Preparing to teach a college course on justice, I was looking for some video to help make justice issues real to my young students. In my search I came across a recent documentary called Unnatural Causes. (http://www.unnaturalcauses.org/video_clips.php) This seven-segment, four-hour series examines the health of Americans. Though health is quite a hot topic these days, and especially healthcare policy, this documentary looks beyond healthcare to the social conditions that influence health—a perfect topic for a class on justice.
The documentary's authors marshal several important long- and short-term studies to demonstrate that health is contingent on more than personal lifestyle or genetic inheritance. For instance, poor smokers are much more likely to die a premature death than wealthy smokers. Another example focuses on race: Well-educated African American women have poorer birth outcomes than Caucasian female high school dropouts, and genes cannot explain the difference. And they reveal more evidence of how social and economic differences lead to disparity in health.
A briefing paper from the National Association of Chronic Disease Directors (http://www.chronicdisease.org/files/public/HDIG_Briefing_Paper_Final.pdf) puts it succinctly: "Racial, ethnic, socio-economic, and other health inequalities in the United States are human made. They are socially and politically constructed, not determined biologically. Therefore, instead of dealing with the consequences of racial, ethnic, socio-economic, and other health disparities, we need to examine the causes of such disparities and inequities, and start planning what we can do to prevent them."
In this swirling and at times depressingly controversial debate over healthcare policy, it is easy to lose sight of factors other than specific elements of health policy. Of course, healthcare policy is critical to health and therefore to a just society. High-cost, low-access healthcare delivery does have a deleterious effect on health. But let's keep our eyes and activism on the big picture—a picture that includes education, housing, banking, transportation, welfare, race relations, and immigration—in a just attempt to secure increasing equality for all Americans.
Bret Kincaid is associate professor of political science at Eastern University in St. Davids, P