Inequities in health care

Better health for the wealthy?

By FRITZ MAYER

LOCH SHELDRAKE, NY — It’s something most of us suspect intuitively: wealthy people tend to enjoy better health and longer lives than poor people. The point was powerfully underscored at Sullivan County Community College on September 16, with a screening of segments of the PBS documentary series “Unnatural Causes: is inequality making us sick?”

Speaking after one of the segments was screened for the audience, Carol Ryan, the director of Sullivan County Public Health Services, showed that the issue is relevant to our area. With a series of charts she showed that the highest levels of poverty in the county are found in the population centers of Fallsburg, Liberty and Monticello, and that is also where the highest incidences of hospitalizations for asthma occur.

On a national level, according to the program, “people in the highest income group can expect to live, on average, at least six and a half years longer than those in the lowest. Even those in the middle (families of four making $41,300 to $82,600 a year in 2007) will die, on average, two years sooner than those at the top.”

The series also points out a number of surprising findings regarding health care in the United States. For instance, we spend twice as much per person than any other industrialized country, yet we have fallen behind in many measures of health. For instance, the country comes in 30th in infant mortality rates, behind such countries as Slovenia.

The segment on infant mortality, incidentally, was one of the more provocative ones in the program. It effectively pointed out that wealth, or a lack of it, is only one of many environmental factors in determining good health outcomes.

According to the series, for instance, black women in the United States are more than twice as likely as white woman to have children with low birth weight. If this were simply a function of wealth, it could be assumed that wealthier black women, such as those with college degrees, would fare better than those with less education. But it turns out that black women with college degrees are still more likely to have low birth weight babies than white woman who had dropped out of high school.

Interestingly, African immigrants to the United States have low birth weight rates similar to white women in the United States. Two doctors who appear in the film, neonatologists James Collins and Richard David, express the opinion that the elevated risk in black American women is due to “the cumulative impact of racism they experience over their lifetime.”

The screening of the film was sponsored by the Sullivan County Rural Health Network (RHN), which is dedicated to promoting good health in all citizens of the county. Guests at the screening included members from county agencies, nonprofits, health care facilities and other organizations.

The RHN planned to form a subcommittee from among the attendees at the screening to deal with issues related to inequities in health care.

Go to unnaturalcauses.org for more information.