Unnatural Causes: Is Inequality Making Us Sick?
"We know that social class is the most important determinant of health - above all other risk factors," says Len Syme, HRA's Co-Principal Investigator, in Unnatural Causes, the seven-part series now airing on PBS.
The series explores why living in America is not a "ticket to good health." And how social class, economic status, and ethnicity relate to health status, in America and around the world.
Dr. Michael Marmot, a former student of Len's whose work is featured in the series, has charted the health of British social servants for over 30 years. Even in Britain, where everyone has access to health care, Marmot found that rates of illness correlate more closely with status than with commonly recognized health risks such as high cholesterol, lack of exercise, and smoking. Marmot says, "We find social gradients in health everywhere."
Yet Syme is optimistic that we are changing the way we think about health. "This is the first time in American history when we are really beginning to come to terms with social issues, going beyond medical care."
The series' producers and partners are hoping to motivate communities everywhere to explore and act on health equity issues. A set of public engagement tools is available to facilitate community action - a high priority in Len Syme's work and in the work of HRA. Len says, "One of the most impressive thing happening is these community gatherings" across the country in conjunction with the TV broadcast.
(See Len's commentary about this topic in the March/April issue of Health Affairs.)
Regional Gathering on Improving Health Literacy
The best health care won't help people if they don't understand health information. Research shows that people who have limited literacy or limited English proficiency are especially vulnerable. They have poorer health, more illnesses and hospitalizations, and higher mortality than the rest of the population.
"Consumers cannot take full advantage of the wealth of health information available to them if they cannot understand it," said Cindy Ehnes, Director of the California Department of Managed Health Care (DMHC), at a western regional symposium on March 10.
Participants shared innovative uses of technology to address health literacy barriers, such as a telephone touch-tone response program to help patients manage their diabetes at home. Several speakers highlighted HRA's communication resources as models that effectively address health literacy barriers.
Health literacy - the ability to understand and act on health information - has emerged as a major health issue, exacerbated by the increasing complexities of disease management and of the health care system.
The Sacramento gathering also addressed ways to advance national and state policy at the local level. This was one of a series of "town hall" meetings sponsored by the national Centers for Disease Control and Prevention. The meeting was co-sponsored by DMHC and HRA.