Archive for July, 2013

Health Disparities: One Approach to Causes and Solutions

The concept of health disparities is a topic which deeply concerns me. Nailing down a definition of health disparities is a little difficult, but, in essence, it’s the idea that different people groups (regional groups, ethnic groups, cultural groups, socioeconomic groups, etc.) experience diseases and illnesses at different rates. There are a number of factors that contribute to these disparities, some biological, some psychological/spiritual, some social. It seems to me that, inasmuch as these disparities are preventable, we should prevent them. (The ethics of this statement deserve their own fleshing-out, but I’ll save that for another post).

Right now, I would like to comment on a few statements made in the documentary series Unnatural Causes, which, on the whole, I would recommend. It does a fairly good job presenting problems and raising questions, even if the answers it offers might not be the the ones I would give. I will start with one comment, since I’ll never actually get around to this if I try to do everything at once.

At one point in the first episode (transcript here), the documentary discusses the relative paucity of grocery stores that offer fresh foods (compared to abundant fast-food chains) in low-income areas. This limits the availability of healthier foods for low-income families. To me, this does seem like a problem. However, this is the explanation offered:

It’s not the design of nature that these environments are going to be different. They arise as a result of policies or the absence of policies that create these enormous inequalities and resources.

The suggestion is that governmental policies (presumably zoning laws and the like) or the lack of such policies are the cause of the unavailability of healthier foods for poorer people. I would like to examine the logic of this statement by drawing an analogy to a statement made earlier in the documentary.

Earlier, this statement is made regarding the many and varied causes of illness and disease:

Health care can deal with the diseases and illnesses. But a lack of health care is not the cause of illness and disease. It is like saying that since aspirin cures a fever that the lack of aspirin must be the cause of the fever.

The lack of health care does not cause disease. In the same way, I would argue that the lack of governmental policies cannot cause grocery stores to avoid certain neighborhoods. Sure, governmental policies might be one way to fix the problem (not necessarily the solution I would prefer), but a lack of policies is not the cause of the problem.

There is a tendency to look to the government to solve every problem encountered which is pervasive in the discussion of health disparities. Personally, I would like to see a theological engagement with health disparities with an emphasis on how the church can become involved in solving problems of health disparities. It seems to me that health care is, at its core, a ministerial endeavor, and the church should be (and historically has been) intimately involved in medicine.