Film: In Sickness and in Wealth

 

“In Louisville, Kentucky a data Maps gives a clearer picture of what conditions correlate to illness and death across the city. Death rates from lung cancer has better outcome in the East. The lighter shades mean lower rates of death and illness and the darker shades and being higher rates. The highest rates of death from diseases of the heart are in the West End. The data is an indicator of population health excess death. The notion of excess death says that you should be able to predict in any one-time frame how many people in a population will die and the number that die is higher than that. That differential is excess death. Premature death should not have happened it is not as if we will not die. We all will die but the question is at what age, with what degree of suffering, with what degree of preventable illness. These are death rates from all types of cancer, and you see the same pattern in some areas. People die three to five or even ten years sooner than in others. Cancer and heart disease are almost twice the rate in some areas as in others”.

 

The film shows many faces of Louisville population spread over 26 neighborhoods or council districts. It shows social and economic environment of each district with a distinct health profile. The movie reveals that further East are more affluent communities. Furthest East and North is council district 16, is the most affluent community.

 

 The film reveals Whitehall’s study, “The lower the grade of employment the higher the risk of heart disease but not just heart disease every major cause of death so if you were second from the top you had worse health than you if you were at the top if you were third from the top you had worse health than if you were second from the top all the way from top to bottom.”

 

 The movie suggests a correlation between the health of populations in Louisville and the social conditions that can be seen as you go from one council district to another.

 

The film alluded that American children who live in poverty can have lifelong health consequences. “Just the burden of day after day not knowing whether there's going to be food on the table or not knowing whether you're going to have a roof over your head is actually toxic to the brain and the reason for that is because when the stress hormone levels go up and if it stays up for days and weeks on end those hormone levels literally interfere with the development of brain circuitry they interfere with the development of connections in the brain so we begin to see in children who experienced toxic stress long term impacts of what's basically been chemically damaging to their brands the concept here is the pileup of risk the cumulative burden of having things that are increasing your chances of having problems as opposed to the cumulative protection of having things in your life that increase the likelihood that you're going to have better outcomes economic security.”

The notion that poor people are in worse physical condition and have an increased risk for death compared with those who are better off is worrisome. United States is a wealthy nation and to have a population that could not afford to live a healthy life is heart-breaking! This disparities in mortality rates between the rich and the poor in illness like heart disease, cancer, and diabetes have widened. https://cityroom.blogs.nytimes.com/2007/09/27/health-wealth-gaps-in-new-york-neighborhoods-are-sobering-report-shows/?searchResultPosition=1

What can we do as a nation to address the disparities in health?

I personally in favor of government guaranteed health insurance. While a single-payer system is not the only way for the government to guarantee coverage for all, I think one way to think of such a system is to consider it “Medicare for all.”

But such a system would have to be accompanied by a hard look, led by medical experts and members of the community, at what works and what doesn’t, an assessment of how we can best budget our health care dollars to achieve the best possible health care outcomes. Such a system would take time and there would be hard choices, and not everyone would be happy. But we might come closer than we are to representing the interests of most Americans.

 

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