The central message of the Occupy Movement is that the vast differences in resources between the upper one percent and the remaining 99% of the population is unjust. It is unjust because people have unequal opportunity to access resources and to earn a livable income. This gap has been growing over the past thirty years in the United States. The Occupy Movement in the Bay Area and across the country gives voice to a shared concern about this trajectory of unequal opportunity.
A starting point for restoring truly equal opportunities is to recognize the relationship among access to educational resources, jobs, economic status, and health. They interact in a cycle. Poor health in adults compromises their ability to make a living. Poor health in children compromises their ability to get an education which, in turn, affects their future ability to make a living. And so the cycle continues.
It is not by accident that the wide differences in income and living conditions between Hunter’s Point area and more affluent neighborhoods of San Francisco are associated with a ten year difference in life expectancy. These patterns are replicated throughout the Bay Area, between Richmond and Contra Costa County, and between the flats and the hills of Oakland. Simply put, health is wealth, and wealth is health. Inequality in one yields inequality in the other. Concern about this “inequality syndrome” should occupy the conscience of an enlightened democratic society.
To Occupy is to fully engage in policies that enable all members of society to lead healthier lives. This requires a recognition of the importance of the environmental and social determinants of health. These include safe streets, neighborhoods, workplaces and schools; parks and recreation facilities; access to healthy foods and clean water; and opportunities for meaningful work and civic participation. Equity in education, labor, housing, and transportation policies, is essential to health. This “health in all policies” approach addresses the underlying inequalities affecting our health.
We can start on this approach by implementing the California Department of Public Health’s 2020 Healthy People objectives. Here are four examples. First, enhance access to and availability of physical activity in our schools and communities. Second, increase the number of communities with retail outlets that provide healthy foods. Third, eliminate the marketing of tobacco advertisements to children, adolescents, and young adults. Fourth, ensure health during formative years by increasing school-based health centers and school nurses in grades K through 12. Efforts such as these can help achieve more equal and just opportunities for both health and wealth.
These are not the only policies needed to narrow the gaps in health and income but they are a place to start. It is time to move from raising awareness to implementing solutions. It is time to move from occupation to action
Authors of this post: Stephen M. Shortell, dean of the School of Public Health-UC Berkeley, and Joe Schucter, School of Public Health doctoral student