Health Disparities

Last night I watched part one of Unnatural causes… is inequality making us sick? on PBS. The premise of the series is that economic status + education is the single biggest determinant of health in America. This is not controversial as it is well known that life expectancy is tightly correlated with social class in stratified nations and with income in the US. What was remarkable was to see the data presented side by side with very personal stories of how poverty creates health problems which are beyond the control of individuals.

My point in bringing this up is not to belabor the premise of the documentary but to point out that there are very reasonable things that could and should be done to reverse this problem.  A national health care solution would be an obvious way to help huge swaths of the population but it is not a solution to the problem (don’t misinterpret me here though, it is vital that we provide health care for everyone in such a way that it does not influence their economic outlook).  The solution starts with reducing economic disparity and increasing education access.  As discussed in the documentary, European nations have implemented these types of programs with great success and have seen improvements in dissociating class from health to the benefit of the entire population.

So what to do here in America?  

First, vote with some degree of knowledge about what your vote actually does for you. As Physioprof  and many others have discussed over and over again, the vast majority of Republican Americans vote in a way that is in direct opposition to their economic interests.  Hopefully the escipades of GWB and friends have knocked some sense into many voters who have been duped by the evangelical Republican strategies.  

Second, increase access to education.  Obviously, government can and should play a big role in this, but what about those of us (probably most of my potential readers) working within the educational structure?  Many of us likely work at institutions with endowments that are growing at an astonishing rate.  Rather than sitting on this fortune, universities should take a serious look (and we should encourage them through our activities) at releasing students from the economic burden of tuition.  Several major universities are in the process of doing just this but the commitment is, in most cases, still too small.

It so happens that my institution is considering tuition wavers for all in-state (its public) students. To my astonishment, many in the university structure are opposed to this proposition. Why? The argument I hear most often is that it devalues education — students only really appreciate it if they have to pay for it. To that I say, WTF! So, I’m gonna start fighting to support this proposition and my angle is going to be health disparities (and we’ve got a serious problem with health disparities in this here Western state). I hope to chronicle my activities in this project here on this little blog from time to time and I urge those of you with like mind to get involved where you can.  

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6 responses to “Health Disparities

  1. Dude, I thought I had paragraphs, what is happening here…

  2. Alright, think I fixed it.

  3. Hey, welcome. I really enjoyed your first post for its specificity–a boatload of useful suggestions for those of us looking ahead to the job market, thanks!

    I’d like tuition to be quite low indeed, but I have a slight tilt towards the “you’ll value it more” argument. Have you ever visited Oxford or Cambridge? My experience in Oxford was that the uni students, all of whom were there basically free, spent every single night drinking. Now, that may have more to do with English youth culture than with the uni being free per se, but it’s worth keeping in mind.

    My working premise would be: tuition should be low enough that one can afford it through 10-15 hours of work-study per week. That would keep it in check and set a straightforward benchmark. I worked 10 hrs/wk during a fair amount of college, and it’s not too onerous a burden to place on anyone who wants an education.

  4. Thanks for the encouragement DJ&MH.

    I’ve never been to Oxford or Cambridge but have been to the US and Canadian versions of big ones. I have also seen what you are referring to. I don’t like it, but, I really want to see all obstacles removed from getting an education especially for unis that are supposed to serve a certain population (like most state unis in the US).

    The idea of removing tuition altogether is to use it as a measure to alleviate poverty by giving open access to the best route to do it, getting a uni degree. I might lean toward making the tuition graded by your income; however, this could inhibit upper middle class folk from voting for such a measure. If it applies to all then more people would be inclined to think it is helping them too even though the measure is primarily aimed at people in poverty. In other words, I think it is so important to do this that I am more than willing to concede a few people (say as high as 20%) taking advantage of the system in order to improve the lives of those it will most strongly effect.

    Finally, the point of the documentary was that England had more or less remedied this problem already through a number of social programs including universal health care and low tuition rates. The US has done virtually nothing and programs that did exist have been cut (see Pell Grants for instance) under the Bush administration.

  5. You might be interested in this book if you haven’t read it already-

    ‘Class Matters’ by Bill Keller

    Its an eye opener.

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