Some of you might know that my day job is working for a charity that supports other charities in the local area, some of which are the most deprived areas of the country. Part of my work within that and in previous jobs was in Community Development and when I was studying for my MA in Community and Youth Work I learned a lot about injustice, inequality and linked to overcoming that – empowerment.
I really wanted to share this video as the facts and figures in it made me think. I talk a lot about being healthy and living a healthy life, but when you consider what most of us in this country would consider as healthy it is a million miles away from what that means in other countries, and even parts of our own country. I have blogged before about healthy eating on a budget, but I know that the issue is a lot more complicated than the price of vegetables – to help address inequalities in our own country at least, I feel people need to be educated and empowered to make a change.
The figures in the video are quite scary: 99% of mothers who die in pregnancy and childbirth are from developing countries for example. Even in the UK there is nearly a 10% difference in average life expectancy between the poorest and richest London boroughs.
London School of Hygiene and Tropical Medicine have launched this video as part of their campaign to draw attention to the problems of unequal healthcare across the globe, across countries, and even between areas of individual cities. Some of the reasons for health inequality include differences in lifestyle, education, income, housing, ethnicity and of course accessibility to healthcare. You can find out more about the Make Health Fair Campaign here.
I’ll let the video do the talking, but I’d love to know your thoughts, what are your opinions on this topic? How do you think we can work to address health inequality in the UK and globally?
{ 5 comments… read them below or add one }
This is actually exactly what I’m studying. I’m from the states & getting my M.S. in Public Health Nutrition (which will also give me my Registered Dietitian credentials) as well as an MPH in Community Health Education. I think in the states the scariest thing is that we spend more money than pretty much any other country when it comes to health expenditures, however the quality of our health care is extremely low (I believe we are 29 on a list of developed countries). It’s really sad- not everyone in the states has access to adequate care. In the states you are allowed to be on your parent’s insurance plan until you are 26. But since I am in school and pay for everything myself, I am disqualified for that. I do have insurance coverage, but it doesn’t cover dental and right now I am actually in need to having my wisdom teeth extracted, yet would have to pay out of pocket for that. I think for me, I struggle with this because if someone who is educated, has a job, and pays her way through life struggles, then how can you expect the poorer population to strive. Obviously a rebuild of the system is in order, but that’s difficult too when you have bi-partisan politics thrown into the loop.
One thing I did find interested and empowering is a couple of years ago in one of my graduate nutrition classes we did a project and found that individuals who live in the poorest neighborhoods pay more for fruits and vegetables than those in the highest income neighborhoods. And I don’t just mean when you account for cost of driving/taking public transit/etc, I mean that the actual food at the grocery stores is more expensive. WHAT?! Isn’t that crazy? But then we went in and did interviews with the individuals that live in the neighborhoods and for the most part, the individuals in the highest income neighborhoods were in tune with the issues that we were trying to address. Furthermore, the individuals living in the lowest income neighborhoods were really trying to do what they felt was the “right” decision, they just didn’t have enough support around them to do so. While that sounds depressing, it was actually empowering because a lot of times in the states, the poorer individuals are often considered lazy and are perceived as not caring about their health, but for the most part, that could not be farther from the case!
I know I just went through a lot of topics- but in our neighborhood, we are trying to help alleviate health disparities by improving public transit and removing food deserts. And while that doesn’t sound like a lot, you have to begin somewhere and I’m really proud of our community for recognizing those disparities and taking the first step here. As for health care- I’m still up in arms about that… perhaps I’ll just move to Canada ;)
Sorry for talking your head off there, but health disparities are something I’m obviously pretty passionate about :)
Don’t apologise, thanks for this! I’m passionate about this too and find it really interesting. I can’t believe that the food is actually more expensive in poorer areas, its crazy! Its also good to see that people were actually trying to do what they felt was right – with that in mind do you think its an education thing? I.e. educating people more on basic good nutrition? I find that in the UK there is health information, but its really poor and does not talk about whole v processed foods, which for me is the fundamental basis of good nutrition. At least we do have the NHS, but as that video shows, we still have huge inequalities here too :-(
It’s interesting that you feel that in the UK its the quality of the education. In the states, I’d say its a variety of things. As a whole, I feel that most individuals are pretty well educated. I mean, most know to eat more fruits and vegetables and less processed crap. What I find challenging is the lay media. People like Dr. Oz, Oprah, Self Magazine, etc are considered the experts. Low carb diets cause weight loss! Low fat… high protein.. etc. And when it really comes down to it, its all about calories. Eat less, move more and you lose weight. Doesn’t seem complicated, but the lay media confuses people. There are also behavioral challenges. I actually work with a clinical psychologist who is also an RD and we approach everything from a behavioral standpoint, which is where the majority of the evidence lies. As a practicing RD, I can only be reimbursed by insurance if I use behavioral based interventions. I think across the nutrition profession, this is where things get messed up. Using education instead of behavioral (i.e. eat fruit instead of chips as opposed of looking at the behaviors that cause over eating). Again, seems simple, but this is another area where people get confused.
Being in the south, there are a whole other set of challenges. A lot of the programs that are set up are using state money. Where does the state get money? Federal government. Who is present? A liberal. The south has a horrible reputation of being stubborn, racist, and conservative (which is ironic considering Alabama, Mississippi are 2 of the poorest states), so there’s resistance there with people not wanting to enroll in programs that are supported with government money when Obama is president. There’s also a lot of fatalistic thinking here. A lot of the poorer individuals we meet have this deep ingrained thinking that “well my mom had diabetes, so I will too and so will my children and grandchildren.” How do you even target that type of thinking? I think again, this is where a lot of psychology comes into play. I’m pretty sure I haven’t answered your question at all… but I think what it comes down to is there’s a huge issue with personal opinions getting in the way of science. When the professionals contradict themselves so much and put bandages over problems instead of making small steps to reverse issues and make for a better future, what can you really expect the general public to do?
I think that is such a huge part of the issue, there is no one consistent message coming from the government and the media alike – for most people they do just need to understand that simple message of eat less move more and eat more whole foods. I have found the confusing issue to be all of the ‘low fat’ ‘light’ products on the shelves when I have spoken to people they don’t seem to know where to start when it comes to improving their health, in part because of all the mixed messages they get about what is ‘right’ or ‘wrong’. I did not even think about those kind of political issues you mention in the southern states, we don’t have those kind of political issues, but generally we have some difficulty of people resisting governmentally run programmes – especially ones linked to obesity in their kids. I’ve been working in the voluntary / not for profit sector and that seems to be a more community focused and engaging approach for getting people involved. Oh and the behavioural thing is massive, a lot of clients I have worked with its about reversing learned habits and creating new ones. I think on the ‘its my destiny to have this disease thing’ all we can try and do is educate people on the effect that lifestyle change can have on that, and remind them that it’s not always their fate to develop it.
excellent video….really makes you think. Thank you for sharing xx
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