Unnatural Causes: Is Inequality Making Us Sick?
Airs Thursday, March 27-April 17 at 10:00pm on KNPB.

What’s happening to our health? While we pour more and more money into drugs, dietary supplements and new medical technologies, a groundbreaking new documentary series crisscrosses the country investigating the findings that are shaking up conventional beliefs about what really makes us healthy — or sick. It turns out there’s much more to our health than health care, bad habits or unlucky genes. There’s a hidden killer in plain view: the social, economic and physical environments in which we are born, live and work profoundly affect our well-being and longevity.

Unnatural Causes: Is Inequality Making Us Sick? airs Thursdays, March 27-April 17, 2008, 10:00-11:00pm on KNPB.

The four-hour series coincides with the presidential election-year debates regarding the estimated 47 million Americans who lack health coverage. But Unnatural Causes goes further, asking what makes us ill in the first place. The series probes why one’s economic status, race and zip code are even more powerful predictors of health and life expectancy than smoking.

Each episode sheds light on the mounting evidence that work, wealth, neighborhood conditions and lack of access to power and resources can get under the skin and disrupt human biology as surely as germs and viruses. Experts and public health professionals emphasize that because these conditions are distributed unequally, so are patterns of chronic disease: e.g., heart disease, stroke, diabetes, asthma, even some cancers.

Unnatural Causes raises unsettling questions with far-reaching political and social implications and suggests new remedies for an ailing society:

• Why does the most powerful nation in the world now rank 30th in life expectancy (worse than Jordan) and 31st in infant mortality (worse than Croatia) despite spending two-and-a-half times more per person on health care than the average industrialized country?

• Why do recent Latino immigrants, though poorer, enjoy better health than the average American when they arrive in the United States, yet suffer a rapid decline the longer they are here?

• Why are some African-American and Native-American populations less likely to reach age 65 than people from Bangladesh or Ghana?

The series reveals a continuous health gradient tied to wealth. Life is longer and healthier at the top. At each step down the socioeconomic ladder — from the rich to the middle class to the poor — people tend to be sicker and die sooner. The least affluent die on average six-and-a-half years earlier than the rich. But even middle-income people die more than two years sooner than those at the top. Poorer smokers face higher mortality risks than rich smokers.

Evidence also suggests that racial discrimination imposes an additional health burden. With many diseases, African Americans, Native Americans and Pacific Islanders — at all income levels — fare worse on average than their white counterparts.

Unnatural Causes challenges our conventional approach to prevention, which has mostly been limited to encouraging healthy behaviors. But much of what affects our health lies outside an individual’s control and these too are health policies: better land use, transportation and business investment; ensuring that every neighborhood has access to supermarkets and healthy foods and not just fast food joints, liquor stores and mom-and-pops; creating safe streets and green space so people can walk, jog, bike and play; investing in our schools; paid vacations and family leave; and living-wage jobs with career ladders.

As a society, we’ve made changes that loosened the “wealth-health” linkage and improved the health of all before. Researchers attribute the 30-year increase in U.S. life expectancy over the 20th century not merely to new drugs and medical technologies but to social reforms such as the eight-hour workday, child labor laws, universal high school, civil rights laws, a progressive income tax, social security and the right to form unions that ensured that benefits from economic growth were more widely shared.

But Unnatural Causes makes the case that — despite the gains of the past — America has been moving in the wrong direction. Today, the top one percent of the population holds as much wealth as the bottom 90 percent. Approximately 22 percent of our children live in poverty. And as inequality grows, our life expectancy ranking continues to drop — down from the top five in the 1950s, and lower than even a few years ago, as more and more countries surpass the U.S. with better health. Renowned health experts assert that we need not only universal health care to cure us when we’re sick, but also better and more equitable social and economic policies that can protect and promote our health in the first place. Social policy, they say, is health policy.

• "In Sickness and in Wealth," Thursday, March 27:
This episode uncovers the connections between healthy bodies and healthy bank accounts — and why residents of so many other nations, including many poorer countries, live longer and healthier lives.

• "When the Bough Breaks/Becoming American," Thursday, April 3:
Looking into why African-American infant mortality rates are twice as high as those for white Americans; and understanding the "Hispanic Paradox."

• "Bad Sugar/Place Matters," Thursday, April 10:
“Bad Sugar” travels to the O'odham Indian reservations of southern Arizona where residents have perhaps the highest rates of Type 2 diabetes in the world. "Place Matters" takes a look at what policies and investment decisions create neighborhood environments that harm — or benefit — the health of residents.

• "Collateral Damage/Not Just a Paycheck," Thursday, April 17:
"Collateral Damage" shows how globalization is affecting health — often in unanticipated ways. "Not Just a Paycheck" takes a look at how job insecurity and unemployment affect health.

Airs Thursday, March 27-April 17 at 10:00pm on KNPB.