Complexities of Health

Apr 212005
Authors: Meg Burd

When issues such as Medicaid cuts and calls for more comprehensive health care initiatives, both here and abroad, catch our attention, it is easy to think of the concepts of "health" and "health care" in terms of illness and the ability to immediately treat illness.

While obviously, ideas about ill-health and well-being are important concepts in our perception of health, when examining issues such as the recent threats to Medicaid programs and a lack of affordable health coverage for many people in the United States, it is important to acknowledge that "health" is a concept that extends far beyond whether someone is acutely sick and involves a complex series of issues that should be examined and hopefully addressed.

Indeed, things such as gender discrimination, racism and low income are all interrelated in the discussion of health and greatly affect both people's "wellness" as well as their access to health care.

As Linda Whiteford, an anthropologist from Florida, suggests, the concept of health is socially produced, and one must understand "the social conditions in which health and illness are created, defined and continued." Being "well" is connected very intricately to politics, economic status, race, ethnicity and gender.

Take for instance recent studies from the Canadian Research Institute for the Advancement of Women that found that women in minority communities tend to have "greater vulnerability to illness and home care services" and also typically work at jobs that do not offer any health coverage.

For minority communities, battling historical inequality and continuing racism is a major issue. Many communities face poverty because "a system of social relations operates in such a way as to deprive them of a chance to share in the more desirable material and nonmaterial products," notes Vernellia R. Randall on the Health, Racism and the Law Web site. This institutionalized racism impacts both health and access to health as these community members often have less access to higher-paying work and "less income and social status has a direct impact on health," notes the Canadian Research Institute.

For women in such communities, issues of getting good health care or even maintaining well-being can be doubly difficult as the difficulties of gender discrimination are added to the mix. Women's health for a long period in history was seen as less important than men's, or when it was a focus, medical discussion of women tended to focus only on reproduction and the reproductive parts of a woman's body.

Consider today what springs to mind when "Women's Health" is mentioned: topics such as breast cancer, menopause, childbearing or birth control. While these are indeed important topics, it is important to realize that women are more than just reproductive creatures, and "it is important to look at women's' whole health, pay attention to gender actors in all matters of health and wellness, and not just view women as walking reproductive systems," the Canadian Research Institute cautions.

It is important to note that it is the women in the minority communities who often face dire struggles in both finding their own well-being and accessing health care for themselves and their families. They are often the ones who earn the least and have the least opportunity for work that offers health care or even decent wages.

This leads to poverty, which is a major factor in wellness. Wealth, the British Medical Journal notes, is "the single most important driver of health worldwide, even more important than smoking." With a stable living wage, one is more likely to see good health both personally and in the family. Struggling with poverty increases the chance of illness, which increases missed days from work that leads to more lost wages and poverty.

As can be seen, these interlocking factors of race, gender and income are all important in addressing health. It is vital, then, that programs such as Medicaid are understood in terms of these conditions. Since the majority of Medicaid users are women (with nearly one in 10 American women receiving health care coverage through Medicaid, according to the National Women's Health Network) it is important to socially value of such programs.

Similarly, it is important that we recognize that ensuring good health for all people in America and worldwide requires not only addressing things such as illness, but also addressing issues such as poverty, gender and racial discrimination, and the ability to access health services that come along with these factors.

Meg Burd in an anthropology graduate student. Her column runs every Friday in the Collegian.

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