Wednesday, September 01, 2010

Inequality: the Real Cause of Poor Health

SOYMB found this article of interest.

University of Washington epidemiologist Dr Stephen Bezruchka has been writing and speaking for nearly two decades on the real cause of illness and poor health. As he repeatedly points out, lifestyle factors (including smoking) only account for ten percent of the causation of illness. According to Bezruchka, the single most important determinant of adult health status and life expectancy is your mother’s income and social status during pregnancy and the first three years of life. Early Freudians used to make similar claims about unfavorable “psychological” influences on infants and young children, it is now clear the effect is biological rather than psychological. That it relates to “epigenetics” – a term referring to changes in gene expression caused by mechanisms other than the underlying DNA sequence. Studies show that environmental stress and hormones (particularly stress hormones) produced during pregnancy can cause genetic code to be transcripted (into proteins and enzymes) in such a way to negatively affect the development of the immune system – in addition to predisposing the fetus to biochemically based mental illnesses.

However the most important epidemiological finding, according to Bezruchka, is that the effect of low income status on health is much more pronounced in societies with extreme income inequality. Study after study bears this out. In other words, a poor person’s adult status and life expectancy will be worse if he is born into a country with big gap between the economic status of its rich and poor - such as the US where 10 percent of the population controls 71 percent of the wealth.

Epidemiological studies – as long as scientists have been doing them – have always shown that poor health correlates directly with low income and social status. Even in Dicken’s time it was taken for granted that the poor – undernourished and living in cold, damp, overcrowded tenements – were far more prone to illness than their middle class counterparts. Dr Susan Rosenthal, in "Sick and Sicker", also points out that it’s only in the last thirty years that politicians and policymakers have made sick people responsible for their own illness. In her mind this shift to a new “blame the victim” mentality has been deliberate – to justify aggressive social service cutbacks by both Republicans and Democrats. Opinion makers try to convince us that class differences have disappeared in the US. For example, it’s extremely rare to see working class families depicted on American TV. Even mentioning the existence of an underclass leads to accusations of “class warfare”.

Rosenthal points out that minimum wage workers aren’t just poor. They also work in exploitive, arbitrary and often punitive job settings that they feel powerless to change. The immense stress of confronting this massive stress on a daily basis takes an enormous toll on both the human body and psyche.

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