The Complexity of Health is...Complex
The only part of this article I truly like is: "...particularly at risk here because of significant underlying disease health disparities and disease comorbidities -- and that is an unfortunate legacy in our health care system that we certainly do need to address." Yes, absolutely, so much needs to be "addressed" about the health care system in the US! That would be a long blog that I do not have the bandwidth for today.
However, I do have the energy to address something else about the content in the recent CNN article where Jake Tapper interviews Alex Azar, the Secretary of the Health and Human Services. Azar has made a comeback from the wrath of an early fumble to let Americans know that people with chronic health conditions are more likely to die from C-19. He points out that members of the African American, minority communities are at greater risk and that obesity, high blood pressure, and diabetes are top of the list contributors. He then does a great job of tip toing around the conversation about fault for C-19 and chronic health conditions, implying people are not at fault. But, let's face it, people do blame, judge, point their finger at others (and themselves) for what they eat (or don't) and how much they exercise (or don't) and how big (or small) their body is and eating habits, physical activity habits, and body size are top of the list of shame and blame factors when it comes to chronic health conditions. Things like diabetes and body weight are so full of finger pointing & self-blame, and Azar's weak mention of people not being at fault will quickly fade into the distance. Sadly, our culture is chock full of criticizing eating habits, physical activity habits, and body weight/shape/size all in the name of health. How dare you eat those processed chips! I need to lose X pounds to be healthier!
What I have found gets consistently left out of the conversation when we are talking about the health of human beings is how so many other factors such as genetics or socioeconomic status influence health and well-being. Does a person have consistent access to nutritious food, or access to safe spaces to be active and move the body? Is there a safe place to call home? Does a person make a living wage? Does someone have access to affordable and reliable health care? So many factors outside of eating habits, physical activity habits, or body weight influence health outcome for people. This concept is referred to as the Social Determinants of Health (SDH) and if you are interested in learning more about the SDH this is a good place to start, and here is a great infographic. You will notice the SDH highlight how incredibly complex human health is. Physical Environment, Genetics & Biology, and Social Circumstances account for 53% of health outcomes and they are mostly outside of one's control. Furthermore, Individual Behavior makes up 36% of the SDH; physical activity and diet patterns are just 2 of approximately 17 individual behaviors that influence health, so that works out to just a small fraction of our total health outcomes. Again, human health is incredibly complex!
Absolutely, just as Azar states, our healthcare system needs to be addressed badly! So does systemic racism, classism, sizeism, and anything else that is contributing to such enormous inequality and inequity for our population. It is this inequality and inequity that is driving poor health outcomes, and in turn, a greater risk of C-19 complications. Every time you see a headline blaming someone's health for contracting and/or dying from C-19, I encourage you to think just a bit more as to what might be contributing to the human beings poor health in the first place.