[Reblog] A ‘birth lottery’ still determines who gets to live longest, healthiest life
A ‘birth lottery’ still determines who gets to live longest, healthiest life | joe rojas-burke.
From the 16 June 2014 post at JOE ROJAS-BURKE- Science Writer
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The latest data suggest that lack of social mobility remains as significant a problem as it was decades ago. In the generation entering the U.S. workforce today, those who started life in the bottom fifth of income distribution have about a 9 percent chance of reaching the top fifth. That compares with an 8.4 percent chance for kids born in 1971, according to research by economists Raj Chetty of Harvard, Emmanuel Saez of the University of California, Berkeley, and colleagues.
What’s astonishing are the huge differences in mobility depending on where you grow up, The odds of escaping poverty and gaining prosperity are less than 3 percent for kids in many places across the South and Rust Belt states. But in some parts of the Great Plains, more than 25 percent of kids born to the poorest parents move into the upper-income strata as adults, the economists found. The datasets are available here.
I don’t think it’s a coincidence that the places on this map with the lowest social mobility also tend to have the worst health outcomes. Lack of mobility is strongly correlated with worse segregation, greater income inequality, poor local school quality, diminished social capital, and broken family structure – factors that are also linked to poor health.
Even when poor children manage to escape poverty, a “birth lottery” may still determine who gets to live longest and healthiest. Exposure to adverse conditions during fetal development and early infancy appears to be capable of causing irreversible consequences decades later, such as increased vulnerability to weight gain, diabetes, heart disease, and premature death.
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[News article] Dental care in school breaks down social inequalities
From the 10 February 2014 Science Daily article
A new global survey documents how dental care in the school environment is helping to assure a healthy life and social equity — even in developing countries. But there are still major challenges to overcome worldwide.
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Around 60 per cent of the countries that took part in the study run formalized teaching in how to brush teeth, but not all countries have access to clean water and the necessary sanitary conditions. This constitutes a major challenge for the health and school authorities in Asia, Latin America and Africa in particular.
“Countries in these regions are battling problems involving the sale of sugary drinks and sweets in the school playgrounds. Selling sweets is often a source of extra income for school teachers, who are poorly paid,” explains Poul Erik Petersen.
He continues: “This naturally has an adverse effect on the children’s teeth. Many children suffer from toothache and general discomfort and these children may not get the full benefit of their education.”
The biggest challenges to improved dental health in low-income countries are a lack of financial resources and trained staff. Schools in the poorest countries therefore devote little or no time to dental care, and they similarly make only very limited use of fluoride in their preventative work. Moreover, the healthy schools in low-income countries find it harder to share their experience and results.
Social inequality is a serious problem
Social inequality in dental health and care is a serious problem all over the world:
“However, inequality is greater in developing countries where people are battling with limited resources, an increasing number of children with toothache, children suffering from HIV/AIDS and infectious diseases — combined with a lack of preventive measures and trained healthcare staff,” says Poul Erik Petersen, before adding:
“Even in a rich country like Denmark, we see social inequalities to dental care, despite the fact that dental health here is much improved among both children and adults. The socially and financially disadvantaged groups of the population show a high incidence of tooth and mouth complaints compared with the more affluent groups.”
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[Reblog] Social inequality: A blind spot for health reporters

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.
Dozens of news stories over the past year have reported on the disturbing data showing that Americans are dying younger than people in other wealthy countries and falling behind in many other measures of population health.
But much of the reporting I’ve seen shies away from covering a crucial part of the story: How social inequality may be the most important reason why the health status of Americans is failing to keep up with progress elsewhere.
Being born into poverty, growing up with curtailed opportunities for education and employment, living in a disadvantaged neighborhood – these social determinants of health are like the cards you’re dealt in a game of poker. It’s hard to win if the deck is stacked against you.
Researchers in sociology and public health have developed a fair amount of evidence that social status (typically measured by income or education) may be the most significant shaper of health, disability and lifespan at the population level. In the picture that is emerging, social status acts through a complicated chain of cause-and-effect. Education equips people with knowledge and skills to adopt healthy behaviors. It improves the chances of securing a job with healthy working conditions, higher wages, and being able to afford housing in a neighborhood secure from violence and pollution. The job security and higher income that tend to come with more education provide a buffer from chronic stress – a corrosive force that undermines health among lesser educated, lower income people. Research consistently shows that more education gives people a greater sense of personal control. Positive beliefs about personal control have a profound impact on how people approach life, make decisions about risky behavior, and cope with illness.
Since 1980, virtually all gains in life expectancy in the U.S. have occurred among highly educated groups. In a revealing analysis published in 2008, researchers looked at long-term changes in infant mortality and adult deaths before age 65 and found a widening gap between haves and have-nots over the past 30 years. If all people in the U.S. population experienced the same health gains as the most advantaged, they found that 14 percent of the premature deaths among whites and 30 percent of premature deaths among people of color would have been prevented.
But news outlets seem almost afraid to dig into questions about social inequality. Take, for example, CNN’s coverage of the Institute Of Medicine’s “Shorter Lives, Poorer Health” report in January. The IOM experts examined many measures in which the United States is lagging behind gains in other nations: infant mortality, disabilities, homicides, teen pregnancy, drug-related deaths, obesity, prevalence of AIDS, and life expectancy.
When the CNN coverage got around to explaining likely causes, it tossed out a range of possibilities, most of them blaming individual behavior. Compared with other wealthy nations we eat too much, spend more time driving than walking, fail to use seat belts, abuse more drugs, and use guns to shoot each other more. In the middle of this laundry list, the CNN report makes a glancing reference to the social determinants of health: “Americans benefit much less from social programs that could negate the effects of poverty.”
In July, a headline-garnering paper in the Journal of the American Medical Association explained how the U.S. lapsed from 20th to 27th among wealthy nations in terms of life expectancy at birth, and from 18th to 27th in terms of premature deaths.
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- World Health Organisation: unemployed youth in Britain are a public health time bomb (telegraph.co.uk)
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