Unnatural Causes 3 – Becoming American (Transcript)1. What are the Social Determinants of Health t

  Unnatural Causes 3 – Becoming American (Transcript)1. What are the Social Determinants of Health that were illustrated in this video transcript? Ooh ooh ooh. Give me your poor your tired your huddled masses the poem goes. Today many new immigrants to the US are still poor and tired but they’re certainly not sick. In fact they may be healthier than the rest of us. They’re doing something right and we have to understand what it is And try to spread that benefit to a larger segment of society. That’s the lesson that immigrants teach us in public health. But the good health many immigrants arrive with comes with an expiration date. Instead of improving their health life in the US often has the opposite effect. Within a generation they see their health advantage is undermined by the same social forces that are rode the health of all of us. These new Americans become more like old Americans they get unhealthy. I’m adored burnout arrived in Canada Square Pennsylvania from his native Mexico to work in the Mushroom Farms. He was 21 years old. 40 miles south of Philadelphia. Can it square clams that title mushroom capital of the world. Mexicans have been migrating here to work since the 19 seventies. They make up almost 1. Fourth Town’s population. Amador burnout works at kale and Mushroom Farms. One of the biggest harm or they grab a low number again modality for your thunder settlement with the way that spray and now I lose. My way though less compression tabs per outta trouble what your Aldi loss hit to the FLSA In almost 25 years in the US I’m a daughter burnout has never once been to a doctor and he’s not the exception. I sat in on this meeting and I remember the generalizations. They’re always late for their appointments. Always dirty and they all have infectious diseases. And I thought to myself having worked now for several years with Mexican population that boy or were they getting these generalizations from In the early 990s Steve Larson worked as a doctor with a Kinect square Mexican community. And I had several thousand patients I would see. So I had the data crunched and I pulled it out in this meeting and I said wow you’re actually quite wrong. These are young healthy people for the most part. They’re not here to train a system. That’s a myth. Health data gathered by researchers going door to door in Alameda County California mirror what Larson saw and can it square. And one of the things that the data told us In our health department was that immigrant Latinos have the best health of anybody in the county. By far they had the lowest rates of death lowest rates of heart disease lowest rates of all the major killers. And that was a startling finding to us. We couldn’t understand why the poorest. Most socially marginalized population actually had the best health better health not just in other poor people but better health than the wealthiest segments of our societies. That’s profound On the other side of the country in Cambridge Massachusetts Dr. margarita allegory leads a team looking at a similar phenomenon through the lens of mental health. So you can see that in the 19 sixties the researchers identified what they called us. The Latino paradox. They were surprised to find that Latinos were immigrants who have lower education. Lower income were under very stressful conditions of adaptation to the US had actually lower rates of psychiatric illness than whites who were higher income higher location. And this is also being shown in cardiovascular disease and cancer Mrs. White a paradox. One explanation is that Latino immigrants who come here have better health on average than those who stay behind. But researchers are also circling in on a second hypothesis. I think the other explanation has been more about the role of very strong cohesive family ties that hold Latino families together. Even under hardship And this very strong family ties facilitate people struggling through disadvantageous conditions. For 20 years Amador binom traveled back and forth between Mexico and Canada square. That I’m glad that we’re seeing or sadness is hit and miss neighbor but yeah which must collapse had dogs. Say Ahmadi. After he got his law adore filed papers for his family to join and it took nine years to get approval when they finally arrived in the US a year ago. But I remember what I said but painlessly. I’ve been to their battle with the audio and Amador and his wife Bernard data have lots of family and can it square. They help ease the stress of settling in a new country. Obama then I’ll say that I mean a company. I’m not a loose young come down on us. But I’m gonna sort of mindless they just not dealing catalog medicine. Hawaiian plus here we’ll see on that cannot be said for immigrants to this country aspects of culture of tradition of tight family social networks and community social networks that essentially form a shield around them and allow them to withstand the deleterious than negative impact of American culture But maintaining the support networks of close family and community is becoming increasingly difficult. For all Americans. We now work longer hours than any other industrialized nation even Japan. The average American now spends 50 minutes a day commuting. 