I just watched the first of a four part series on PBS titled “Unnatural Causes: Is Inequality Making Us Sick?” California Newsreel produced this documentary about all the ways in which inequity fundamentally affects health. I encourage you to look in your TV listings for it or go to the California Newsreel website unnaturalcauses.org.
Many things impressed me about what I saw in this first segment. For example, researchers and practitioners state flatly that we live longer now mostly because of improvements in our standard of living with only a minor contribution from medical advances; that inequality in income and wealth predicts health and illness; that health is affected by the control we have over our workday (the less control, the worse our health); and that, even taking these factors into account, just being African-American predicts poorer health. And they were not contradicted. There is no “On the other hand, experts from the Reactionary Science Institute disagree.”
Even better, a physician from Louisville, Kentucky who is leading efforts to counter the effects of inequality says outright that his work isn’t about getting people to eat more fruits and vegetables, it’s about empowering them—not to be better patients, but to be better activists, to learn how to develop and use political power for social justice. Music to my ears.
In following the campaigns for President, I haven’t seen a glimmer of this kind of health awareness. It reminds me that the purpose of political institutions like the Presidency and Governor and Legislature and Police and Courts is to maintain stability and manage change when the need arises. It’s our job to make change.
Although we might wish for an elected official who will lift up the downtrodden, reduce inequality, increase the control we have over our work, and eliminate racism, that happens only when a movement pushes those officials to do it. So the strategy of enabling people to exercise their power for better health is the right path. The documentary “Unnatural Causes” promises to show us how to build power and with it health from the ground up.
The institutions of our health care system are not built for this kind of health advocacy: it is a top-down system that’s about getting people into treatment, not redistributing income, wealth, and power.
That’s why we need to build power and health in another way. Our health care system is in crisis because it doesn’t address inequality as the core cause of damaged health. It’s also in crisis because it has no institutional means to empower people to build the healthy social and physical environments they need.
I’ll give you an example of how this other kind of empowerment works, an example we’ve discussed on this show before: aerial spraying to eradicate the light brown apple moth. Citizen activists concerned about their health are resisting this attack by the California Department of Food and Agriculture. They’re using their own experience supported by science to make their case—experience such as asthma attacks in children in the aftermath of the first round of spraying in Santa Cruz and Monterey Counties last fall. Public health officials are now following them—for example, the Public Health Officer of Santa Cruz County is now calling for a complete study of the pesticide the Food and Ag Department intends to use, issues first raised by citizen activists.
Power is as much about information and whose information counts as it is about organizing people to take collective action. Building power and health from the ground up, as the experts featured in “Unnatural Causes” advocate, calls for more than enabling participatory democracy. It calls for enabling participatory science.
