Inequality in disease
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The social inequality of the United States is deep-rooted and widespread, even extending into a person’s health, and more specifically their likelihood of developing a disease. Biological factors or inheritable characteristics cannot explain the huge disparity among the disease rates for lower-class African Americans and upper-class whites. Rather, it is social factors associated with different social groups that determine to a large extent who acquires diseases. Heart disease is the most dangerous disease in the America, followed closely by cancer, and with the fifth most deadly being diabetes. The general risk factors that are associated with these three diseases include obesity and poor diet, tobacco and alcohol use, physical inactivity, and access to medical care and health information. While these risk factors may seem to be individual choices concerning health, it is important to recognize that they are greatly dependent on socioeconomic features, such as gender, race, income, environment, and education, and that a person’s likelihood for developing heart disease, cancer, or diabetes is in part determined by these social factors. Men are more likely than women to die from heart disease. African Americans and other racial minorities are more likely to die from heart disease, cancer, and diabetes than their white counterparts. Those living in poverty or with low income are also more likely to develop heart disease,[2] cancer, and diabetes. People living in poor neighborhoods and areas and with low levels of education have a similar fate.[2]
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[edit] Gender
Gender as a defining characteristic of a social group has different effects for the different diseases. Men are 30% more likely to suffer a stroke than women. Women generally have a healthier diet, and tend to consume fewer fats and carbohydrates. Women are also more likely to engage in regular exercise and follow their doctor’s orders concerning healthy habits. Men are more inclined to hot tempers and emotional outbursts that can increase blood pressure. Men are also more likely to be smokers than women. Both men and women battle cancer, but different forms of cancer pertain more or less to the different sexes. Breast cancer affects women more than men, and prostate cancer affects men more than women. Lung cancer, however, is the number one cancer-related killer for both men and women, but men are more likely to develop and die from it. Diabetes, on the other hand, is more deadly for women. In recent years, the mortality rate for diabetes is higher for women than it is for men.
[edit] Race
Race is a strong determinant of disease rates, mostly because racial minorities make up a large portion of the lowest social level. African Americans are more likely to die from heart disease than whites because they are less likely to engage in primary prevention techniques, such as exercise and a healthy diet. Also, more African Americans are obese or overweight and are smokers.[2] Similarly, African Americans have the highest death rate and shortest survival rate of ant racial and ethnic group for most cancers.[3] African Americans are more likely to smoke mentholated cigarettes with higher carbon monoxide concentrations, which put them at greater risk for developing lung cancer.[3] Obesity is more common in African Americans in part because they are less likely to engage in leisure-time physical activity.[3] The prevalence of Type 2 diabetes is four times higher among African Americans and other racial minorities due to both poorer diets and less physical activity.[4]
[edit] Income
Income is a huge factor contributing to the prevalence of heart disease because it is a predictor of many other social factors, such as one’s neighborhood, education level, occupation, and overall social status. Income itself, as well as the distribution of income affect the occurrence of heart disease. Populations with high levels of income inequality display higher rates of heart disease than populations with more evenly distributed income. People living in poverty are less able to afford healthy food, spend time participating in physical activity, and pay for medical care that can reduce the risk of heart disease.[10] The lack of insurance for those in poverty is another cause of health disparities relating to heart disease.[10] Low-income individuals tend to face greater stress, and with low funds, many people turn to high levels of food consumption, smoking, and alcohol use as a way to cope.[10] People living in poverty are also more likely to die from cancer than their more affluent peers because they do not have access to high quality cancer prevention, early detection, and treatment services.[3] There is a close correlation between increased poverty and increased diabetes, as well.[6] The reasons for the diabetes discrepancy are generally the same as those for heart disease and cancer; low-income individuals cannot afford healthy food or medication, and tend to have more stress in their day-to-day lives.[6]
