What your vote means for global health

/ / Global Health Voices @ UC Berkeley, Global Health Voices @ UCBerkeley

In Baltimore’s inner-city neighborhood of Upton/Druid Heights, a man’s life expectancy is sixty-three years old. Less than five miles away in the Greater Rowland Park/Poplar neighborhood, life expectancy is eighty-three years old.


What could account for such a large difference? Sir Michael Marmot illustrated global inequality through the lens of a broken health system and dysfunctional economy last month in a lecture at UC Berkeley, while also debuting his new book, The Health Gap.


12189225_1079318252081048_6649304234478051716_oMarmot explains that this twenty-year gap does not just exist in Baltimore— though the differences are very dramatic there—but they exist in cities all around the world, including Glasgow, New York City, and even in Berkeley, California. He explains that these dramatic differences in health are not a simple matter of rich and poor, as poverty alone does not drive ill health; rather, leaders and politicians have augmented inequality through legislation and policies.


Marmot doesn’t let us get away with just blaming the politicians.   In a comparison of child poverty around the world, he points out, “ United States figures are worse than Latvia—you are a democracy! This must be the level of child poverty that you want or else you would elect people that did differently.”


While clearly being facetious in this moment, Marmot makes a good point. If we truly live in a country in which we create our own laws, how did we let it get this bad? Well, it’s because most of don’t think it’s that bad. When people think of inequalities, they tend to think immediately only about inequity and poor health among the poor. Some go as far as thinking that the poor are architects of their own misfortune. If you’re not a hedge-fund manager and you’re not poor, then you’re in a good position. Whether or not you think the poor construct their own demise, at the end of the day, you say, “I’m glad it’s not me.”


However, that type of passive logic can lead people to forget that we are actors on the same stage. Unfortunately, depending on the location of where you were born, your physical appearance, and potentially even your last name, your script is pretty much already written out for you. Marmot summarizes the script like this,


“If you’re dumb and poor, you stay dumb

If you’re dumb and rich, just hang in and it will all turn out okay

If you’re smart and rich that’s just fine

If you’re smart and poor, I’m sorry but you got dealt the wrong hand.”

We have to look no further than our own U.S. Baltimore soil to witness the performance.


It is becoming common knowledge that the “pick-up-your-bootstraps” American is a fantasy. The reality is that by the age of three years old, children in low socioeconomic household will know 3 million words less than their middle and upper class peers. The reality is that even though Walmart’s economy is bigger than the UK’s, most people that work in Walmart receive food-stamps… our federal government is subsidizing Walmart. That is the type of economy we have created and with passive voices accept as our reality.


I can guarantee that you will never in your lifetime hear a politician say, “Well, I think the poor children of Baltimore should stay where they are and that Walmart employees should never receive livable wages.” That means, that as a voting population we have to not only actively listen to the propositions of our leaders, but we also have to find a better way of assessing their values and intentions besides a series of two-hour, choreographed debates on television.


After attending Sir Michael Marmot’s lecture, I had the pleasure to procrastinate for my microbiology midterm by reading The Wealth Gap. In the opening passage describes an anecdote of a female patient visiting with a psychiatrist. She has reoccurring depression and she explains that her husband is drinking and beating her, her son is in prison (again), and her teenage daughter is pregnant. She explains to him that she does not have energy, has difficulty sleeping, and does not feel that her life is worth living.


Marmot explains that the psychiatrist’s solution was to prescribe more “red pill” and less “blue pill” (she was currently taking the blue pill), however it was startlingly obvious that her depression was related to her life circumstances. That is precisely the issue that we have as a country. Rather than going to the source of our illnesses and issues, we take a pill or pass an ornamented law with living conditions and health of our population rapidly deteriorating. Even worse, we do nothing and weroar that poverty is a stain on civil society and vote for the politician that says the same.


My vote this next election goes to the politician that says poverty isn’t a stain at all. It’s something we have the capability of taking action against and removing it. We can Oxi-Clean it!


In all seriousness, no presidential candidate has yet to enlighten this movement. At least not in my eyes. Ideally, the next Presidential candidate would just quote Sir Michael Marmot’s book directly in a public speech in a snazzy suit. Seeing as it is unlikely the next presidential candidate will even talk about public health, I will be listening carefully for the candidate whose platform is more creative than just, “take some more red pills.”