Photo: Courtesy of Carol Naughton/Purpose Built Communities
Amid growing awareness about “ZIP code” health disparities, some struggling areas are trying new ways to reinvent their communities and move residents toward better health and wellness.
Some of these projects involve health experts and housing developers to help get local officials out of their silos and into multi-sector projects that will overhaul poorer urban neighborhoods, where maintaining good health can be challenging, two such experts told AHCJ members during a recent webcast. Continue reading
Poverty is a poignant reality – and an overwhelming one. If you’re a reporter, you might struggle to find the story in health inequality. But at Health Journalism 2015 in Santa Clara, Calif., panelists shed some light on the health disparity between high and low incomes – and who it hurts.
Nearby Silicon Valley has massive income inequality, and panelists from Northern California gave attendees some local perspective. The panel, moderated by independent journalist Sheree Crute, explored how wealth influences health, as well as how to provide – and cover – health care in an impoverished community.
Luisa Buada, R.N., M.P.H., chief executive officer, Ravenswood Family Health Center, said the top earners in Silicon Valley can make $3,500 a week and the mean cost of a home is $855,000, but 86 percent of patients in her clinic are at or below 100 percent of the federal poverty level (FPL).
“We’re living in a place of extraordinary poverty surrounded by extraordinary wealth,” Buada said at the April 25 panel. She described “another kind of homelessness,” in which low-income families are priced out of the astronomically expensive Silicon Valley. This creates a barrier to health care for those people, she said. Continue reading
The U.S. and other wealthy nations have practically eliminated all of the infectious diseases that seemed to account for the unequal burden of death in poor households and neighborhoods in earlier times. And yet inequalities in mortality have continued at more or less the same level since at least the early 1800s. What has changed are the major causes of death, which are cancers and chronic disease of the heart and vascular system.
Social scientists Jo Phelan and Bruce Link were among the first to make the case that inequalities in health are unlikely to change unless policy makers address inequalities in income, education and social status. Link and Phelan developed an influential theory that describes how social forces are the fundamental causes of health disparities.
A new key concept in AHCJ’s core topic area on the social determinants of health gives a quick overview of fundamental causes theory, the supporting evidence, and the implications for health policy. The theory predicts that interventions that aim solely to change individual risk factors will tend to worsen social inequalities in health, and there is some evidence that this really happens. Read more…
It didn’t sit right with Olga Khazan, an associate editor at The Atlantic, seeing so many people focus on individual behavior as the root cause of public health problems such as obesity, diabetes and heart disease. She’d come across too many studies revealing how health is shaped by external factors such as educational opportunity, the physical environment and social quality of neighborhoods, and the corrosive effects of prolonged exposure to stressful living conditions.
In How Being Poor Makes You Sick, Khazan came up with an appealing lede to draw readers into a deeply reported story about the complicated, nuanced realities of the social determinants of health:
When poor teenagers arrive at their appointments with Alan Meyers, a pediatrician at Boston Medical Center, he performs a standard examination and prescribes whatever medication they need. But if the patient is struggling with transportation or weight issues, he asks an unorthodox question:
“Do you have a bicycle?”
Khazan found an efficient, compact way to frame the story to make it highly readable, while fitting in a tight exposition of the research linking social adversity to poor health via stress, lack of education, poor nutrition, environmental toxins, altered gene expression, and other pathways. I talked to Khazan about how she came up with her idea and executed the reporting. Read more …