What you’re worth helps determine how long you’ll live

Money may not buy love, but it certainly helps you live longer. Wealth is one of the factors that contribute to disparities in health and longevity according to a report published in a Nov. 22, 2013 supplement to Morbidity and Mortality Weekly Report, a CDC publication. Race, sex, education, and geographic location are other key factors.
Dr. Chesley Richards, director of the CDC's Office of Public Health Scientific Services was the originator of the report: Health Disparities Persist in America.

"The purpose of the report is to highlight disparities in health that still exist in the country.”

The NIH’s National Cancer Institute also helps to define the groups of people that have some of the highest disparities with regard to health, and consequently higher rates of illness and death.

“Many different populations are affected by disparities. These include

• Racial and ethnic minorities
• Residents of rural areas
• Women, children, the elderly
• Persons with disabilities”

The CDC includes 29 different categories in their weekly morbidity and mortality report, with 10 additional categories added for this report on health disparities.
A summary of the findings include a list of diseases and conditions and the area of the population most likely to be effected. Comments by the author are enclosed in parentheses.

1. The rate of teen births has dropped overall by 18% from 2007 to 2010 with the biggest reductions among whites, blacks and Hispanics. (Public information campaigns, contraception education and contraception use have helped reduce the rate of teen births.)
2. Job related injuries and sickness were highest among low wage earners with limited education. Hispanics made up a larger part of this group, as well as foreign born workers. (Poor people will take high risk jobs to survive, and they often have no recourse regarding unsafe working conditions.)
3. Binge drinking is most common among those 18 to 34 years old, with whites making up a majority and those with higher incomes. (This population includes a lot of male college students.)
4. Tuberculosis has declined by 58% from 1992 to 2010, but TB is still high among racial and ethnic minorities and foreign-born residents. (The lack of testing and treatment among the poor for TB will be helped with the preventative measures included in the Affordable Care Act.)
5. Diabetes is most prevalent among Hispanics, blacks and those with low incomes and education levels. (It is much less expensive to eat a diet high in carbohydrates than one high in protein and fresh vegetables. Diabetes is often related to obesity, which also ties back to a high carbohydrate diet. There is a genetic factor involved with diabetes that combines with dietary issues related to income that makes many Hispanics and blacks at high risk for diabetes.)
6. Infant death rate for blacks is more than double that of whites. (This is related to prenatal care and diet, the age of the mothers, and the environment of the infant after release from the hospital.)
7. Suicide is about four times higher in men than in women. This applies to all age groups, race and ethnicity. American Indians, Alaskans and whites have the highest rates of suicide.
8. Cardiovascular disease is the leading cause of death in the US, with blacks about 50% more likely to die of heart disease or stroke than whites. (The reasons for higher death rates of blacks versus whites are a combination of genetic factors, diet, access to testing, and access to treatment.)

This report has added 10 additional variables in the analysis of what is causing the disparity of health care. Comments by the author are enclosed in parentheses.
These areas include the following:

1. Access to healthy foods (Low income is a key factor.)
2. Activity limitations due to chronic diseases (leading to obesity and loss of physical functionality)
3. Asthma attacks (often caused by pollution or indoor contaminants)
4. Fatal work-related injuries and illnesses (due to poor safety conditions and bad work environments)
5. Non-fatal work-related injuries and illnesses (due to poor safety conditions and bad work environments)
6. Health-related quality of life (leading to people stopping treatment rather than undergoing painful or debilitating procedures)
7. Gum disease in adults (Congress specifically excluded dental care under Medicare for nearly all procedures. The ACA includes dental care for children under the Essential Health Benefits provision.)
8. Living close to major highways (This is primarily due to high levels of airborne pollutants from automobiles and trucks.)
9. Tuberculosis (The enhanced preventative services of the ACA will help in the detection and treatment of TB.)
10. Unemployment (The unemployed have not been able to afford health insurance. With the government subsidies that are based upon income being a part of the ACA, the health care disparity will be reduced, but not eliminated.)

There is also the need to collect more consistent health data that have been lacking in surveys, such as disability and sexual orientation, the authors noted.
Dr. David Katz, director of the Yale University Prevention Research Center had these additional comments about the CDC’s report on health disparity.

"This report is a timely reminder that the United States has vast resources that are very unevenly distributed. We have huge disparities in health, because we have huge disparities in everything from income to education. We will best eliminate health disparities not by improving disease care, but by improving equity.”

The difficulties that have occurred in signing up for the Affordable Care Act (ACA) has overshadowed the impact that the ACA will have on reducing the disparity in health care.
The key provisions of the ACA to provide testing for diseases like diabetes and heart disease will provide for quicker diagnosis and treatment, with a long-term benefit of reducing overall health costs. Provision for birth control, along with prenatal care in the ACA requirements, will also impact the rate of teen births and infant mortality.
The reasonable expectation is that people will take advantage of the preventive services provided by the Affordable Care Act and the overall health of the nation will improve.