On Disparities and Health

We had a lecture today from one Dr. Flack, a very interesting man whose lectures I always enjoy. The topic was health disparities, specifically disputing a number of common assumptions.
1. For example "There are health disparities between races." In reality the genetic differences between races are minor. The reason African Americans and Hispanics appear to be disadvantaged is that they are disproportionately poor. Now that in and of itself is a result of disparities in economic opportunity...but African Americans are not inherently unhealthier than other groups.

2. "The United States spends the most on Health Care but still lags most other developed countries in Health Status." There is a false assumption here: the medical establishment can create good health in a population. The truth is, most diseases of high prevalence in the developed world are dependent on choices made by individuals years before the disease presents itself. The fact that Americans choose to live unhealthy lifestyles leads to the poor results on international surveys. Spending more money won't fix that.

As Americans we have gotten used to the idea that you can buy your way into anything. But in medicine there is a limit. The only way to improve health generally is to convince people to live healthier lifestyles.

There is one group of people, however who are consistently disadvantaged when it comes to medical care...the poor. They live disproportionately in cites, where access to fresh fruits and vegetables is limited, and fast food abounds. Where it isn't safe to be outside at night, the only time many people could exercise. They have less access to education, they drop out more (educational attainment is the single biggest determinant of health status) And there are fewer medical clinics and hospitals to serve the populations of urban poor. Consistently underserved.