UNNATURAL CAUSES is inequality making us sick? HEALTH EQUITY research topics and resources to learn more
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Image Thumbnail Introduction to Environmental Justice E-mail to a friend
TRAINING CURRICULUM from the Asian Pacific Environmental Network (APEN)

APEN has nearly 15 years of experience working with low-income Asian immigrant and refugee populations from the Laotian and Chinese in Oakland and Richmond, California, including elders, youth and women. Our organizing and advocacy manual documents APEN's leadership methodologies so that others may use it to organize their communities. This initial curriculum book focuses on healthy homes education tools tailored for API community-based organizations and their leadership.

Image Thumbnail Investigating How Racism Harms Health: New approaches and new findings (pdf) E-mail to a friend
ARTICLE by Nancy Krieger, CCHERS Winter Newsletter 2008, pps 3 and 5

Krieger looks at the history of and present trends in considering "race" in epidemiological research. Though theories regarding the influence of living conditions and social factors on the comparatively poorer health of African Americans go back even to the time of slavery in the U.S., the potential for biological explanations to justify first slavery, then second-class citizenship has contributed to the continuing dominance of bio-determinist (now genetic) explanations for "racial disparities" in mortality and health outcomes. New research is presenting strong evidence that social factors, including racism itself, have powerful effects on physical health.

Image Thumbnail Is Inequality Making Us Sick? E-mail to a friend
EDITORIAL by Larry Adelman, in the AFL-CIO's "Point of View"

The series executive producer of UNNATURAL CAUSES makes a compelling case for focusing our attentions and policies on the social determinants of public health problems, not just on treating people once they're sick.replika ure

Image Thumbnail Is living in the United States bad for our health? E-mail to a friend
NEWS ARTICLE by Paul Gullixson Santa Rosa Press Democrat, October 2009

With Americans commuting longer, working longer and often living with fewer people or by themselves, social isolation is on the rise. As hard as it may be to believe, one in four Americans now say there is no one in their lives with whom they can discuss important matters. This isolation, combined with stress, takes a toll on health.  People who are socially isolated are at greater risk for infections diseases, diabetes, stroke, and cardiovascular disease.  In order to improve health communities must look beyond health care toward what is breaking down in the community: social support, friendship networks, family ties.

Image Thumbnail Issue Brief: Racial and Ethnic Health Disparities (pdf) E-mail to a friend
ISSUE BRIEF by Kate Meyers, Kaiser Permanente Institute for Health Policy

This piece provides a roadmap for understanding the complex issue of disparities in health and health care. By breaking down the major themes from IHP's more comprehensive review and analysis of this topic published in March, this paper highlights the major factors that influence health disparities and the most promising arenas for policy action in a short format for quick reference. Together, these papers aim to support thinking, analysis, and discussion among groups from all different sectors that impact health.

These and other reports are also available at kpihp.org under the "Racial and Ethnic Health Disparities" issue area link.

Image Thumbnail Job Stress and Heart Disease: Evidence and Strategies for Prevention E-mail to a friend
SCHOLARLY ARTICLE by Paul A. Landsbergis, et al., Scientific Solutions, 1993

A seminal article linking stress and high demand / low control work to heart disease and other health problems.
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Image Thumbnail Latina mothers poor in wealth, rich in health (pdf) E-mail to a friend
NEWS ARTICLE by Yvette Cabrera, Milwaukee Journal Sentinel, August 11, 2002

National health records show that Latina women have significantly lower rates of premature and underweight births compared to Americans from other racial/ethnic groups - even than individuals wealthier than them. Cabrera looks at the story of this "Latino epidemiological paradox," and the hypothesis that Latino culture plays a major role in the health advantage.

Image Thumbnail Legislative History of Food Distribution Programs (pdf) E-mail to a friend
REPORT from the U.S. Department of Agriculture

The report includes links to each federal food  program.