10 million of us take two hours or more. One in four Americans say there is no one with whom they discuss important matters. That number nearly tripled in the last 20 years. Social isolation is on the rise in the United States. An isolation can kill. That was the finding of a seminal study conducted in California in the 19 seventies. It was astounding. Overall people who are really isolated are at increased risk not only for cardiovascular disease but for infectious diseases for diabetes for strokes for cancer We’re at increased risk from almost every cause of death. Social isolation kind of metaphorically accelerates the rate of aging. The fact that you’ve got something when you were 50 instead of 80 or 30 instead of 60 is because being socially isolated is a chronically stressful situation which just kind of leans on the body. Nagumo silvio but staying socially connected in a way that protects health takes more than close family ties. That’s one of the lessons of America that your family isn’t enough Ultimately to protect you against some of the influences of america if it really is a challenge to try to make sure that before the inevitable breakdown of these close family units occurs that the communities are organized in ways to essentially. Keep that sort of protective shield. Ally They’re burnout may have found some of that community support in Canada squared itself. It’s a Pennsylvania town with a Quaker sense of mission. And it does more than many communities to invest in its future with good schools social services and many other resources to support all its families. I think what makes Kennet square so unique in that regard are the different organizations that are trying to not just bridge and create a link with the immigrant population but is also I think helping US population not fall into the category of being underclass Everyone benefits if no one is left behind. That was the idea behind bridging the community meetings begun by Joan holiday in 1997. As a public health nurse felt this community got so many resources for being such a small tone but we were talking to each other. The meetings are an opportunity for residents to find out about resources available in the area and exchange services. Community 23 years. And I’m starting a tossup fruit for kids with addiction issues. You know it is feeling lucky. My name is Philo. Vasquez. They think choline picky they weren’t kale and mushroom and I pick mushrooms. If you know anyone who wants to part-time or full-time or anything we just we really have a great need for bilingual receptionist. There are people in poverty. There are people here who need but I don’t think it’s a large population that find themselves in dire straits. Not like you would find a similar communities in other areas of the United States. Another resource for families is the garage Towns Youth Center after school students come here to work with volunteers used a computer lab or just hang out. Alfredo burnout often comes here to do his homework. He his brother Israel practices his English with a retired executive chaos. And then I’m going to put this by saying I’m sorry I dare anybody can edit it up Bain state but a handful chaos even get bullet is Intel hand thing oscillate and then it is deployed yet. Spend some mental song nest them. Sociale but a that I left bus on that. But I live in and demand kick off a well-kept but it’s on that island community support and can it square gives Alfredo and Israel reason to be hopeful as they look ahead. And if they can climb the economic ladder they stand a better chance of a healthy future. In America wealth pretty much equals health. And that’s true for me It is true for the poorest person in in the quote unquote inner city. There’s a gradient and all the way along the way you can find yourself. Somewhere along that gradient. It’s not like you’re poor India badhealth and then you’re not poor and you have good health. For each step along that wealth gradient you have a corresponding step of hell When you’re a new immigrant the relationship between wealth and health is relatively loose. As you become more American that relationship becomes tighter and tighter and tighter. After only five years in the US Latino immigrants are 1.5 times more likely to have high blood pressure than when they first arrived. And to be obese. Rates of heart disease and diabetes also increase. More than 20% of Latino households are poor. The longer they’re here the more immigrant families struggle with discrimination low paying jobs bad schools and bad housing. And if that environment is giving you cues which are not valuable that you have very little prospect for a good future that starts to build up internalize that devaluation. One and for Latino children drop out of high school. Shockingly one in seven teenage Latino girls. Attempts suicide. Immigrant Latinos as they culturally. As this Accumulate their children start to lose that sense of why it is that they were here they lose that connection to their parents hopefulness. They become more American they acquire American habits American diets american sensibilities. They’re gaining traction and the American way of life but they’re losing that hopefulness that they’re immigrant parents brought with them that might actually be health protective. Today the Burnouts are still healthy but they’re facing the same kinds of pressures and stresses. Many of us live with day in and day out Bernard de to burnout packs mushrooms. Staffers some labels from nameless. This almost voices telling them. Suddenly those heck into just put them in the team to say this. Bernard data earned $6.50 an hour. Like many American families the Burnouts need as many incomes as they can generate money yet though homes and test out on my loan. What about events and dishwashers and does a ampersand I’d had a throw away unless there’s the quad at all not the nail it up but I saw the other six because I had a guy came and got a lot of Mia and don’t Cij unless yet that AS a quiz covers vessel I will miss caliphate casualness. What I saw them. Suddenly. They had a lot of them are low spin as a sum on a nominal level but at the level Mark. Can I blow against mental illness it like half of American household. The Burnouts live on about $46 thousand a year. And they’re trying to make ends meet. And one of the most upscale counties in Pennsylvania Even renting a small house by