I am tired of attending funerals and hearing of the needless deaths of individuals who have died unnecessarily from conditions that could have been cured if treated or prevented in the first place.
This holiday season reminds me of twelve-year old Deamonte Driver, a young African American who died in the shadows of our nation’s capital last February from a toothache that progressed to a brain abscess.
Deamonte’s mother was repeatedly refused dental services for an $80 tooth extraction that could have saved the life of this young boy. He died because he had no insurance and no dentist would pull his rotten tooth without payment up front.
Another tragic death from a treatable cancer occurred with one of my student’s father, a retired El Paso fireman whose retirement left him without insurance. He was too young for Medicare and had “too much” income to qualify for Medicaid. No one would give him the potential life saving chemotherapy he needed without putting money up front.
My father, a sailor in the Pacific front during World War II, survived the sinking of his destroyer by a Japanese submarine, and somehow escaped death or injury in the insuring kamikaze suicide attacks; lived only to be killed 50 years later from an addiction to nicotine that the tobacco industry knew would kill people.
Our current health care system is a “sick care system” with over 70% of the health costs occurring in the last year of life. In 2007, as a country we spent over $2.3 trillion dollars on sick care or over $7,600 for each person living in our nation. What do we get? We have one of the most sophisticated sick care delivery systems in the world, yet we rank 37th when our health outcomes are compared against others such as Cuba at 39th and Costa Rica at 36th.
According to the Paso del Norte Region Health Report of 2007-2008 our local health indicators are some of the worse in the nation. Among USA counties, El Paso has the highest rates of cancer, stroke, and diabetes. Otero County has the highest rates of heart disease, chronic lung disease and injuries. Doña Ana and El Paso counties have the highest rate of death from cancer and heart diseases. Juarez has the highest rates of death from influenza, diabetes, and AIDS.
We have fewer registered nurses, physicians, dentists and other health care workers than in any other part of Texas except for the Lower Rio Grande Valley. Outside of the metropolitan area the rest of the county is considered medically underserved. The number of primary care providers to serve our population is half of the average found in the rest of Texas.
The majority of the causes of death such as diabetes, heart disease, stroke, and cancer are the result of smoking, obesity, and lack of physical activities. In fact depending on where you live your chances of dying is influenced by access to health care, healthy foods, transportation, quality education provided to you and your children, air quality and other environmental hazards.
The proportional importance of factors shaping health is determined 40% on behavior, 20% related to environment, 20 %t on genes, and 10 % on health care.
Where we are in our social structure is the highest predictor of health. Those at the bottom of the social economic ring are unhealthier and die younger. In comparison those at the upper end of the economic spectrum even when they smoke and are obese are healthier and live longer.
According to the Public Broadcast Service series, “Unnatural Causes,” those in the middle class have a 50% higher chance of dying sooner than those on the top. Furthermore, those in the lower economic sector are 400% more likely to die sooner than the upper economic sector.
El Paso ranks as the 7th poorest county in the nation with 26.4% of our population considered poor. We have over 32% of the population without health insurance and in some colonias the rate exceeds 60%. In El Paso 68% of our residents have a high school education and dropout rates in some of our public schools are as high as 50%.
However as a city and county we can take action now to start addressing the other 60% of the other determinates of health. A health population equates to an educated and healthy workforce.
Our schools must be held accountable for their outcomes. New and innovative teaching methods must be implemented to insure that no child, particularly boys, are left behind. A young boy who cannot read by the third grade is at substantial risk to be a high school dropout. Charter schools that are not hampered by bureaucratic restrictions should be financially supported and encouraged to locate in our poor communities. A child with an education insures opportunities for more economic security and the ability to make informed decision about healthy options.
Access to healthy foods for those areas without easy access to grocery stores is critical. Food desserts that exist in many of our poor neighbors must stop. We need to insure, in collaboration with our local government and private sector, local markets are given recognition for being a good neighbor. This recognition would only be awarded when fresh fruits, vegetables, meats, and other products are made available at rates found in more accessible communities. The creation of public garden plots, support for farmer markets, financially supporting local grocery vendors to sell fresh produce, diary products door to door as was once common practice will all assist in making healthy foods available. In other parts of the nation where this approach has been used the health of community members improved as well as the profits of the local vendors who offered the service.
Public transportation must be improved. Our city does not seem to have a transportation plan that encourages the use of public transportation. People without transportation particularly in the rural and in some of our poor areas are left with few options. Our sister city of Juarez has public transportations that serves their entire city. New transportation models must be developed and a long term strategy for transportation must be implemented.
Parks and recreational facilities for our youth must be a high priority. We must demand that physical education is taught in our schools along with curriculums that teach children how to be healthy. Food selections in our schools must include healthy options. Highly addictive food containing high sugar content and Trans fats must be completely eliminated from the school lunch menus. The Women’s Infant and Children program must include access to fresh fruits and vegetables.
A child who is obese will in most cases be an obese adult. We know that obesity kills. In fact the progress made in extending the life expectancy of our citizens may be lost through premature deaths due to health problems associated with obesity. The obesity epidemic will kill our children in their prime of life.
We are surrounded by environmental pollutants that may come from our proximity to smelters, refineries, asphalt plants, auto emissions, pesticides, lead both naturally occurring and as result of paint and other industrial activities, and polluted water. Studies to better understand these environmental hazards and solutions to minimize their impact are urgently needed. The economic impacts to our community from these industries must be balanced with their impact on the health of our citizens.
As a community we must muster the political will to say “enough is enough”. Our communities must be empowered to find solutions. We create through a shared vision solutions to these challenges. We can work with both our elected officials and the private sector to insure we have adequate number of health care providers, more Federally Qualified Health Plans, that our schools take action so they become part of the solution to create a healthier community, that we begin to believe that access to healthy food is a right, that parks and recreational activities means a stronger workforce, that public transportation means more opportunities to create a more educated labor force and enhances access to health services, and that our environment must not be a contributor to poor health no matter how much the economic benefit.
The Obama election may mean that perhaps the “stars” are aligning so that healthcare becomes a right and as a nation we may have finally place significant emphasis on health promotion and disease prevention activities that can improve our health and assure quality health care is available to all individuals living in our country. Maybe such an investment will mean that young people like Deamonte Driver won’t die from a tooth ache.
References
Portions of this article were inspired by a speech given by US Representative Elijah Cummings, (D-ND) Key Note Address on December 18, 2008 at the National Health Institutes, National Center for Minority Health Disparities conference on the Science of Eliminating Health Disparities. Representative Cummings gave a very moving speech about health disparities.
Regional health status data was taken from Paso Del Norte Health Foundation: Strategic Health Intelligence Planning Group Assessment of Determinants of Health in the PdNHF Region: A Review of Select Health Indicators for the counties of El Paso and Hudspeth in Texas; the counties of Doña Ana and Otero in New Mexico; and the city of Ciudad Juárez, Chihuahua, Mexico. Retrieved from Internet on December 19, 2008 from http://www.pdnhf.org/documents/659PdNHFRegionalHealthAssessment5-6-08Revised.pdf
And references from Unnatural causes taken from Unnatural Causes: Is inequality making us sick? Retrieved from Internet on December 19, 2008 from http://www.unnaturalcauses.org
This story first appeared in El Paso News Paper Tree on December 22, 2008.
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