Personal
pursuits make a difference for health. Individuals who take responsible steps
whether it’s more physical activity, smoking cessation or medical
adherence face complex environmental challenges where place matters. Some face forces more formidable than will power. The
research provides evidence to shed light on influences for health. A
recent study published in the New England Journal of Medicine demonstrates how place matters.[1] These results show better health outcomes for those who have an opportunity
to relocate to better living conditions. A move out of high level poverty areas improves the potential for health. Access to healthy food, safe spaces for play and adequate living conditions works in the fight against childhood obesity and diabetes compelling the need to
broaden our focus in designing community-level interventions. There are many factors that influence health, the Commission for a Healthier America
offers a view:
 |
|
Influence on Health:
Broadening the Focus
|
|
|
|
|
|
"Behaviors,
as well as receipt of medical care, are shaped by living and working
conditions,
which
in turn are shaped by economic and social opportunities and resources" [2]
Consider another striking example: the
climb of out of poverty, educational achievement and economic prosperity doesn’t
change the high risk of preterm births and maternal death for black women. Dr. Michael Lu an obstetrician and gynecologist believes "that for many women of color, racism over a life time, not just during the nine
months of pregnancy, increases the risk of preterm delivery. To improve birth
outcomes, Lu argues, we must address the conditions impacting women’s health
not just when they become pregnant but from childhood, adolescence and into
adulthood.” The video
clip is telling as is the entire documentary series “Unnatural Causes.” [3]
There
are social determinants of health. We should address issues beyond the
doctor’s office that impact health. Where we live, work and play influences
health, medical care and health care, our environment influences our personal efforts to achieve health. [4] Our national
foreclosure crisis is making people sick, physically and mentally.[5] Yes,
financial ruin is about personal responsibility. However, these situations are
also tied to increasing rates of unemployment and economic downturn. It’s like thinking about how your personal spending impacts
the nation’s economy without considering the roles of financial institutions and
corporations. You make the mortgage payment every month, but the equity in your house diminishes. You go to work every day, but the same paycheck buys less of everything including healthy groceries so you grab fast, cheap food. Exercise routines may compromised when you have to work a second job to meet the bills. The stress of daily living over time may become chronic stress and put your health at risk.
The
low hanging fruit to address personal behaviors may heal some, but
doesn’t remedy the pervasive ills facing our society. My colleagues in community development, public health and health professions are dreamers, change agents, builders, innovators, leaders and champions for health and healthier living this makes me hopeful and willing to work for progress and the future.
References
-
Ludwig J, Sanbonmatsu L, et al.
Neighborhoods, obesity, and diabetes–a randomized social experiment. N Engl J
Med. 2011 Oct 20;365(16):1509-19.
- Prepared for the Robert Wood Johnson
Foundation by the Center on Social Disparities in Health at the University of
California, San Francisco.
- Courtesy of UNNATURAL
CAUSES: Is Inequality Making Us Sick? Produced by California Newsreel
with Vital Pictures. Presented by the National Minority Consortia.
www.unnaturalcauses.org; www.newsreel.org
- Robert Wood Johnson Foundation Vulnerable Populations brief A New Way to Talk about the Social Determinants of Health. July 2010
- Robert Wood Johnson Foundation, Human Capital brief ”Foreclosure
Process Takes Toll on Physical, Mental Health.” October 2011
N.B. This post was prompted in response to Dr. Jen Gunter's blog #OccupyHealthcare post and furthers my comments.
