Geographical Stratification of Contagious Health

September 30, 2016

 

                       

                         It is a wide known fact that the location of where one lives has a substantial impact on health status. Most people can’t help where they grow up, and where they grow up is more than likely where they will reside in the future. This is especially worrisome for individuals who grow up in low-income areas that promote unhealthy behaviors, which can lead to a propagation of unhealthful habits over time. A recent article in The Atlantic discussed the ins and outs of this problem, and the role that geography plays in it. The original journal article was previously reported on in The New York Times, and was published in the April 26th edition of The Journal of the  American Medical Association (JAMA). Expectedly, the study found that individuals who had higher incomes had greater longevities; there was a 14% gap in longevity between the poorest 1% and richest 1%. Life expectancy varied locally among the poorest individuals in low-income areas. Geographic differences in life expectancy in the lower-income regions were associated with negative health behaviors, such as smoking, but not associated with physical environment factors or access to medical care. The results of the study seem fairly obvious that if you keep a health conscientious diet and a lifestyle that promotes exercise and other healthy actions, you will be more likely to have a greater life expectancy and less likely to suffer from chronic disease.

 

  1. Graphic from the study which demonstrates those lower-income areas, such as Detroit have shorter life expectancies than those in wealthier cities, as shown in The New York Times article.

                        However, what is intriguing is looking into why there seems to be promotion of unhealthful behaviors in the poorest regions. Research has shown that your actions tend to mimic the actions of those around you. Think about it- if you see a friend exercising, aren’t you more likely to exercise as well? Social influence has a major impact on a variety of factors, but especially smoking, obesity and exercise. There are several barriers to health and to physical activity, and lack of support in particular is a major barrier, especially in these poorer regions where sedentary lifestyles and unhealthy behaviors are contagious. Social influences are just one factor as to why in the poorest, low-income regions there is a positive trend of smoking, obesity, inactive lifestyles as well as greater chronic disease prevalence, including higher rates of diabetes, hypertension and stroke. But how do we fix this problem that seems to be ever so ingrained into society? I mean, can you really help where you are born? The answer is not simple nor should we expect it to be when the problem itself is so multi-faceted.

                       Numerous public health agencies across the country both locally and nationally are working to solve this problem. One solution that the authors suggest in the article in The Atlantic is to put more housing in healthy cities; especially housing for low-income individuals. Housing in an area that places the individuals amongst people who exercise and promote healthful behaviors will likely encourage them to engage in those healthful behaviors as well. The social influence of living in a healthier, safer neighborhood may lower child obesity rates, as there would have safer areas to play and to be active. If more housing was in ‘healthier’ areas of cities, more low-income, likely sedentary individuals would be closer to parks and other areas to participate in recreational activity or even commute to work in a manner that requires more physical activity, such as biking, walking, or roller-blading.

                        The ultimate problem is that by geographically sorting individuals based on income, you end up encouraging unhealthy behaviors that lead to chronic disease and possibly further health complications. While the problem itself is multifactorial and has so many layers, I believe it would be wise of U.S. policymakers to look further into similar solutions. If simply by changing the geographical location of housing for low-income individuals, we could likely limit not only some of the negative effects of having poor health and a lower life expectancy, but also the momentous costs and effects that come from substantially overcrowding the already packed, high-cost healthcare system.

 

Keywords: healthy behaviors, exercise, social influence, low-income, geographical areas

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