Image Thumbnail Lessons From Sweden (pdf) E-mail to a friend
ARTICLE in the Review of Economic and Social Trends, April 2008

An excellent four-page primer on the Swedish model of social protections, prepared by the Canadian Centre for Policy Alternatives. There have been changes to the Swedish welfare state over the past two decades and, in some areas, inequality has increased. However, other social policy areas have expanded and other forms of inequality continue to steadily decline. Like the other Nordic lands, Sweden has been considerably more resistant to the ‘imperatives’ of global integration, and the article considers what we could all learn from their experiences.

Image Thumbnail Life and Death From Unnatural Causes: Health and Social Inequity in Alameda County E-mail to a friend
REPORT from Alameda County Public Health Department, California

This report takes an in-depth look at health inequities and underlying social inequities in Alameda County based on local data. Part One describes the nature and magnitude of health inequities in the county. Part Two describes social inequities and proposes policies to address social inequities-the root causes of health inequities. Sections include: segregation, income and employment, education, housing, transportation, air quality, food access and liquor stores, physical activity and neighborhood conditions, criminal justice, access to health care and social relationships and community capacity.

Also see Alameda County Public Health Department Director Dr. Tony Iton's comment on press coverage of the study.

Image Thumbnail Life at the Top E-mail to a friend
EDITORIAL by Sir Michael Marmot, New York Times, 2005

"The Oscar winners are a quirky example of a phenomenon that is remarkably widespread: the higher your status in the social hierarchy the better your health and the longer you live..."

Image Thumbnail Life Course Model (pdf) E-mail to a friend
ARTICLE from Family, Maternal, and Child Health Programs, Contra Costa Health Services

A two-page pdf with a clear, brief overview of the Life Course Model, along with a list of references to learn more. The Life Course Model suggests that a complex interplay of biological, behavioral, psychological, and social protective and risk factors contributes to health outcomes across the span of a person’s life.

Image Thumbnail Life in a Town Without Poverty E-mail to a friend
Dr. Evelyn Forget

Once upon a time in Canada, there was a town where no one was poor.  That might seem like a fairy tale, but it's an historic fact. From 1974 through 1978, as part of a labour market experiment called MINCOME, all of the almost 13,000 citizens in and around Dauphin, Manitoba were guaranteed annual income support to keep them above the poverty line.

With support from CIHR, Dr. Forget has spent three years comparing the administrative health care records of Dauphin's citizens between 1974 and 1978 with those of a control group of people fausse richard mille living in similar Manitoba communities at that time. She found that people appear to live healthier lives when they don't have to worry about poverty.

Image Thumbnail Links in the chain of adversity following job loss E-mail to a friend
SCHOLARLY ARTICLE by Richard Price, et al., Journal of Occupational Health Psychology, 2002

How financial strain and loss of personal control lead to depression, impaired functioning, and poor health. The first author, Rick Price, is featured in Not Just a Paycheck.

Image Thumbnail Liquid Gold (pdf) E-mail to a friend
NEWS ARTICLE by Pauline Arrillaga, Associated Press, 2002

Arrillaga discusses the history and politics of the Pima's long struggle for water rights.

Image Thumbnail Living at an Epicenter of Diabetes, Defiance and Despair E-mail to a friend
NEWS ARTICLE in the New York Times, January 1, 2006

The second in a series of in-depth articles about New Yorkers living with diabetes, this article describes the epidemic of diabetes in low-income neighborhoods like East Harlem.


Image Thumbnail Making Early Childhood Count E-mail to a friend
Canadian Medical Association

Regardless of the industrialized country studied, all data to date reveal that most children at every socio-economic level are remarkably similar at birth. However, inequalities in development emerge early in childhood, usually before school entry. It is imperative for governments to provide universal, affordable access to effective early childhood programs starting in the first few years of life, to improve the experiences of all young children as well as those who are most vulnerable. Along with these interventions, an effective measurement system is required. The 4 approaches discussed here are the building blocks.

