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Social And Economic Status May Be A Death Sentence In America, Says Congressional Hearing
 

“The lower people’s income, the earlier they die and the sicker they live,” said Steven Woolf, Director of the Center on Society and Health at the Virginia Commonwealth University in testimony before the a Senate committee earlier this month.  The hearing was called by the US Senate Committee on Health, Education, Labor, and Pensions and its Subcommittee on Primary Health and Aging. The hearing was entitled “Dying Young: Why Social and Economic Status May Be A Death Sentence in America.”

Key Points

Among the key points made by Woolf are that economic policy is not just economic policy—it’s health policy. Second, Woolf noted that relieving economic hardship for Americans is a smart way for Congress to control medical spending. To illustrate his point, Woolf reported that 25% of all deaths in Virginia would be averted if everyone had the death rate of Virginia’s five most affluent areas. Given that possibility said Woolf, “no form of health care reform, and no treatments by doctors and hospitals, can rival that kind of effect.”

In a final takeaway message for Congress, Woolf stated “…health is affected not only by what’s in your bank account but also, perhaps most importantly, by policies that put people on the road to economic success, such as helping our young people get a good education.”

The hearing was called in part to provide evidence for not slashing spending in future budget negotiations for education reform, job training, urban renewal, and other safety net programs. In closing, Woolf emphasized that “Cutting a program to save money may save nothing if it makes people sicker and thereby drives up the costs of health care.”

Harvard Epidemiologist

Also testifying at the hearing was Harvard University social epidemiologist Lisa Berkman. She discussed life expectancy in the United States and reported on the findings from a recent National Academy of Science panel which found that the US ranked at the bottom of 21 developed countries. Of even greater concern, said Berkman, is the gap between the risk of death for those at the bottom versus those at the top in the US.  She reported on increasing mortality gaps over the years and said “the fact that the size of the risks varies so much suggests that such large inequalities are not inevitable or innate, and gives hope that there are ways to reduce the burden of illness for our most vulnerable citizens.”

Cause of Health

A third speaker at the hearing was the University of Wisconsin’s David Kendig.  He reminded the congressmen that “health is

produced by many factors including medical care and health behaviors and, importantly, components of the social and physical environment in which we live in like income, education, social support, and the structure of our neighborhoods. The bottom line is that we will not improve our poor performance unless we balance our financial and policy investments across this whole portfolio of factors.

How Healthy We Could Be

Dr Kendig is one of the colleagues who helped create the County Health Rankings (www.countyhealthranking.org) and he discussed modeling state mortality rates and how much they could improve.

They found that if each state had the highest level of all the determinants that any state had already achieved, then even the healthiest state New Hampshire could improve mortality by 24% and the least healthy West Virginia by 46% by working on reducing smoking rates, increasing insurance, increasing high school and college graduation rates, increasing median family income, and increasing employment.

Readers interested in learning more about the testimonies and the discussion at the hearing can view the hearing at :

http://tinyurl.com/lato73m
 


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