time, and subgroup of the population. The epidemiologist attempts to determine who is prone to a particular disease; where risk of the disease is highest; when the disease is most likely to occur and its trends over time; what exposure its victims have in common; how much the risk is increased through exposure; and how many cases of the disease could be avoided by eliminating the exposure.

For this first show, they look at the lives of several individuals who live in Louisville, Kentucky. Each lives in a different section of town, and each has a different income level. At the beginning, either the sociologist or an epidemiologist shows us a map of Louisville, and how the frequency of all the diseases we tend to think come from our individual preventative health choices can be mapped according to district. The poorest have more cases of cancer, of high blood pressure, of diabetes. By following these individuals, we begin to get a peek as to why income level allows for more choice to actually follow good health practices.

But good health practices do not decide all, and this is one of the points mr windbag missed: even with other preventative factors accounted for, people at different status levels have corresponding degrees of these diseases. The first to find it was one of those experts in Britain...where they have the universal health care. The occurrences of these conditions have everything to do with whether you have "the ability to influence the events that impinge on your life."

I always find the science of body chemicals interesting. That karma thing, after all. I learned that when we have a stress response, the body releases cortisol. When life is good, and you have stress sometimes, that's ok. A little adrenalin gets released, you deal with the stressful thing, and the levels go back down. When your life is chronically stressed, as when you're poor, or when you have a high demand, low control (and low paid) job, your cortisol levels stay up, and that is not good. When children grow up with that, that is very not good. It affects the development of the brain. This is toxic stress. It causes lifelong problems.

It affects whether you get colds. There was one (ew-producing) study shown in which people were fed a cold virus up their nose. The people in lower-income levels, lower-status levels were more likely to get the colds.

Having learned this, you should not be surprised to learn that "African-Americans die earlier ...across the social gradient."

Why do we have such a health crisis? For all our "freedoms" we have a very inequitable society. One of those epidemiologists said, "Those countries where wealth is more equitably distributed are healthier."

Go see the rest. Be a part of the conversation. The next one I go to see tomorrow, Place Matters.

Health is more than health care. Where we live, work and play impacts health. The food we eat and the stress we endure contribute to our health. How can investments in education and neighborhoods improve the health of our whole community? Find out how…

  • Monday, March 17 :: Midland Library, 5:30 p.m. 7:30 p.m.
  • Saturday, March 22 :: Portland Community College-Cascade, 1 p.m. - 3 p.m.
  • Wednesday, April 2 :: Northwest Library, 6:30 p.m. - 7:45 p.m.
  • Saturday, April 19 :: New Columbia Education Center, 12 p.m. - 2 p.m.

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