After the event: Root causes of health disparities

Gilda's Club Seattle hosted Dr. Maxine Hayes, the state health officer, last night for a lecture on the root causes of health disparities in society.

This lecture was the third session in a four-part series based on the Unnatural Causes documentary.

Dr. Hayes was a fascinating speaker who actually published an article in the Buffalo Physician about today's health buzz back in 1971. She realized back then that people weren't dying for medical reasons, they were dying of poverty. She described a program where she took government funding to plant gardens-not write prescriptions.

"Medicine contributes the least to health," Dr. Hayes said. Fifty one percent of what influences our health is healthy behavior (environment is 22 percent and genetic makeup is 17 percent). Interestingly, health care only has a 10 percent influence rate. McGinnis, et.al, 2002

For the past 50 years, our health policies have focused on: 1. Health behaviors & personal risk factors, and 2. access to health services. Today, however, people are noticing other influences: Institutional biases, stress, environmental risk, language, education, mental health & social support, economic opportunity & equity, and trust in the health system and research. These are called social determinants of health.

"Genetics loads the gun, environment pulls the trigger," Dr. Hayes said.

We can't blame poor health on lack of health care. There must not be a change in health care policy, there needs to be a change in health policy.

"The choices people make are based on the choices people have," Dr. Hayes argues. If people can't walk on safe streets will they exercise? If people are surrounded by fast food restaurants will they eat a variety of fresh foods?

I must admit, I left last night's lecture feeling rather helpless in addressing this issue. Dr. Hayes works on a policy level with people like Ron Sims. After two years in the Peace Corps I want to know what I can do on a community level. Isn't there a need for a brochure or Web site? Perhaps a group or committee?

If you knew that you could change the health of this nation by improving an urban planning or zoning policy, what would you change?