In the past year, it has been heavily impressed upon Kansas Citians that one’s health is to a significant degree determined by factors beyond one’s control. The COVID-19 era is a key moment to further break down the reactionary notion that personal health choices are all that stands between an individual and optimal physical and mental well-being. It’s broadened our understanding of how health is also a product of social conditions.
The first and most elementary fact to note is that viruses, while often focusing on vulnerable populations such as the elderly, are not often entirely discriminatory. They end the lives of the young and healthy as well. Regardless of one’s habits of eating, exercise, or not smoking, random exposure to illnesses new or old as one shops for groceries or rides in an Uber helps introduce the point: The environment often makes a mockery of our personal choices, as important as those are.
The family you are born into, where you grow up, and other factors beyond your control — and often your own awareness — have a large impact on your development and health as a child, which in turn impacts your health as an adult. (And the environment you happen to be in continues to affect you.) Poverty, extremely stressful on the mind and body in many ways, is the ultimate destructive circumstance for children and adults alike. Take the disturbing life expectancy differences between the poor and the better-off, for instance. In Kansas City’s poorest ZIP codes, which are disproportionately black, you can expect to live 18 fewer years on average compared to our richest, whitest ZIP codes, as Flatland reported on June 22. Poor families are less likely to have health care offered by an employer or be able to afford it themselves. They live in social conditions that include more violence or worse air and water pollution. They can at times only afford housing owned by negligent landlords slow to take care of mold, and cope with a million other factors.
During the pandemic, what serious observers of the social determinants of health predicted came true: Black Kansas Citians were hammered by COVID-19. Here we feel, today, the cold touch of slavery and Jim Crow, which birthed disproportionate poverty, which nurtured worse health, which resulted in Black Kansas Citians being more likely to catch coronavirus and die from it, as The Star reported even in the early stages of the pandemic. Worse still, on Feb. 24, the paper noted that richer, whiter ZIP codes — the areas of less urgent need — were getting disproportionately more vaccines than poorer areas with more Black residents. The vaccines were first shipped by the state to health centers that were convenient for some but distant from others.
Imagine history and race playing a role in your health, how soon you could get a shot. Imagine transportation options and where you live being factors. Likewise, imagine the kind of job you have doing the same: Lower-income workers are more likely to have front-line jobs at restaurants and grocery stores, where you can catch the virus. The privileged, better-off often work from home.
Whether it is drinking water you don’t know is unsafe or working at a job that requires much human contact during a pandemic, the determinants of health stretch far beyond exercising, eating right, and choosing not to smoke. To reflect on this fact is to understand a moral duty. If social conditions affect the health of individuals and families, it is urgent to change social conditions — to build a decent society, one without poverty and the many horrors that flow from it.
In this moment, one important way to help move toward this goal is to urge the U.S. House to pass the reconciliation budget that just passed the Senate, to extend the direct child tax credit payments to families, boldly expand education and health care, and more. Onward, a better world awaits.
This article first appeared in The Kansas City Star: https://www.kansascity.com/opinion/readers-opinion/guest-commentary/article253638658.html
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