Privilege multiplies, leading to investment, whereas disadvantage accumulates, leading to deterioration. This community-focused theme was central to the 12th anniversary of the Movement is Life Musculoskeletal Health Disparities Caucus last week in Washington, DC sponsored by Zimmer Biomet.
The operational thesis of the altruistic, well-organized, articulate team of about 200 participants from organized academia to street-front activism is that movement and musculoskeletal well-being are key to escaping negative social determinants of health. Public/private cooperation can combat multigenerational inequities, disparities, and divisions.
Dr. Mary O’Connor, Chair of Movement is Life and Mayo Clinic Professor Emerita of Orthopedic Surgery, shared the success story of “Operation Change.” The common problem of older minority women having joint pain leading to limited mobility, decreased physical activity, increased obesity, and the subsequent comorbidities of hypertension, heart disease, diabetes, and depression were addressed with education, movement, and motivational interviews. For example, Dr. O’Connor cited that in eighteen weeks, participants’ walking speed increased 18% without medications or physician intervention. The mutual support of the women members was the major cause for improvement.
The profound differences in healthy life expectancies across America are astounding, as discussed at the caucus. Understanding and defining a problem are the first steps in finding solutions. Although COVID has highlighted inequities, many people in our nation still underestimate the disparities.
An interesting challenge has been created to engage and teach using a “Health disparities and social determinants discussion map.” On one side of the imaginary “Disparity Divide and Systemic Racism Boulevard” are obesity overlook, no-access Appalachia, redline road, poverty park, incarceration heights, struggling hospital, food desert way, waste incinerator, and smoke shadow school. The other side of the great divide includes gated community, privilege park, co-pay circle, prestige health system, good school gardens, and tax-break towers.
The object of the “game” is to estimate the life expectancy of an area and then find the facts. Multiple sources of internet information exist including the Community Well-Being Index. Please consider checking your city and/or county’s statistics.
“Redlining,” which was sanctioned post-WWI, has had profound lasting effects. Historic maps and descriptions of neighborhoods with significant consequences that persist to this day include food deserts, poor transportation, lack of sidewalks, and increased crime rates.
Sensational tragedies hit the news media daily—gun violence, hate crimes, and other heinous events. No question the victims suffer; but an even greater injustice to many more people, causing even more misery, are the long-standing, multi-generational social and political determinants of poor health and unsatisfactory well-being. These trends lead to learned helplessness that must be addressed.
Recognizing the problem is the first step—a diagnosis. Addressing the “disease” with a comprehensive plan is the therapy. Our nation is now at the in-between stage with some communities showing intense improvement, others just waking up to the problem, and sadly others still asleep or in denial.
Check out the websites above; then play the guessing game of healthy life expectancy to see if you are in a “wholesome” ZIP code or should consider moving.
