Class and Health

We have all heard the term “stressed out,” and most of us feel thusly quite often. We also know that stress can impact our long term health in insidious ways, and is often linked to many of the most common diseases people our prone to in the twenty-first century – including heart disease, diabetes, anxiety, depression, and perhaps certain types of cancer.

As our community of Keene and the Monadnock area strives towards its goal of being the healthiest community of the United States by 2020, we must consider what types of stressors members of our community are experiencing that we can help alleviate. Now let me switch gears. As some of you readers know by now, I have spent a good part of my life living in Latin America and/or in contact with Latin American cultures and places. In Latin America, everyone knows and acknowledges the presence of class in society. People of all socio-economic levels openly discuss and acknowledge how tremendously important and significant class is in shaping their lives and overall society as well. In fact, they have a saying which is that, “People in the United States are racist, but not classist; while we in Latin America are classist but not racist.”

In many ways, this saying is significantly wrong in both Americas: The United States and Latin America. But for the purposes of this short article, it does highlight an important characteristic of the United States – which is that much of the discourse around race and the challenges and problems facing so-called minorities are actually problems of class. Here we are talking about things like poverty, unemployment, being on food stamps, young single mothers, etc.

And an often unacknowledged truth about this region, and the United States as a whole, is that there is a lot of poverty and issues of class difference that we sometimes do not directly acknowledge and face. And yes, white poverty in our area is a serious problem, and one that seems to be getting worse.

You can see it every day walking along downtown Keene. Or take a visit to the new Co-op followed by one to Walmart – look at folks shopping for food at both places. Sometimes the class differences are shown even in things like different styles of dress and manners, different food and consumption choices, etc.

How does this connect with stress and health? According to Robert M. Sapolsky, one of the leading specialists in stress who is a Professor at Stanford University and a recipient of the MacArthur Foundation Genius Grant, analyzing how stress can make you sick involves three legs of a stool.

One is the mainstream medical view that focuses on biological aspects such as bacteria, genes, etc.

The second is the people who focus on the mind-body issues, with the idea that poor health is about psychological stress, lack of control, etc.

And the third has to do with a person’s place in society. According to Sapolsky’s in-depth research, low Socio-Economic Status (SES) is the single most important factor in a person’s health and longevity. As he puts it, “if you want to increase the odds of living a long and healthy life, don’t be poor.”

However, it is more nuanced than this. Even in places where the poor have universal access to health care, unlike the United States at present, low SES is still an important health impediment. What Sapolsky outlines in the last chapter of his book, “Why Zebra’s Don’t get Ulcers,” is that “It’s not about being poor. It’s about feeling poor, which is to say feeling poorer than others around you.” (p. 373) In other words, income inequality can be as important in stressing people out as actual poverty itself.

The United States today has greater income inequality than when I was growing up, as all the evidence points to. Even in the decade that I have been living in this area, I have noted more and more small stores and businesses closing down, unemployment and underemployment for many people – especially young adults who do not have a college degree and other economically vulnerable groups – dramatically rising. At the same time, support services are being cut, and life is getting more expensive. This is a dangerous mix, from a health standpoint.

Research also shows that what is known as social capital –i.e. a cohesive community that helps each other, efforts to reach across the social class divide and bring people in lower SES up, not via charity but through long-term policies in areas of employment creation, housing, public transportation and more, can have far reaching positive health benefits and a decrease in stress. Both Canada, our neighbor to the north, exemplifies this as does Brazil, which has carried out significant poverty reduction programs in the last decade or so that have had far reaching and very positive consequences for that country.

If we want to be a healthier community by 2020, addressing honestly and directly the socio-economic inequality that exists among members of our town and region, and then trying to find ways to narrow the gap both perceptually and materially, is a critically important component of our goal.

3/2014 published in the Monadnock Shopper


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