What did the Whitehall Study reveal about the connection between health and wealth?
Living in America is considered a ticket to good health as the United States spends millions of dollars in a health care area and has the highest GNP in the world. However, the level of the population’s health, including morbidity and mortality, remains high. In addition to the social status, smoking, eating fast food, drinking alcohol, and low physical activity contributes to the increase of morbidity.
In this connection, researchers point out the connection between health and wealth. On the example of Louisville, Kentucky, it was stated that social determinants play an integral role. According to the study, different parts of the city die and suffer differently. Wealthier areas live two years longer than the middle-income population. It concerns such diseases as diabetes, stroke, and others.
Dr. David Williams says, “Stress helps motivate us. In our society today, everybody experiences stress. The person who has no stress is a person who is dead.” Describe the body’s stress (fight or flight) response. How is chronic stress different? How does stress increase the risk of illness and disease?
During the body’s stress, the person’s body conveys a biological response. In other words, cortisol is released that improves memory helping the person to survive. Therefore, stress is considered as motivation. At the same time, chronic stress might lead to the exhaustion of the immune system and several diseases. Continuous stress influences glucose level and heart rate variability and increases the risk of heart attack and diabetes. Besides, chronic stress affects the psychological background of the person. As it was stated in the video, the pager’s permanent beep might cause strong irritation and stress.
Describe examples from the film that illustrates how racism imposes an additional health burden on people of color. Give examples of both “everyday” racism (being treated unfairly) and “structural” racism (access to resources, power, status, and wealth). Describe how these differences affect health in different ways.
“everyday” racism might manifest itself everywhere, for example, in the street. As Dr. Troutman says, “a woman grabs her purse when I come into the elevator.” It leads to permanent tension and affects a biological level of the organism causing coronary artery disease, high blood pressure, and other diseases. “Structural” racism limits access to wealth, status, resources, and power. According to Chris Takes, the core of the problem lies in the social hierarchy. Improvement of the economic policy would improve health policy. This kind of racism is revealed in unemployment or difficult access to the appropriate health care. Mainly, it affects psychologically, causing disappointment and misunderstanding.
The movie describes different examples of how policies such as employment, education, and housing all affect health. In your opinion, what kinds of policies need to be created to promote equal access to health?
The example of Corey Andersen reflects the dependence of health on employment. He has plenty of demands to perform and limited control of his work. Likewise, Andersen’s housing is situated in the criminal area as his wife notes firefight. All the above create conditions of strong everyday pressure for people’s organisms and minds. If one lives under permanent control and stress, he or she cannot feel safe and, as a result, be healthy (Howden-Chapman, Chandola, Stafford, and Marmot (2011). According to Pharr, Moonie, and Bungum (2012), “unemployed, with either less or greater than one year of unemployment, reported significantly worse perceived mental health scores as compared to employed participants” (p. 5). Another participant of the study, Jim Taylor, has a well-paid job. It allows him to choose a place where to live, to purchase healthy food where he wants, and comfortably get to his job driving a car. It becomes obvious that Taylor lives without chronic stress as he can afford it.
Education is a significant determinant as well. College graduates live two years longer than high-school graduates (Baker, Leon, Greenaway, Collins, & Movit, 2011). It is determined by the type of job but mainly whether the person could afford it or not. The study compares two districts revealing the college education and life expectancy, in particular, district 24 (15,4 percent, 75,3 years) and district 16 (63,8 percent, 79,3 years). Furthermore, the study moves to the ninth district, where indicators are even lower. Obviously, such a separation did not cause by nature but by social status.
In my opinion, some measures need to be implemented to improve the current situation. For example, it would be better to decrease the cost of education and health care services as the majority of low-income people cannot afford it. In its turn, it would reduce the level of stress, enhancing the health of the population.
Your group has been asked to participate in public testimony to the MO House of Representatives on Public Health. What would be your group’s Top 3 Public Health Concerns? Discuss your 3 Public Health issues and give evidence-based documentation to support your answers.
