The name of the film is Unnatural Causes: In Sickness and in Wealth, by the filmmaker Larry Adelman. The film begins by highlighting the explicit differences in health between the United States and other industrialized nations. It points out that although the United States is the wealthiest of the industrialized nations, it's people continue to live shorter, sicker lives. The film argues that the reason why the overall health of our country is the way it is, is because of the level of social inequality and the maldistribution of wealth. As Sir Michael Marmont stated "there are huge inequalities in this society. All this wealth is maldistributed, and I think that is why the U.S. as a whole has relatively poorer health amongst the rich countries." An example of maldistribution of wealth I can think of is in the article; Savage Inequalities: Children in U.S. Schools, where the poorer schools received less than half the computers the wealthier schools received.

The film also argues that our genetic makeup is not the sole determinant of our health. The environment we are exposed to, how we interact with that environment during our lifetime, also plays a role in determining our health. In the article we read in class titled; Identities and Social Locations: Who Am I? Who Are My People? The authors wrote about how their lives were shaped by the environment in which they grew up. As stated in the film by Nancy Krieger " there is one view of us as biological creatures, that what we see in our biology is innately us because of who we were born to be, what that misses is that as adults we interact constantly with the world in which we are engaged, that's the way in which our biology actually happens." Individuals living in Louisville Kentucky's more affluent neighborhoods, with higher socioeconomic status, had increased life expectancy rates. These social determinants of health, such as where we live, play, and work can in turn influence our overall health. The film showed that individuals of lower socioeconomic status were twice as likely to die from diseases such as diabetes, stroke, and heart disease. As demonstrated by Sheldon Cohen in his research on release of cortisol levels in relation to stress and socioeconomic status " higher status equals less stress, less stress equals better immune function."

I found that the film doesn't explain in much detail what the social determinants are, so I went ahead and found a website that seems to do an excellent job explaining this  https://www.cdc.gov/socialdeterminants . As delineated on the CDC website as well as the film, the conditions in which we live, the extent of poverty to which we are exposed to, our socioeconomic status, behaviors, lack of education, physical and social environments, can influence our access to safer neighborhoods, and healthier foods, therefore directly affecting our health. The website also provides us with policies that can help guide communities when attempting to improve their physical and social environments.


Comments

  1. Hello Yanery,

    As a minority myself, I always wondered is social and economic inequality making people sick? The film certainly answered this question. Now more than ever I am convinced that people who have a lower socioeconomic status are more likely to get sick, to live a shorter life (due to stress and other health issues). Sheldon Cohen did an amazing job to demonstrate how stress in humans produces excess amount of cortisol in their bodies can mess up people's immune systems.

    I totally agree with you, the higher status a person possess will equal to less stress,. Less stress certainly will equal to having a better immune function and a longer healthy life.

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  2. Thanks for sharing that link, Yanery!
    I'm wondering, as a school nurse, what kinds of environmental factors you see IN the school. There is a push right now from student activists in PVD (like the Providence Student Union) to improve school conditions, e.g. lead in the water. Also thinking about other factors like stress caused by standardized testing and other school factors....and what role school nurses can play in getting administrators and policymakers to "look upstream" at the social determinants of illness.

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  3. Since you are a nurse, I imagine you had a keener insight into the cortisol issue than the rest of us in the class. It certainly seems so from what you've written. I, having no medical background, found that aspect of the film interesting and surprising and even heartbreaking, but in truth, it was a little beyond my reach. Thanks for your thoughtful post and for linking the CDC article.

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