Americans spend more money on health than anyone else in the world, yet they live shorter, less healthy lives than citizens of other rich countries. The complex reason for this is the multiple factors that affect our health. The simple reason is the fact that people seldom talk about these factors. Here are five things that people should be talking about when they talk about health:
The passage of the Affordable Care Act of 2010 has had a lot of people focusing on healthcare—particularly how costly things like doctor visits and prescription drugs are. This overshadows a debate about health itself and how economic standing can give someone an advantage or disadvantage in this respect.
Money pays for access to treatment, but it also pays for conditions that contribute to health. For example, the Affordable Care Act cannot make housing more affordable. The cost of housing determines where someone can live, and this can greatly affect one’s access to healthy food. The average income of a community also affects tax revenue, which in turn affects funding for pollution management and other things. All of these factors go into developing the health of a population.
The nature of the distribution and means of wealth (about 35-45% of wealth is inherited) reveals systematic elements in place to address in order to make health—not just healthcare—affordable.
A person’s health is dependent on many environmental factors: air quality, water quality, sanitation, infrastructure—whether it be related to public transportation, housing, or other commodities like green spaces— and many other features that are characteristic of where someone lives. Social surroundings are also paramount. Are there people available in the community to care for others when they’re in need? Are there social programs in place to promote community trust and education about how to improve public health?
Place extends further than one may think. Occurrences such as climate change show that the management of a single neighborhood’s environment can have a ripple effect on a regional and even global scale.
While non-human factors such as wealth or the environment can certainly have an impact on the health of communities, the fact remains that those communities are made up of people. The way in which people interact is a crucial element that determines health.
It’s easy to tie health to hygiene and the spread of disease. This causes people to be preventive and exercise caution in terms of social interaction. However, the spread of the quality of health is not only determined by the management of infectious diseases, but rather also includes societal habits. For example, someone is 57% more likely to suffer from obesity if he maintains close relationships with other people who are obese.
This idea of contagion may cause people to think that isolation from certain people can promote better health. Unfortunately, this notion does not take into account the impact of isolation and social stigmatization. People who live in isolation are more likely to suffer from addiction and depression and have a higher potential risk of suicide. Isolation in combination with advancing age also increases the chance of difficulty in mobility and other health issues.
Social interaction and inclusion combats these negative health conditions, and works to destigmatize certain issues by creating supportive social networks. For example, healthcare workers who worked to reduce the marginalization of the LGBTQ community made dramatic progress in the management of HIV/AIDS and in diminishing the stigma that accompanies the disease. It’s likely possible to successfully employ similar tactics in order to improve treatment of addiction along with many other public health challenges.
Just as the management of a local environment can positively affect the global environment, so can an individual improve their health by realizing that they are not isolated. This is how compassion—caring about other people’s health—enters our discussion.
Compassion encourages people to invest in programs and policies that benefit the greater public good even without an immediate return. For example, a policy that may call for state funding to manage a measles outbreak can benefit the whole state by preventing the disease from spreading.
People once thought health was determined by a balance of “humors” (four types of fluid) in the body. Through the development of the scientific method and questions brought about by medical research, this idea has been dismissed, and researchers have developed more effective, fact-based medical practices.
Knowledge rarely grows in a straight forward fashion. Often it occurs in a trajectory characterized by asking and answering questions and then revisiting those answers with more detailed and nuanced questions later on. This pattern is important to understand how it might be best to talk about health. For example, we know that if someone gets a staph infection he should take an antibiotic. But it’s also very important to understand how the patient was infected in the first place.
Knowledge gives us an understanding of health, but continuing to question what we think we already know helps us to see where to investigate in the future.
While statistics regarding health factors are widely shared, the reason behind them are not often as discussed. When we talk about health, it’s important to approach the subject holistically, looking at a wide range of contributive factors. In order to truly make any change we have to engage in these types of conversations that look beyond narrow ideas about how health works.