Friday, January 15, 2010

SES matters too

(no I didn't misspell sex!)

With regard to chronic and terminal disease, health experts are consistent and quick to say that lifestyle is the most important factor for either risk or protection (things we do or don't do make it more or less likely that we will become ill or injured). We hear most often that we should moderate our diets, exercise and not smoke. Experts say that our lifestyle is more important than our genetics or any other factor. It has the most influence. Today on Talk of the Nation (I only caught the end), which had several guests, I believe Esteban González Burchard, MD is the one who said that the two most important determinants of health were SES and lifestyle.

SES is socioeconomic status. I believe that the reason SES was mentioned is because they were discussing race and that race is important to know when doing research and forming plans for health promotion etc, because disease is NOT an equal opportunity destroyer. Dr. Burchard was saying that having more of a certain disease condition in a particular race was NOT about the race itself, and that the culture and environment had to be considered.
A person with less education (less than 12), low (minimum wage +) paying, low skilled jobs (or none) and little income has a low SES. Persons in these conditions are more often exposed to things that may lead to disease. Perhaps a person works in a factory where they are exposed to toxic chemicals, or have limited safety equipment. Or the person is forced to seek low income and inner city(pollution) or isolated rural (farm work? tobacco use?) housing where there is no access to healthy food or exercise facilities. And surely, persons with low SES have limited access to medical treatment and even less access to preventative measures, like PAP smears, colonoscopy and the like. Persons with less education may not understand messages about healthful eating, or warnings about products. They may never even hear that sunscreen is protective against skin cancer and vitamin D is a wonder drug. The exact opposite could be said of person with higher socioeconomic status and this is why the speaker noted that SES is an important determinant of health.

It is imperative that education on the lifestyle that promotes active long life be targeted to groups that would not normally be exposed to it. The promotion must also be delivered in a way that all persons can understand, accept and adopt. I hope to be involved in that kind of health promotion as soon as possible :)

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