[edit] Environment
The neighborhoods and areas people live in, as well as their occupation make up the environment in which they exist. People living in poverty stricken neighborhoods are at a greater risk for heart disease the supermarkets in their area do not sell healthy foods, and there is increased availability of stores selling alcohol and tobacco than in more affluent parts of town.[2] People living in rural areas are also more susceptible to heart disease, as well. An agriculturally based diet rich in fat and cholesterol, combined with an isolated environment in which there is limited access to health care and ways to distribute information creates a pattern in which people living in rural environments have higher levels of heart disease.[2] Occupational cancer is one way in which the environment one works in can negatively affect their rate of disease. Employees exposed to smoke, asbestos, diesel fumes, paint, and chemicals in factories can develop cancer from their workplace. All of these jobs tend to be low-paying and typically held by low-status individuals. The decreased amount of healthy food in stores located in low-income areas also contributes to the increase rates of diabetes for persons living in those neighborhoods.[6]
[edit] Education
The lower a person’s level of education, the higher their chance of being diagnosed with heart disease. People who have not graduated from high school have a 2.4% greater risk of dying than those who did graduate high school. Education level is also related to smoking, overeating, and not exercising,[2] thus education also affects rates of cancer and diabetes. A lack of knowledge about the risk factors of these diseases, as well as the understanding of symptoms and when to go to the doctor greatly affects both the development of disease as well as the prognosis of it.
[edit] See Also
[edit] References
1.^ Women, heart disease and stroke. American Heart Association. Retrieved on April 7, 2008.
2.^ ^2 ^2 ^2 ^2 ^2 ^2 Cort, Natalie A.; Stewart-Fahs, Pamela. Heart disease: the hidden killer of rural black women. Retrieved on April 5, 2008.
3.^ ^3 ^3 ^3 ^3 Cancer facts & figures for African Americans 2007-2008. American Cancer Society, Inc. (2008). Retrieved on April 13, 2008.
4. ^ ^4 American Diabetes Association. Retrieved on April 13, 2008.
5.^ Cancer facts & figures for Hispanics 2006-2008. American Cancer Society, Inc. (2008). Retrieved on April 13, 2008.
6.^ ^6 ^6 ^6 Daniels, Peter (1/30/2006). Diabetes in the US: a social epidemic. Retrieved on April 13, 2008.
7.^ Abel, Barbara (5/27/2005). Men and heart disease: take lifestyle cues from women. Retrieved on April 14, 2008.
8.^ Women catching up to men in lung cancer deaths. MediLexicon International Ltd (11/12/2006). Retrieved on April 6, 2008.
9.^ Nelson, Nancy (6/17/2004). The majority of cancers are linked to the environment. Retrieved on April 6, 2008.
10.^ ^10 ^10 ^10 Massing, Mark; Rosamond, Wayne; Wing, Steven; Suchindran, Chirayan; Kaplan, Berton; Tyroler, Herman (5/1/2004). Income, income inequality, and cardiovascular disease mortality. Retrieved on April 13, 2008.
11.^ Rastegari, Esther C. (2006). Occupation exposures and cancer. The Gale Group, Inc.. Retrieved on April 6, 2008.
12.^ Gutierrez, David (2/27/2007). Heart disease rates in U.S. vary by region, education level. Retrieved on April 6, 2008.
13.^ Hitti, Miranda (10/5/2004). Heart disease risk linked to low education: not finishing high school a risk factor for heart disease death. Retrieved on April 6, 2008.
14.^ Shi, Leiyu; Macinko, James; Starfield, Barbara; Politzer, Robert; Wulu, John; Xu, Jiahong (6/2/2004). Primary care, social inequalities, and all-cause, heart disease, and cancer mortality in US counties, 1990. Retrieved on April 6, 2008.
15.^ Nelson, Nancy (6/17/2004). The majority of cancers are linked to the environment. Retrieved on April 6, 2008.
16.^ Gregg, Edward W.; Gu, Qiuping; Cheng, Yiling J.; Narayan, Venkat; Cowie, Catherine C. (8/7/2007). Mortality trends in men and women with diabetes, 1971-2000. Retrieved on April 7, 2008.
