The Rich Stay Healthy, the Sick Stay Poor
Health and Economic Development Primer in one easy lesson (via SocProf’s Twitter feed):
This is not surprising to see the contrast between the prosperous (at least until now) areas, in green where chronic illnesses prevail but are diseases tied to aging, as opposed to the semi-periphery and periphery where infectious / parasitic diseases are prevalent along with accidental deaths. Obviously, to be born and live in a prosperous society makes life more secure on different levels.
Extending lifespans and expanding health has been, for the most part, a Macro story of discontinuities.
The rise of vaccines (with a possible contribution from the coincident rise of people getting a high school education) got the Developed World to the point where Major Organ Failure became a primary factor.
Lungs are first: pneumonia and tuberculosis don’t kill the young so often as they did. (Vaccines, testing).
The heart was next. Major advances in the immediate post-WW II (what the Europeans tend to call “post-war”) period—up to and through transplants and ever-advancing bypass surgeries—made it more difficult to die because your heart was weak or flawed.
The next step is the brain; rather more problematic, though progress gets made.
Note that the key assumption in all of the above is access to and use of the available advances. In a system that de facto rations by ability to pay (the U.S.), there is a greater likelihood that the rich will live longer—or, more accurately, that the poor will die unnecessarily sooner. Which is what has been happening.
This post dedicated to the memory of Isaac Asimov, who survived a heart attack for fifteen years and a triple-bypass that gave him nine more years of writing (though with collateral effects that would not occur today).
yes, and with the rising life expectancy of the rich we can raise the SS retirement age for the poor. it’s a win win.
“In a system that de facto rations by ability to pay (the U.S.), there is a greater likelihood that the rich will live longer—or, more accurately, that the poor will die unnecessarily sooner.”
Hmmm. I think that before the 20th century the main advances in health were communal: better sanitation, vaccination, etc. I remember being surprised as a kid in the 1950s reading that in the U. S. the poor were generally in better health than the rich. (Among adults, that is. Childhood mortality is greater among the poor.) Sitting at a desk all day and enjoying rich food is not a very healthy lifestyle.
Since then smoking has decreased dramatically, and people with desk jobs have started going to the gym and watching what they eat, while the poor often eat fast food, which is cheap, and easier than cooking at home if you have a second job or both parents work. In addition, the treatment of heart disease has progressed, along with expensive surgeries. I think that all of these factors have tilted things in favor of the rich.
Ken:
Happy New Year! Amazing what a little primary and preventitive healthcare will do for a population. Unfortunately, it does not have the same return as an MRI, etc.
This (me) is pure speculation, asking for comments from people who disagree with me or know more:
When I look at poor people where I live I see remarkably bad health. I don’t know if it’s genetic or just the consequences of no money. Bad teeth stand out. But other signs of poor health, and when you talk to them they are full of stories about being sick.
It could be just money, but I suspect those genes. Still, an “intelligent self interest” would suggest we do what we can to help them. Preventive dental care ought to be a good place to start.
Recall that in WWII a lot of soldiers were found to be undernourished. Its only post WWII that food got cheap enough that it became not nearly the problem it had been in the past. As a result we see the rise of obesity among the poor, (It used to be the middle class and above that had the surplus income to get obese). Food now makes up a smaller portion of the total expenses of families than at any time in History (about 10% according to the BLS).
These days, people who eat a lot of prepared foods like Hamburger helper or Kraft Macaroni and Cheese (no real cheese in a ton of it) and sugared cereals are living mainly on corn and concentrated corn syrup. Corn is not the kind of thing you want to eat a lot of because it’s almost all carbs. But, the carbs in processed food fills people up and if you don’t have a lot of money, it’s what you eat. Thus, weight gain and rising obesity among poor people. Luckily, there’s a lot of money in treating (but not curing) diabetes. This deadly diet and the profit margins of drug companies are directly linked.
Generally speaking, glasses and dental care cost cash money more and more people don’t have. In this country, the condition of peoples’ teeth is a sure sign of their social/economic status. So, those bright shining incisors are a badge of middle class or higher status as well as health. Proof positive that rationing already exists here. You gotta pay to get treated. Anyone who thinks that the ACA will create rationing is ignoring what is right in front of their lives. NancyO
“Lives” should be “eyes.” NO
It is the corn thing that allows food costs to be only 10% of the average budget. Now one wonders if a lot of people are perhaps depressed and committing slow motion suicide because they see their elderly period as a bad time all around, better to live well today and follow the sermon on the mount and let the morrow take care of itself. It is amazing the religious right does not take that message to heart and say don’t worry be happy.
Ken,
You will notice that almost all ‘advanced care’ that is available to Medicare patients was once ‘heavily rationed’ so only the rich could get it. Then, over time, it became cheaper and eventually available to all. Asimov’s triple bipass is a perfect example. Once only the rich could afford something like this. Now it fairly common through-out the land.
This is the golden goose that has continuosly been improving our lives to this day. My brother-in-laws business partner had some very experimental work done on his heart – no way any insurance would cover it (over $200,000 just for the 1-week regime plus more for follow-on care, monitoring etc). He wrote them a check.
At the time he was given less than 3 months to live (basically his heart could stop at any time). That will be 5 years ago this summer. A poor person with the same condition would long ago be dead.
This is a great outcome!! Why? Becuase in another 5 years this treatment will be mainstream and cost $20,000, and in 15 years it will be covered by Medicare and be called the ‘standard’ treatment for his condition.
And the team that figured this out will be one to the next big money making venture finding another cure for another heart problem.
