The biological understanding of health and disease has evolved from miasmas (vaporous exhalation formerly believed to cause disease) to germs to individual risk factors tied to specific diseases. Now you are challenged by the knowledge that many people get chronic illnesses without having the known critical risk factors (e.g., smoking) that some may try to avoid in an effort to be healthy. The scientific revolution in health creates an even bigger challenge.Stress and inflammatory processes are sometimes seen to be critical factors affecting our biology. The stress response helps us get out of the path of the oncoming car or shelters us from falling debris in an earthquake. But if we turn it on while we are stuck in traffic, angry at the boss, experiencing financial difficulties, or dealing with another rejection, it does not benefit us. While some may cope better than others, those who are economically less fortunate and have to cope with issues of poverty may be less able to withstand stressful encounters. Today, health and illness tend to follow a socioeconomic gradient, in which people in lower socioeconomic groups tend to have higher mortality than those in higher socioeconomic groups. In general, those lower down the ladder of income, success, and wealth will exhibit lower health outcomes than those higher up. Societies with a bigger gap between rich and poor do worse in health outcomes overall than societies with a smaller gap because there is more unhealthy stress in unequal societies (United Health Foundation, 2013).There are exceptions to the gradient in health that present learning opportunities. For example, Latinos or Hispanics appear to have better health outcomes in the U.S. than non-Latino whites, a concept termed the Hispanic Paradox (New America Media, 2012). Reasons for this disparity are debated. One point of view is that the social support Latinos or Hispanics offer one another can counteract some of the adverse effects of having lower socioeconomic status.For this Discussion, you consider how cultural and economic factors influence those biologic mechanisms that can result in disease for specific segments of the population. You also propose possible policy solutions to reduce the burden of disease.
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