Hyperbaric chambers used to reverse aging in the “Holy Grail” study

Over the past 100 years, we have made incredible strides in health care, progress that would be considered miraculous for any generation before. To take an example, the life expectancy in the United States in 1950 was 68.2 years. We have since added 10 years to this average. Social programs have helped young and old, two of the most vulnerable populations in health, receive unprecedented care and attention. And telemedicine has decoupled the health support and oversight of many Americans from physical hospitals, expanding access to care.

Yet despite this progress and despite it, spend more than other OECD countries on health care The United States preserves vast disparities in health. As James Madara, CEO and Executive Vice President of the American Medical Association, wrote on the organization’s website: “The American healthcare system that exists today is a mishmash of ideas, programs and regulations that are both extremely expensive and and despite its size and technological advancements, our health care system is plagued by huge gaps and inequalities that favor some groups while unfairly disadvantaging others. “

Our current situation has its origins in the tectonic socio-historical forces that have changed and fractured the healthcare landscape. For those at the top, access to high-quality care, education, resources and social networks serves to protect their health. For those who live in the canyons, the ground continues to deteriorate with every past and ongoing crisis. Take, for example, the disproportionate fallout from the dissolution of the law on mental health systems .

Then came COVID-19.

COVID-19 worsens health disparities in the United States

Communities on the wicked side of health disparities in the United States have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.

“There is a common divide in American communities, and that is poverty,” said Debbie Salas-Lopez, MD, MPH , Senior Vice President of Community and Population Health at Northwell Health. “This is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future well-being.”

Social determinants have huge effects on health, and poor communities have unfavorable social determinants. To choose one of the many examples, food insecurity reduces access to quality food, resulting in poor health and community endemics of chronic diseases. The United States Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.

The pandemic did not create poverty or food insecurity, but it exacerbated both, and the results were catastrophic. A study published this summer in the Journal of General Internal Medicine suggested that “social factors such as income inequality may explain why some areas of the United States are hit harder by the COVID-19 pandemic than others.”

This does not mean that the situation is better families in the United States have not been injured. An article from the Center for Economic Policy Research noted that families in counties with higher median incomes have suffered adjustment costs associated with the pandemic – for example, reducing income interactions to align with social distancing policies. However, the document found that the costs of social distancing were much higher for poorer families, who cannot easily change their living conditions, which often include more people living in one house and an outhouse. to public transit to work and to grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and healthcare, where maintaining physical distancing can be nearly impossible.

The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. “Our interpretation is that the poorest people are less able to protect themselves, which leads them to different choices – they face a steeper trade-off between their health and their economic well-being in the context of the threats posed by COVID-19, ”the authors wrote.

“There are so many pandemics that this pandemic has exacerbated,” noted Dr Salas-Lopez.

One example is the health-wealth gap. Mental stressors associated with maintaining low socioeconomic status, especially in the face of extreme wealth, can have a physically degrading impact on health. Writing on this gap , Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and alter the prefrontal cortex and other brain functions through anxiety, depression and cognitive load.

“So from the macro level of whole body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear,” Sapolsky writes. “It is scandalous that if children are born into the wrong family, they will be predisposed to poor health by the time they start learning the alphabet.”

Research into economic and mental fallout from COVID-19 shows two things: unemployment is hitting low income and young Americans most during the pandemic, potentially further widening the health-wealth gap; and that the pandemic is not only worsening mental health stressors, but is doing so at clinically relevant levels. As the authors of a review As have been written, the effects of the pandemic on mental health are in themselves an international public health priority.

We have to find ways to unify this country because we are all human beings. We are all created equal and we believe that health is one of these important rights.