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June 13, 2016 by Kalmanovitz Initiative Leave a Comment

WCP: Health Class

The United States has long struggled to expand access to high quality health care to all its people, yet the health of the poor and the working-class is also tied to social factors such as where they live, their income, and their relationships. In today’s Working-Class Perspectives post, community psychiatrist Kenneth Thompson argues that in order to improve the health of poor and working-class communities, we must connect health care with social policy.

For a long time and to this day, this has been the American approach to health care, though the ACA does a bit to address it.  Given this, some Americans may assume that the recent increase in mortality among white folks reflects a lack of access to needed care. The work of two other Brits, Thomas McKeown and Michael Marmot reveals the inadequacy of this belief.  McKeown made the trenchant observation that it wasn’t health care that made people healthy, but rather the conditions in which they lived. Marmot pressed this observation and, in a series of famous studies of civil servants in the British Government, found that health status was tied in a step-wise fashion with class.  Poor working-class people had worse health then their middle-class colleagues who in turn were less healthy than the highly paid executives.  These findings created a fire storm around the world, but some thirty years later, the idea has finally begun to find its way to the US in the form a focus on the “social determinants of health.” Where people live, their income, the resources available to them, the web of social relationships they experience, all come under this rubric. Health isn’t just about people’s lifestyle — whether they smoke or drink — or about their access to health care. It is fundamentally about the kinds of lives people live and how they are socially structured. Health is profoundly ecological– it reflects the social habitat and physical environment people live in.

Take a moment to read the post in its entirety and check out other Working-Class Perspectives posts on our website.

The renowned Working-Class Perspectives blog is brought to you by our Visiting Scholar for the 2015-16 academic year, John Russo, and Georgetown University English professor, Sherry Linkon. It features several regular and guest contributors.

 

 

Filed Under: Visiting Scholars Tagged With: Affordable Care Act, Health Care, John Russo, Kenneth Thompson, Mortality, Sherry Linkon, Social determinants, WCP, Working-Class Health, Working-Class Perspectives

May 2, 2016 by Kalmanovitz Initiative Leave a Comment

WCP: Parts and Wholes: Unpacking Reports of White Working-Class Death Rates

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A study finding increased mortality for the white working-class drew a lot of attention last fall. Yet as Jack Metzgar demonstrates in this week’s Working-Class Perspectives post, the focus on race obscures some important class-based patterns.

Janell Ross recently provided a thorough rundown of black-white disparities in The Washington Post: “On just about every measure of social or economic well-being, white Americans fare better than any other group. That’s true of housing and neighborhood quality and homeownership. That’s true of overall health, health insurance coverage rates, quality of health care received, life expectancy and infant mortality. That’s true when it comes to median household earnings, wealth (assets minus debt), retirement savings and even who has a bank account.” Ross’s bouquet of links, based on very solid sources, documents an appalling degree of racial injustice, especially toward blacks. But, unlike Case and Deaton, these sources all compare the entire white population with the entire black and Hispanic populations, with no internal differentiation. As with death rates, all these disparities might look very different in a five-category comparison like Case and Deaton use. I’m betting, for example, that whites with only high school educations or less have nowhere near the “typical” white family’s wealth of $131,000. Routinely differentiating the white population by educational attainment would not show that we overestimate racial injustice, but it would almost certainly show that we grossly underestimate class injustice.

You may read the post in its entirety and see other Working-Class Perspectives posts on our website.

The Working-Class Perspectives blog is brought to you by our Visiting Scholar for the 2015-16 academic year, John Russo, and Georgetown University English professor, Sherry Linkon. It features several regular and guest contributors.

Filed Under: Visiting Scholars Tagged With: Death rates, Jack Metzgar, John Russo, Life expectancy, Mortality, Sherry Linkon, WCP, White Working Class, Working-Class Perspectives

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Georgetown University's Kalmanovitz Initiative for Labor and the Working Poor develops creative ideas and practical solutions for working people that are grounded in a commitment to justice, democracy, and the common good.
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209 Maguire Hall
Georgetown University
37th and O Streets NW
Washington, DC 20057
202.687.2293

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