What determines how healthy you are? What you eat, how often you exercise– that's a big part of it. Getting your annual checkups. But when we step back and look at healthoutcomes across our community or our society,we see health disparities that are not explainedby these individual choices. For example, rates of the five leadingcauses of death in the United States are all higher in rural communitiesthan in urban or suburban communities. Or babies born to motherswho have not completed high school.
Are twice as likely to diebefore their first birthday compared to babies born to motherswith a college degree. Our life circumstances have a huge effect on our health. “Health is Wealth” is presented by Meridian Health Services with support from LifeStream Services. Health experts and economists refer to these lifecircumstances as “social determinants of health.”.
So when we look at the social determinantsof health, so those are the conditions in the environment where someone may beborn, where they live, where they work, where they play, where they worship,that directly impacts their health, their well-being,and also their quality of life. Another related phrase is “health equity,” which the CDC defines as “the statein which everyone has a fair and just opportunityto attain their highest level of health.” Dorica told me this idea of health equityreally crystallized for her years ago when she was researching local povertystatistics to present to a group.
And I began to share my findingsand someone said, “Dorica, the number is 1.” And I thought, No,the number is not 1, right? I can't find any communitythat is dealing with 1% of poverty. And he said, “No, the number is one.”And as it began to kind of sink in, what I realized wasit was about the one person: if one person did not have access, if one person was struggling,then our community had work to do. And the actual poverty statisticsare obviously much higher than one person. 15% of Hoosierslive below the poverty line.
And almost 13% are uninsured. If you live in poverty or are uninsured,or both, you're going to struggle to be able to payfor the medical care you need. For example, I mentioned earlier that the rates of the fiveleading causes of death in the U.S. are highest in rural communities. Why is that? I think some of the challengesthat Indiana faces, particularly our rural communities within Indiana,on getting access to health.
Care would be twofold. The first is just having accessto health care. If you live in a rural community,transportation could be an issue. Knowing where to go could be an issue. But then secondly,being concerned about the cost when you do get to your health careprovider is definitely a concern. And so those in our rural communitiesthat may not have access to health care or access to insurance really struggleto make sure that they're gaining the care that they needfor their long term health game plan.
But economic stability is onlyone of the social determinants of health. The Healthy People 2030 Initiative groupssocial determinants of health into five main areas:Economic Stability, Educational Access and Quality,Health Care Access and Quality, Neighborhood and Built Environment,and Social and Community Context. Dorica told me the top three barriers to health equitythat she sees on a regular basis through her work with Open Doorare housing, food, and stress. If someone doesn't have access to food,chances are they're.
Probably not going to follow the regimenthat their doctor has given them, be it medicine that needs to be purchasedor even showing up for the appointment, because I at this time need to take careof what that tyranny of the moment is. I need to take care of the factthat I don't have food. I need to take care of the factthat I don't have housing. And those things, coupled with everything else that I'm dealingwith, is creating a great deal of stress. So if I am stressed,then the likelihood of me really focusing on my health is slim to nonebecause that's only causing more stress.
So it creates this huge divide between my health and my survival. And sometimes those two thingswon't feel like the same. Health vs. survival. I had never thought about it that waybefore talking to Dorica, and this is why the line betweenindividual choices and life circumstances can often be a lot fuzzierthan we'd like to think. I might see someone else's fastfood heavy diet as unhealthy choices, while for them it may feel like justsurviving, because they don't have a car.
And they have to walk a two-mileround trip to the nearest grocery store. I think to create a healthy habit,you have to first know what some of those healthy habits are, but you also have to be ableto have access to those healthy habits. A lot of times we start with “eatmore healthy; that will make you a healthier person.”But if you don't have access to affordable, healthy food options, you don't have the opportunityto create that healthy habit. in East Central Indiana,we've got a lot of work to do to get our.
Overall health outcomes up to the stateaverage, much less the national average. If we only focus on individuals’healthy choices, we're missing a huge part of the picture. But even focusing on health care in general leaves usmissing a big part of the picture. In a sense, the biggest opportunitiesfor improving our health outcomes are in things like fooddeserts, educational opportunities, transportation access,neighborhood violence. Making changes in areaslike these can improve life circumstances.
In our communities, and, in the process,improve health equity and health outcomes. Help others join this conversationby liking and sharing this video. And in the next episode of “Healthis Wealth” we'll talk about creating healthier habits for your whole neighborhood,so make sure to subscribe. Thanks for watching.I'll see you next time.