Wednesday, April 02, 2008

Unnatural Causes: When the Bough Breaks

Becoming American and When the Bough Breaks will be airing on OPB on this Sunday at 11 am (tomorrow at 7 pm if you have HDTV). I'm sad that it's at such a bad time. Who watches tv at that time? If you're outside Oregon, check your local listings.

An acquaintance friend of mine from way back who works for the County was the facilitator for this showing and discussion. I just love her voice. It's kind of like Fran Drescher's really is, without the exaggerated whine that she does for The Nanny. There's this harmonious alto warble that is so enticingly interesting. I digress... Ms. D is a fabulous facilitator, which made up for Dr. A not being there. Dr. A is so cool too.

Many of us were returning viewers, but for those new to this, D reminded us that these documentaries show us that "health isn't' just about health coverage or even personal choices, but there are social causes to ill health too." Again, I would warn my readers that this review contains spoilers.

Unlike new immigrants, African Americans experience socially caused ill health at the other end of the scale. Their babies are born premature or too small at twice the rate of other groups. Twice the rate! This gap is not corrected by education or socio-economic status. In fact, the gap actually widens the more educated or higher status a black person has.

A couple of doctors saw this gap, and developed the hypothesis that it is due to their unequal treatment in American society. Ya think? But being good scientists, unlike me, your average geeky lay person, they tested. They asked "could the problem be genetic?" They compared the low-weight birth rates between African Americans, African immigrants, and American white women. The immigrants and the white women had similar outcomes. But if you're paying attention and remember the lesson of Becoming're right, immigrants lose this relative equality of health within a generation.

The chronic stress of living with discrimination, and the cumulative experience over a lifetime not only affects the health of a woman, it affects her birth outcomes. The thing is, the sociologist asks, "How do we measure the subtle racism that follows African American women throughout their lives?" Women internalize this. They think about how race affects their lives constantly. How do you measure it? A sociologist, anthropologist, and an epidemiologist got together to do this. They started with a focus group that went on for 15 years.

I thought to myself, I wish they'd do this for fat people. We too are subject to thinking about this constantly. Unlike people of color, we are almost always told to blame ourselves for the fatness of our bodies. We think about this every time we eat, every time we attempt to move about or sit in a space designed for smaller people. This too puts chronic stress on our lives. This too must have an effect on all those health factors that this show is talking about. Yet when studies are done, chances are much more likely they're looking for a way to blame the weight, not the stress.

Some highlights from the discussion

  • premature/small babies: same biological response as during war
  • we can't change the way our species reacts to strangers (tribal response) (I disagree)
  • story about experience as only non-white woman in a group: joined an artist group, at a party nobody sat with her at her table; "I've learned to cope by ignoring it."
  • OHSU graduate student, white: we've learned people with dark skin need more Vitamin D; their bodies cannot manufacture it at all in our Pacific Northwest winters; this also causes low birth weight (I didn't get the sense she was trying to discount the racial gap, but looking for ways to mitigate first...then it seemed she would rather believe a more graspable reason for the gap than racism) She would like to see a test for Vit. D deficiencies as part of a woman's annual exam. Good idea.
  • pregnancy program worker: studies show this gap still exists in the southern states, where they do get more sun
  • policy can't change people's perceptions
  • (me) but it can! this is changing the public dialog. on a national level, the sound bites are separative; appropriate policy can change the sound bites to be connective
  • money follows the policy
  • (me) a question: is it possible that awareness of this, the influence of chronic stress, can change how it influences our health? (I knew my own answer to that question, I know from years of meditation and awareness practice that it does.)

My question prompted a flurry of dialog, prompted by the second facilitator, who asked: Those of you who've seen these shows, have you done anything differently?

  • she herself has told herself "life is too short. let go let god."
  • it's about self-love
  • gonna buy vitamin D!
  • if someone has a problem with who I am, it's their problem
  • find ways to support those in less advantaged places
  • it there's a policy, it's like having a road we can follow
  • important to have good relationships, love
  • good relationships between community members and policy makers
  • this is from Malcolm X: when the people with the problems come up with the solutions, you have better solutions (so true)

Just a side note: I've eaten more Baja Fresh in the last 4 weeks than I had in the whole past year. That is the free food they've had for us. I like it, I just don't get around to going there that often.

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