The department of housing and urban development announced that when women were relocated from the projects to wealthier neighborhoods the incidence of obesity and diabetes was significantly reduced. This is a no brainer.
There are 5 determinants of overall health: personal behavior, social factors, healthcare, and the environment. Among the 5, inadequate healthcare accounts for only 10% of premature deaths, yet healthcare receives the greatest share of our resources and attention (Schroeder S. NEJM 357:1321, 2007). Behavioral factors of health include, smoking, obesity and inactivity, alcohol, and motor vehicle incidents, among others. It is the largest determinant of health and greatest contributor to premature death (accounting for nearly one million premature deaths per year).
Not surprisingly,the people who suffer the most, are the poor. Because of less access to better choices of food and recreational activities they suffer from increased rates of obesity, diabetes, and cancer, poor environmental conditions, and inadequate access to healthcare. The poor are easily forgotten and there are not many advocacy groups taking up their cause for better health.
Many Americans believe it is not their problem-people should be responsible for their own behavior. However, I’m sure poor folks didn’t ask to be born into poverty. Poverty is a breeding ground for nutrition-related diseases such as heart disease and diabetes and is a significant risk factor for Alzheimer’s disease and certain cancers.
There are some states that are tackling the problem of poor nutrition. You see, low income neighborhoods do not even have access to fresh fruits and vegetables because there aren’t any supermarket grocery stores in these neighborhoods. They rely on convenience stores and foods high in fat, sodium and sugar which result in premature death from diet-related illnesses.
Thanks to the Council of State Governments some states have passed legislation to increase the number of supermarkets in underserved areas. For example, in Pennsylvania 50 supermarket projects have opened across the state to serve poor neighborhoods. This is part of the Fresh Food Financing Initiative that was funded in Pennsylvania in 2004.
It appears that only when the problems of the poor become the problems of the middle class do we take notice and act. Now with healthcare reform underway let’s shift our focus to promoting good health. With health as our goal, we will decrease our healthcare costs and provide happier and healthier lives to all Americans. We must all put our prejudices aside and work to hard to achieve this goal.
[Photo By povertyinitiative]