Too often, we confuse health with health care. Health care comes from a doctor or hospital. But health comes from many places we don't normally think of as health at all -- things like good schools, safe neighborhoods and access to a variety of jobs. In other words, if you live in places without those things, you have a lower likelihood of enjoying good health.
Today, a new study from researchers at Stanford's School of Medicine confirms that health disparities across the country have more to do with social factors than the color of your skin or where you live. In fact, the researchers say that some of these social factors even outweigh -- gasp -- the effect of cigarette smoking. (More on that later).
The study, Geographic and Racial Variation in Premature Mortality in the US, looked at counties across the United States and the likelihood of people living to age 70. Lead author Dr. Mark Cullen says this measure is a good alternative to looking at life expectancy, because it shifts attention to events that occur earlier in life. In particular, researchers found that educational opportunities, distribution of income and a mix of jobs accounted for better health outcomes across the population of a county. These "social determinants of health" as public health professionals call them, also explain health disparities between African-Americans and caucasians. "In most parts of the country," Cullen says, "if African-Americans had the same advantages that their white counterparts had, almost ALL of the racial disparity would go away."
The study is national in scope. Here in California, Cullen says that people who live along the coast up to about Mendocino enjoy the best health statistics. But head east to the Central Valley and the health outcomes are much worse.
"It's not surprising," Cullen says, "the dominant theme there is these are regions of relatively lower socioeconomic status, relatively lower levels of educational attainment. We're not talking about individuals here, we're talking about populations at the county level."