the train tracks is expensive. Three-fourths of their income goes to basic expenses like rent food utilities and transportation for a family of six. K and the Bible became the Bible. Three out of four Americans who started out at the bottom of the income ladder in the late 19 eighties were still there a decade later. Yeah. Yeah I guess of FHA There’s this mythology of the American Dream that anybody can move up that ladder with the right amount at gumption but less than they’re certainly anecdotal stories of that and people have good luck and good fortune. But for the most part the overwhelming majority of people don’t move up that later. These economic insecurities you rode the social and family ties that support our health follow-up I’ve noticed but instead though they correlate you stand up and start to see Tom E Yeah keepers yet amnesty. Well I used to actually delegate. I’m your man and nepa novel about Academy mm or one of the things that we know that immigrant parents do is that they work and they work a lot. And so as a consequence their children have less time with them less exposure to them to those cultural aspects of the family of community that their parents inculcated in our children. Again the normal Olga and moderates 118 when they came to the US when social and family ties began to fray it’s the mental health of the youngest arrivals. That’s the most vulnerable. The risk of psychiatric disorders for Latino immigrant children depends on your age when they arrive here. The longer you stay in your country of origin for especially the times where you have a higher risk of developing illnesses like psychiatric disorders like anxiety or depression. The longer you stay in your country of origin to lower the risk you’re going half of developing those disorders. What is it in this country that suddenly increases your risk for psychiatric illness. What are we doing here versus linearity him William Vega has studied the psychological health of Mexican immigrants in California. If nothing else a paradox is putting the spotlight on the fact that the United States has very high levels of depression. And we found when we looked at the population that came as immigrants and had about 13 years or less in the country and they had very very low levels of major depression only about 8% the general population the United States that would be 18 to 20% in a lifetime But those levels increasingly looked at people who had been in the country over 13 years. Say these protective factors began to wear down. And then subsequently over multiple generations we can anticipate that they’ll look increasingly like the American people as a population because they live here they’d become Americans. For immigrant mushroom workers becoming an American as a journey filled with opportunity challenges and risks. A number of workers are beginning to feel the effects of newly diagnosed chronic diseases Yeah I think I’ll still be any linear agnostic ethical missing like almost half of America’s workforce. Mushroom workers get no paid sick days. When recently three mushroom farms allowed law community that is span a social service agency and can it square to open clinics. On-site. Workers don’t like to take time off from work. It’s money not being earned and they really do need to earn money. So that they would not necessarily go to see anybody until symptoms are pretty bad. Whether obesity probably is the leading issue here. And along with that comes all the other problems of diabetes and hypertension hypercholesterolemia. And of course with all that you have strokes coming down the pike congestive heart failure. So we do screening of all of those. For whatever reason the patient comes in. That’s the protocol authorized by the year 2051 in four Americans will be Latino. If we acknowledge that this is the population that’s growing and we have to plan for 20 years from now. 30 years. If the well-being is in prioritize Now. What’s the landscape of our country like 20-30 years from now we’re not going to go per se amongst us but of love than another book with the nato. Good thing I will celebrate knows sake you must stay there but I will make us a Yellow Book. The Burnouts are hopeful about their future But can they maintain their hope and their health as they become more American than America becomes more a part of them. When we talk about acculturation in the process of becoming more Americanized it’s not a process of changing cultures a to Z. It’s a process of selectively taken out elements of American culture. And I think if we can bring that selection process into clear focus of which processes are selected and which are not selected in which you retained from the old culture You have a better mix. And this may have lessons for all of us as a society we can build hope. And we do that by giving people access to those things have given potential for a success. That’s good education that’s access to good jobs decent housing. And then a sense of belonging to a community belonging to something larger than yourself larger than your family. The potential right now is to try to take what we can see. Obviously in new immigrant communities The health protective benefits of big a new immigrant and understand and translate that into public health interventions. That affect the broader community. No ooh Major funding for unnatural causes has been made possible by the Ford Foundation. The John D And Catherine T Macarthur Foundation. The California Endowment WK Kellogg Foundation. The Nathan Cummings Foundation. Joint Center for political and economic studies. And Kaiser Permanente Additional funding provided by these funders This program was also made possible by the Corporation for Public Broadcasting Health Science Science Nursing NURS H371 Share QuestionEmailCopy link Comments (0)

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