Health Inequality is Making Our Nation Really Sick
Nearly one out of three residents of South Texas is obese and about one in nine has been diagnosed with diabetes, according to a report from the South Texas Health Status Review. Overall, the 38 county region on the U.S.-Mexico border area including San Antonio — where 18 percent of Texas’ population lives — has higher rates of both obesity and diabetes than the rest of Texas and than the rest of the United States.
While study authors say that “lifestyle choices” can be linked to the health problems of the region’s residents, it’s important to point out that a lack of health insurance could also be a likely factor. In South Texas, the uninsured rates are double the national average.
The percentage of South Texans who do not exercise regularly and who do not eat a healthy diet is high, but still similar to people in other parts of the state and in the nation: 76 percent of people in South Texas do not eat enough fruits and vegetables and some 52 percent do not get the recommended amount of exercise (150 minutes of moderate physical activity per week).
South Texas also had higher than average rates for many other health problems, including cancers of the cervix, liver, stomach and gallbladder; child and adolescent leukemia; birth defects; tuberculosis; chlamydia and childhood lead poisoning.
Lack of Preventative Care and Insurance Add Up to Chronic Health Problems
While heredity could play a role (obesity and diabetes tend to run in families), Dr. Amelie G. Ramirez, the study’s co-author and director of the Institute for Health Promotion Research at the University of Texas Health Science Center at San Antonio, specifically says that a lack of preventative care probably has a larger effect on people’s health.
Without health insurance, some South Texans may not be seeing a doctor routinely if at all.The study found that Hispanics (who comprise two-thirds of the population in South Texas) had the highest uninsured rate, at 41 percent. Overall Hispanics in South Texas have more health woes than those living in other parts of the state.
According to Ramirez, even people with health insurance fail to see a doctor for regular check-ups. Instead, she says that “we are very much a crisis-care oriented population that seeks care in the emergency room.”
When the ER Becomes the Doctor
The report is about South Texas, but its findings have ramifications for public health in the United States as a whole. Using the ER as, in essence, their “regular” doctor, is something that occurs with more than a few of my New Jersey college students, most of whom are from lower-income families. When a student first told me they’d gone to the ER for a health issue (and missed class, due to having to wait long hours at the hospital), I assumed it was for something really serious, like some sort of accident or injury.
But after seeing the students on campus, and finding they’d been prescribed antibiotics at the most or had (an ailment frequently mentioned) “food poisoning,” I realized that the ER was the only medical care they knew to access. At other times, the “doctor” whom some told me they had seen often turned out to be a chiropractor.
“Lifestyle choices” are an issue for my students. While I’ve often seen them eating an Egg McMuffin-like breakfast sandwiches before a morning Latin class, I’ve seen exactly one or two pull out some fresh fruit. A few years ago, I made a few trips with students to Greece; most found the amount of walking we did to tour archaeological sites challenging. One student missed a few weeks of class last spring as he had to be hospitalized when his blood sugar spiked; he was subsequently diagnosed with diabetes.
South Texas Report Reveals the Health Inequalities in the United States
The report about the elevated rates of obesity and diabetes among South Texans very much shows the extent of “the health inequalities that burden the health of South Texas residents, especially Hispanics, compared to the rest of Texas and nation,” Ramirez says. It’s also a wake-up call to those of us in other parts of the United States and around the globe. 1 in 15 adults in the U.K. (where diabetes is also on the rise) is obese; both obesity and diabetes are now often cited as growing health problems in many nations, including developing ones.
Once seen as the diseases of the wealth — diabetes was even once called the “rich man’s disease” — the report about South Texas highlights how health problems occur disproportionately in the population. With Hispanics predicted to comprise the majority of Texas’ population by 2020, it is all the more imperative that, as Ramirez says, “this knowledge motivates researchers and public health leaders to create and shape interventions to reverse those inequalities.”