Image Thumbnail Making it Politic(al): Closing the Gap in a Generation E-mail to a friend
Anne-Emanuelle Birn

The anniversary of the publication of Closing the Gap in a Generation (CGG) offers a moment to reflect on the report’s contributions and shortcomings, as well as to consider the political waters ahead.  This article highlights the report's contributions to the field of health inequity research while underscoring its limitations.  Ultimately, in its understated references to social justice movements and organizations, its more pointed discussions of civil society’s role,and its advocacy of social redistribution and social protection across the lifecourse, CGG leaves the door open for more transformative change.

Image Thumbnail Maternal Nutrition and Infant Mortality in the Context of Relationality E-mail to a friend
REPORT by Michael C. Lu and Jessica S. Lu, from the Health Policy Institute, 2007

This background paper explores the relationship between maternal nutrition and infant mortality. It provides an analysis of the relationship between maternal nutrition and leading causes of infant mortality, as well as maternal, infant, and child health; an overview of the nutritional status and behaviors of pregnant women in the U.S.; and a comprehensive review of the effectiveness of nutritional supplementation programs in pregnancy. The final chapters reframe the relationship between maternal nutrition and infant mortality within the context of relationality over the life course and offer related recommendations for research, policy, and practice.

Image Thumbnail Measurement and Evidence (pdf) E-mail to a friend
REPORT from the WHO Commission on the Social Determinants of Health, July 2007

This report focuses on leading the development of methodologies and tools for measuring the causes, pathways and health outcomes of policy interventions.

This is an interim report, submitted by the Early Measurement and Evidence Knowledge Network to develop the Commission's final report in May 2008.
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Image Thumbnail Mental health hits home: Is America driving you crazy and then killing you? E-mail to a friend
ESSAY by Stephen Bezruchka

University of Washington professor and emergency room doctor Bezruchka considers how social and economic factors contribute to astronomical rates of mental illness in the U.S., particularly among children.

Miles to Go before We Sleep: Racial Inequities in Health E-mail to a friend
ARTICLE by David R. Williams, Journal of Health and Social Behavior 53(3) 279-295

Large, pervasive, and persistent racial inequalities exist in the onset, courses, and outcomes of illness. A comprehensive understanding of the patterning of racial disparities indicates that racism in both its institutional and individual forms remains an important determinant. There is an urgent need to build the science base that would identify how to trigger the conditions that would facilitate needed societal change and to identify the optimal interventions that would confront and dismantle the societal conditions that create and sustain health inequalities.

Image Thumbnail Minority Health Resources Action Kit for Community Leaders E-mail to a friend
TOOLKIT by the Minority Health Initiatives Department at Families USA

The purpose of this Action Kit is to provide community leaders with the information, tools, and resources necessary to engage in health advocacy and improve the health and well-being of their communities. Sections of the toolkit place emphasis on the importance of public programs in reducing racial and ethnic health disparities.
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Image Thumbnail Money, schooling, and health: Mechanisms and causal evidence E-mail to a friend
Ichiro Kawachi, Nancy E. Adler, and William H. Dow

In this essay, the authors review the potential causal mechanisms linking schooling and income to health, and discuss the twin challenges to causal inference in observational studies, in other words, reverse causation and omitted variable bias. They provide a survey of the empirical attempts to identify the causal effects of schooling and income on health, including natural experiments. There is evidence to suggest that schooling is causally related to improvements in health outcomes. Evidence also suggests that raising the incomes of the poor leads to improvement in their health outcomes.

Image Thumbnail More Than a Message: Framing Public Health Advocacy to Change Corporate Practices (pdf) E-mail to a friend
ARTICLE by Lori Dorfman, Lawrence Wallack, Katie Woodruff, Ch6 in Prevention Is Primary

Public health advocates will be more effective when they learn how to frame their issues in the context of core values. Industry and corporate representatives tend to work within the frame of market values and personal responsibility; advocates may frame their communications based on fairness and social responsibility. The format and brevity of most news stories contributes to an individual-based, non-contextualized understanding of issues, thus advocates should work to present their issues in a clear, concise, "what's wrong? why does it matter? what should be done?" frame.

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