The Titanic and The Health Divide

by Hank Dart

While tragic events can bring the issue of inequality to the headlines every once in a while, it’s more often a problem that lives under the radar of most people.  Yet, as the gaps between rich and poor continue to grow wider and wider and health care coverage remains an important issue, there’s no better time to take a deeper look at the important links that exist between race, class and health.

That health can be impacted by factors like race and class isn’t breaking news. Health disparities have likely been around since the dawn of civilization, and one of the starkest and most well known examples of health disparities is now a hundred years old: The sinking of the Titanic.  On that fateful night in April, 1912, over 1500 souls perished.  But the tragedy wasn’t felt equally across all groups on the ship.  A close look at the passenger list, revealed that third class passengers died at a significantly greater rate than those of the second and first class passengers who paid the more expensive fares.

Such disparities continue to track race and class today when you look at a number of important health outcomes.  African-Americans die from heart disease and stroke at a greater rate than any other group.  They’re also more likely to have hypertension, and along with American Indians, share the highest rates of diabetes.

For cancer, the picture is much the same. African Americans experience cancer rates that are more than twice as high as American Indians, about 50 percent higher than Hispanics and Asian/Pacific Islanders, and 10 percent higher than whites. Racial and ethnic differences in cancer mortality are even more pronounced, with African Americans again having the highest rates.

Looking outside of race, factors like income and education level – so called socioeconomic factors – also have a large influence on health:  so much so that many in the health field call poverty itself a carcinogen.  Rates of heart disease, stroke, and diabetes are also higher in those with lower income and less education.

Why do these disparities exist?  The simple answer is that there are a lot of different reasons.  Unequal access to quality health care and screening services is one very important one.  But there are other important issues around education, language, and living/work environments—to name just three.  Tied together with such things, race and income are also often linked to important health risk factors like smoking, being less active and being overweight.

Clearly, the issue of health disparities is very complex and won’t be solved overnight. But, the situation is far from hopeless.  Awareness of the issue is on the rise, and state and local communities are starting to take concrete steps to fix the problem—whether its offering universal health insurance or helping bring better food choices to poor neighborhoods.

It’ll be a mix of such small and large steps that eventually help fill the health divide in the United States.

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