The first issue we would like to arise is the cost of the health care services. As per research results, low-income populations cannot afford appropriate health services. Additionally, childhood poverty might define a person’s life for years. Living under the subsistence level means never knowing whether you would eat something or not and whether you would find a roof or not. Undoubtedly, it affects children’s brain connections, destroying them (Wickham, Anwar, Barr, Law, & Taylor-Robinson, 2016). Long-term childhood stress increases the risk of problems in the future. Therefore, it is necessary to consider the issue of the health care cost for children and their living conditions. It might be useful to create a special program devoted to the eradication of childhood poverty as children are the future of the country.
It seems important to note that the study also focuses on macaque monkeys’ stress investigation. The investigation revealed that dominant monkeys have better heart indicators while subordinate ones who have to be under control all their life have a higher level of cortisol in their blood. The same tendency occurs in humans’ organisms. The case of Corey Anderson’s mother, who lost her job, also clearly demonstrates the stress as it influenced her both psychologically and physically. Consequently, the second question we would like to discuss is the subordinate position of employees at work.
It goes without saying that there are always should be leaders and subordinates as the group or the company should be managed. The efficiency of the immune system depends on stress. As a result, wealthier people are at lower risk of infectious and autoimmune diseases than those with low- or middle-income. The subordinate position promotes chronic stress. It was stated that people who have education and high-income release less cortisol than those who cannot afford education and, therefore, cannot find a good job. Consequently, it seems considerable to give the latter more freedom to release them from stress. For example, according to Largo-Wight, Chen, Dodd, and Weiler (2011), nature contact influences positively and helps employees to relax at work. It expresses their health, too. They tend to have fewer health complaints and feel less pressure.
Finally, the third issue we would like to consider is the impact of skin color on health issues. As it was discussed in the video, Afro-Americans are subjected to discrimination in health care. Peek et al. (2010) also study that theme. They claim that racism appears between Afro-American patients and their physicians. For example, physicians might express disrespect, poor service, or superficial examination of the patient. As a result, patients feel chronic stress and become get more and more diseases. It seems significant to note that for the majority of Afro-Americans, such pressure is “associated with C-reactive protein, a marker of systemic inflammation that correlates to cardiovascular disease and other health outcomes and precursors to cardiovascular disease” (Peek et al., 2010, p. 15). Thus, it is of great importance to pay attention to the problem of racism that affects Afro-American patients in the United States.
References
Baker, D. P., Leon, J., Greenaway, E. G., Collins, J., & Movit, M. (2011). The Education Effect on Population Health: A Reassessment. Population and Development Review, 37(2), 307-332.
Howden-Chapman, P. L., Chandola, T., Stafford, M., & Marmot, M. (2011). The effect of housing on the mental health of older people: The impact of lifetime housing history in Whitehall II. BMC Public Health, 11(1), 682.
Largo-Wight, E., Chen, W. W., Dodd, V., & Weiler, R. (2011). Healthy Workplaces: The Effects of Nature Contact at Work on Employee Stress and Health. Public Health Reports, 126(1), 124-130.
Peek, M. E., Odoms-Young, A., Quinn, M. T., Gorawara-Bhat, R., Wilson, S. C., & Chin, M. H. (2010). Racism in healthcare: Its relationship to shared decision-making and health disparities: A response to Bradby. Social Science & Medicine,71(1), 13-17.
Pharr, J. R., Moonie, S., & Bungum, T. J. (2012). The Impact of Unemployment on Mental and Physical Health, Access to Health Care and Health Risk Behaviors.ISRN Public Health, 2012, 1-7.
Wickham, S., Anwar, E., Barr, B., Law, K., & Taylor-Robinson, D. (2016). Poverty and child health in the UK: Using evidence for action. Department of Public Health and Policy, 2(1), 1-8.