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Health disparities: is inequality making us sick?

Public Health and Human Services has a vision of a community where all are safe and healthy. The Centers for Disease Control and Prevention, the Minnesota Department of Health, and others are also focused on health and have been studying the link...

Public Health and Human Services has a vision of a community where all are safe and healthy. The Centers for Disease Control and Prevention, the Minnesota Department of Health, and others are also focused on health and have been studying the link between what are called the "social determinants of health" and health outcomes.

Here's an example: There are four people who live in the same town. Mary dies at the age of 69.8, Corey dies at the age of 73.4, Tondra at 75.3, and Jim lives to the age of 79.8, a full 10 years longer than Mary.

What factors do you think played a role in how long they lived? We hear about death from heart disease and cancers, so perhaps their personal behaviors such as smoking or being overweight were a factor? Or perhaps it's a matter of family genetics?

The answer may surprise you. This difference in life expectancy is tied to annual income. Yes, how much money you make will predict how long you will live.

There is a documentary which aired on the Public Broadcasting Service (PBS) entitled "Unnatural Causes: Is Inequality Making Us Sick?" The answer is very clearly, yes.

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In one section of the series, the lives of these four individuals were studied. All four live in the same town, but in different districts, not unlike our neighborhoods in Duluth that we describe as Woodland, Lakeside, Lincoln Park, and Morgan Park.

Mary lives in the poorest district and has a median income of $24,268. She can expect to live 10 years less than Jim, who lives in the richest district and has a median income of $79,878. The trend is very distinct that as income rises, so does life expectancy.

However, income alone is not the only factor that influences health and life expectancy. Many people of color experience a wide range of serious health issues at higher rates than do whites, including breast cancer, heart disease, stroke, diabetes, high blood pressure and respiratory illness.

Researchers are finding that years of discrimination and racism play a role in health through factors such as restricted educational opportunities and employment, limited access to and bias in medical care, limited access to safe recreation and healthy food, residential segregation and chronic stress.

Worrying about violence, schools, and unpaid bills; living in substandard housing or a polluted environment; not having good access to fresh food, reliable transportation, or safe public spaces -- all of these are stressful and have a negative effect on health. These social determinants of health play a larger role in health disparities than do genetic factors or personal behaviors such as smoking, drinking alcohol, or being overweight.

You may think, well, that study was based in some other part of the country, that doesn't hold true for us in Duluth. The fact is our findings mirror those of the documentary; a person living in one specific area of Duluth can expect to live 11 years longer than a person living in

another specific area of Duluth.

I, personally, find that alarming and it shows that we have not yet reached our goal of a community where all are safe and healthy. As a partner in the Un-Fair Campaign, we look forward to working with others in the community to achieve better health and safety for all residents of Duluth.

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If you are interested in learning more, here are a few resources: www.unnaturalcauses.org and www.cdc.gov/socialdeterminants/ .

Ann Busche is the director of the St. Louis County Public Health and Human Services Department. Contact her at (218)726-2096, or e-mail her at buschea@co.st-louis.mn.us . This issue's column is part of a series of occasional columns on issues of race in Duluth.

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