March 28, 2008
Notes from Unnatural Causes - Program 1
Below are some notes I made during the first episode of the PBS program Unnatural Causes.
The U.S. has the highest GNP in the world. It spends 2 trillion dollars on health care - around 50% of what all the world spends.
The U.S. ranks 30th in life expectancy. More babies die in the 1st year in the U.S. than Cyprus.
47 million have no health coverage.
Why are we sicker? Individual diet? Individual behaviors?
Social determinants of health.
Twins who live together until 18 - if they diverge later in life they end up of with different health status.
In the UK - death rates and illness correlate with status even after controlling for health behaviors.
In the US - social gradients exist similar to those in the UK. Over 70% of affluent report very good to excellent health. Good health decreases with income.
College graduates live 2.5 years longer than high school graduates.
In Louisville, KY - life expectancy can vary greatly between districts. Up to 9 years difference between some districts.
Can social policies drive health? What constitutes 'social class?'
Does living in a higher social class give more control over one's life? Does more control lead to better health?
Lack of control leads to stress. Stress raises blood pressure and increases glucose. Stress helps motivates and aids in 'fight or flight' situations. However, if stress is constant too much cortisol is produced leading to lower immune strength.
Chronic stress may affect those more that have less control (subordinates.) Chronic stress from lack of control may lead to atherosclerosis.
Chronic stress (as measured by cortisol) may lead an increases chance of catching the common cold. This may indicate a diminished immune system.
Note - people with more bosses may have more chronic stress leading to compromised immune systems. High demand - low control.
Most of the poor in America are white.
The more years parents own a home the less likely their children are to catch a cold when exposed (lab environment.)
Health outcomes for African-Americans are worse than whites across the social gradients.
83,000 'excess death' each year for African-Americans.
In the early 1900s gov't programs helped many whites to live longer.
Often times non-medical interventions affect health the most. Housing programs and universal education for example.
Economic policy is health policy.
Since the 1980s - gov't slashed programs - reduced taxes for the wealthy - and inequality increased.
The U.S. is the most unequal of the world's democracies.
Countries that have a more equitable distribution of wealth are healthier.
The current generation of young adults may be the first to live shorter lives than their parents.