You see this same progress in medical delivery everywhere you look. My father-in-law was able to do at home dialysis for almost 7 years before he passed away. 20 years ago he would not have made it those 7 years, let alone have the quality of life he had becuase he could do it at home.
So, yes I have no problem with defacto or dejure rationing on ability to pay. The team or company who solves Alzhiemers diserves to get filthy rich. And in 10-20 years from their discovery their treatment will be standard Medicare covered. Don’t kill the golden goose.
Lastly, your correct, the brain is the last big hurdle to be able to fix. Though I’ve read that fixing the circulatory system may solves some brain problems also.
Islam will change
Poor people buy a LOT more junk food than rich people.
http://www.nytimes.com/2008/11/04/health/nutrition/04well.html
You can tell someone who grew up poor if as an adult they have braces (finally get covered on the job). Its a tail-tell sign.
Really bad teath (if not caused by a desease) are mostly do to stupidity. Don’t smoke, don’t do drugs. Brush 2 times a day and floss 3-4 times a week will keep your teath and gums healthy. That will keep your dental needs down to what should be well within even the poorest person (1 per year check-up and cleaning – under $100 – sometimes even cheaper at free clinics etc).
Same with bad eating habits. In under 20 minutes, almost anywhere in the US and for under $5-7, you can get 1000 calories of crap food starting from being in bed on your couch. High calorie crap (mcDonalds type food) is available everywhere. People are not welling to spend the time to prepare and cook a meal. And they have the time (see TV viewing times/week). They probably don’t know how though, and its much easier (and sometimes cheaper) to just get the crap.
Rich/middle class people don’t have either of these problems – and almost by definition you don’t stay in the rich/middle class long if your stupid. They make it to the dentist and usually know the basics of nutrition and can cook (I can).
Solutions? I have no idea. The schools already teach all this and there is plenty of info out there – even for the poorest. You can lead the horse to water…
Life is tough, its tougher if your stupid.
Islam will change
NOt suprisingly the goal is to feel full and junk food is the cheapest way to do it. As noted above corn based food does the deal. It used to be that when total calories were rationed by pocketbook, that the poor went hungry. Today we ration quality food by pocketbook, but calories are able to fit alls pocketbook (in general).
Lyle,
Except for maybe the absolute poorest. That’s not true. You can get good quality food for cheap anywhere in the US. The kicker is you must prepare it yourself. The only place quality food is rationed is at restaurants – and if your poor you should not be eating at the locel Ruth Crist Steakhouse or McDs for that matter.
I can’t say it enough. Anyone can feed a family healthily at minimal cost if the prepare the food themselves and buy staples in bulk. If you insist on eating at McDs et al, then not so much. And learning to cook is free – the library has plenty of cookbooks on the shelf.
Islam will change
islm:
No, you can’t get good food anywhere as stoes will not locate in some areas
Yep, run. There are food deserts in this country where all you can buy to eat or drink is fast food, malt liquor, pints of spirits, and cheap wine. Watts has been like that for a long time. I seem to remember that Maxine Waters tried to get banks and grocery chains to go back into Watts, Compton, etc. Seems to me she is under investigation by the House Ethics Committee regarding dealings with banks. No good deed goes unpunished. You’re right, Buff. But, people on food stamps have to ride buses or walk. In big cities like LA, Oakland, etc. the good stores are out of reach. Can’t speak for the East Coast. NancyO
heck, i can speak for Brownsville, Oregon. you can’t buy real food in the local store. it’s about a twenty mile drive to a store where you can buy real food, if you are careful.
and just to be clear, these are white folks. Republicans for sure. and they are the people i was thinking of when i said the poor seem to be in worse health than rich people like me.
run,
And why would they not locate their? Oh yes, its not safe.
And I have seen few poor people who don’t have access to cars, cable TV, and cash for drugs and smokes. Back to the you can bring the horse to water…
And the places your talking about are a very small part of the US and I stand by the statement that its very easy to acquire good cheap food anywhere if you bother to try.
Islam will change
coberly,
Once again you equate poor people with the family dog. yet don’t see any problem with “enlightened elites” telling them what to eat, where to live, etc etc. So when they get old and infirm will Obamacares death panels put the poor to sleep like an old dog also?
A dictatorship by any other name. People have a right to make stupid decisions. And live with them.
Getting out of the poor house is very easy if you do a few simple things. Complete High school. No drugs, no gangs, no illegal activities. Don’t get married until your 25 and don’t get pregnant (or get someone pregnant) until your married.
yet the poor usually violate all of these…
Islam will change
NO,
First solution – leave Watts.
Second solution, have the local governments actually provide security for companies so they can safely move into the areas. Yea, that may take cops on every corner in some cases, but the locals created the problem.
Third, take the time out of their TV viewing habit to actually go somewhere you can get the food. Most poor have cars, but bikes are cheap and I watched german/dutch women ride their bikes dailey to the grocery store to get the families dailey food. Helps keep down the obesity.(and they did it rain or shine even in horrendous weather). — BTW, you point out one of my biggest gripes about mass transit – its impossible to carry even a small grocery cart full of food home while taking mass transit.
I live in the DFW metroplex and you can get to a grocery store even in bad neighborhoods. Plenty of places to buy cheap, good food in bulk. Plus all the seasonal farmers markets.
The only excuse for eating poorly is stupidity and lazyness. Sorry, I don’t buy the man is keeping people down crap. Poor people are not farm animals and we must expect them to make at least some effort.
Islam will change
Eating healthy and living healthy does not have to be expensive. You can grow your own fruits and vegetables if you have your own garden or open lot. Stop smoking and exercise. I am sure you would look more naturally beautiful than the rich with a lot of plastic surgery and enhancements.