Health & Medicine

Occupy what? Start with health

Steve Shortell

The central message of the Occupy Movement is that the vast differences in resources between the upper one percent and the remaining 99% of the population is unjust. It is unjust because people have unequal opportunity to access resources and to earn a livable income. This gap has been growing over the past thirty years in the United States. The Occupy Movement in the Bay Area and across the country gives voice to a shared concern about this trajectory of unequal opportunity.

A starting point for restoring truly equal opportunities is to recognize the relationship among access to educational resources, jobs, economic status, and health. They interact in a cycle. Poor health in adults compromises their ability to make a living. Poor health in children compromises their ability to get an education which, in turn, affects their future ability to make a living. And so the cycle continues.

It is not by accident that the wide differences in income and living conditions between Hunter’s Point  area and more affluent neighborhoods of San Francisco are associated with a ten year difference in life expectancy. These patterns are replicated throughout the Bay Area, between Richmond and Contra Costa County, and between the flats and the hills of Oakland. Simply put, health is wealth, and wealth is health.  Inequality in one yields inequality in the other. Concern about this “inequality syndrome” should occupy the conscience of an enlightened democratic society.

To Occupy is to fully engage in policies that enable all members of society to lead healthier lives. This requires a recognition of the importance of the environmental and social determinants of health. These include safe streets, neighborhoods, workplaces and schools; parks and recreation facilities; access to healthy foods and clean water; and opportunities for meaningful work and civic participation. Equity in education, labor, housing, and transportation policies, is essential to health. This “health in all policies” approach addresses the underlying inequalities affecting our health.

We can start on this approach by implementing the California Department of Public Health’s 2020 Healthy People objectives.  Here are four examples. First, enhance access to and availability of physical activity in our schools and communities. Second, increase the number of communities with retail outlets that provide healthy foods. Third, eliminate the marketing of tobacco advertisements to children, adolescents, and young adults. Fourth, ensure health during formative years by increasing school-based health centers and school nurses in grades K through 12. Efforts such as these can help achieve more equal and just opportunities for both health and wealth.

These are not the only policies needed to narrow the gaps in health and income but they are a place to start. It is time to move from raising awareness to implementing solutions. It is time to move from occupation to action

Authors of this post:  Stephen M. Shortell, dean of the School of Public Health-UC Berkeley, and Joe Schuchter, School of Public Health doctoral student

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Comments to "Occupy what? Start with health":
    • Bill May

      Health in the U.S.A. is a disaster. It won’t be solved near as simply as having some insurance. Good food is primary to health after clean air and clean drinking water. Most of our food is soil derived and depleted in nutrients (U.S.Dept of Agriculture, 1936). Most all fertilizers, when used, are better for plants than people and live stock.

      A lot of the nutrition available when harvested is also lost in processing. White flour products, sugar, salt, dairy, corn syrup, high fructose corn syrup, hydrogenated cooking oils, margarine, all kinds of fillers and chemicals.

      Our legislators and federal agencies supposed to protect us have given us to the greedy wolves. The food industry, the medical conglomerates,
      insurance companies, chemical companies, the medical schools. ALL ARE ONBOARD THE GOODSHIP, LOLLY-POP. At the cost of our HEALTH and HAPPINESS.

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    • Reaz Mahmud

      No confusion that good health is related to wealthiness. The author is write about the point that poor health affects the education of a student. Not only some policies are needed for minimizing the gaps in health and income but also it should be regulated by the proper authority. People should be aware about the Occupy Movement which start in health.

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    • Linda Mcline

      Every individual can be assigned a health insurance tax status, ranging from full premium tax exemption for those, who have maintained coverage over their entire adult years through ages 21 to 65, to heavily punitive premium taxation for those who have delayed until the last few years before medicare eligibility. This tax gradient should be calibrated to generate revenue to cover the augmented Medicaid assistance under the new law for those who can’t afford health insurance, for whom and for which purpose the legislation was passed in the first place, addressing our national crime of not providing for the health of 15% of the citizens among us.

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    • kurt kramer

      Saving the Affordable Care Act

      The pending health care litigation before the U. S. Supreme Court highlights the vulnerability that it is not founded on the market principle of voluntary participation of freely choosing individuals, but depends instead on mandatory participation, “coercion” as the objectors emphasize. Judging by the oral argument, the Court seems about ready at the end of June to dismember the legislation and set health care coverage for those who can’t afford it back for another 20 years.

      The Democrat creators of the legislation, if they still care about those disenfranchised from health coverage, should at this moment, while the Supreme Court is deliberating, put forward in the Senate a correction which addresses and allays the concern that seems to be bothering the Court. The desired goal of getting broad participation in health insurance can very easily and “Constitutionally” be achieved by tax incentives and disincentives. Every individual can be assigned a health insurance tax status, ranging from full premium tax exemption for those, who have maintained coverage over their entire adult years through ages 21 to 65, to heavily punitive premium taxation for those who have delayed until the last few years before medicare eligibility. This tax gradient should be calibrated to generate revenue to cover the augmented Medicaid assistance under the new law for those who can’t afford health insurance, for whom and for which purpose the legislation was passed in the first place, addressing our national crime of not providing for the health of 15% of the citizens among us.

      If the Democrats rise to the impending challenge and put this correction on the Senate floor post haste before the Court makes its ruling, they will be demonstrating to the Court and the Country that the health care legislation is not fatally flawed, that any “constitutional” loose ends about mandates can be easily tidied up, and that the new system can sustain itself within the stricture that all participation by individuals in health insurance is voluntary.

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    • Cheryl Klos-Montalbano

      Cogent and so true. Once I bought a dozen eggs from a market I’d never used before on my way home from work. When I cracked them–they were rotten. It was very annoying.

      But if I’d been a single mom taking the bus home, intending those eggs to be dinner and maybe breakfast too–what could I have done? Ride a bus back to the store with children in tow to get my money back? Feed the kids cereal? Carry rotten eggs on the bus the next morning to get my money back? Instead of a minor annoyance, it could have been the straw that broke the camel’s back.

      I had other choices for dinner and I could afford to lose the money. But there are so many people who can’t.

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    • w. Bradley

      “It is not by accident that the wide differences in income and living conditions between Hunter’s Point area and more affluent neighborhoods of San Francisco are associated with a ten year difference in life expectancy. These patterns are replicated throughout the Bay Area, between Richmond and Contra Costa County, and between the flats and the hills of Oakland. Simply put, health is wealth, and wealth is health. Inequality in one yields inequality in the other. Concern about this “inequality syndrome” should occupy the conscience of an enlightened democratic society.”

      Wow thank you for this analysis. Now we will know where to start first. And that is healthcare.

      It’s very clear in your message. However, most of the time health care becomes secondary when it should be on the top of the list of action points to do to secure equality and better opportunity for the remaining 99%

      Warren Bradley

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