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How Wealth Buys Health in America



Rukhsar Asef


As the firstborn daughter of two immigrant parents, I witnessed firsthand the hardships my parents faced in their effort to achieve the American Dream for our family. My parents often tended to try and save money by cutting corners when it came to their own physical health by avoiding going to yearly physicals, and on multiple occasions when they were ill. Their justification for doing so was that they did not have access to health insurance, and that visits to their physicians were simply too expensive. Thus, my parents’ physical health was often compromised due to our low socioeconomic status as well as lack of access to care.


In 2004, my father began suffering from high blood pressure as well as cirrhosis which he did not get diagnosed with until 2008. In addition to these problems, my fathered suffered from a smoking addiction which further deteriorated his health. My father turned to smoking cigarettes as a coping mechanism for stressful situations. He would often smoke one pack of cigarettes as a day because he felt he was failing at providing for us, and failing to achieve the riches part of the rags to riches story. His poor health behavior was one again a result of his low socioeconomic status, as well as the structure of our neighborhood.


We lived in Brooklyn, New York in a rather poor neighborhood in a one bedroom apartment. Most of our neighbors including my father worked minimum wage jobs that did not pay enough to support a family in one of the most expensive states in the country. There was little room for advancement in that neighborhood as it was mainly poor, minority groups. Furthermore, we often dealt with our neighbors being evicted, and even committing suicide. Those who were able to keep their homes such as my father tended to smoke until their lungs became black in order to cope with the low quality of life that we were all living.


In 2006, my father had finally had enough to buy a small bagel store in Bronx, NY which turned out to be very successful. I saw our lives change in the blink of an eye as we moved from our small one-bedroom apartment in Brooklyn to a flat in Long Island, New York within one year. Our new neighborhood was an upper-middle class neighborhood. To this day, I have not heard of an eviction, nor seen evidence of a high suicide rate, in our new area. In addition, one of our neighbors convinced my father to use nicotine patches to help break his smoking addiction which was now a possibility since he could afford to do so. Both of my parents started going to their yearly physicals, and to the doctor any time they were ill. Today, my father is able to take medicine for his high blood pressure and cirrhosis because he can finally afford health insurance. While my family was fortunate enough to achieve the American dream, our struggles allowed me to be sensitive to the many public health issues that continue to persist in our society today.

Socioeconomic status is one of the biggest determinants of health in American society. For the most part, a high socioeconomic status is associated with better overall health as well as increased longevity. A high socioeconomic status enables people to afford medical care, prescription drugs, and healthy foods, and to be able to engage in positive health behaviors such as a gym membership. As my own socioeconomic status changed, it became increasingly clear that wealth improved my entire family’s overall health which greatly influenced my personal stance on socioeconomic status leading to a lack of access to medical care, and poor health behaviors.


The United States of America is the only developed country in the world with no national healthcare system. Instead, we have a fragmented medical system that is controlled by physicians and free market principles as there as many insurance plans which range in price. Often, the more expensive plans guarantee coverage for more medical services. Since I grew up in an environment in which doctors’ visits were often avoided, I believe that a national healthcare system is vital for better population health. Lack of access to care due to absurdly high medical costs leads to poor health for marginalized groups as they are usually the ones with the lowest socioeconomic status. Additionally, lack of access to care leads to increased stress which leads people to make poor health behaviors such as excessive drinking or smoking. These poor health behaviors further worsen population health, and decrease the overall life expectancy of Americans. As a wealthy, developed country, we need to prioritize the health of our people in the most efficient, and effective way possible.


In addition to increasing access to care, it is crucial to change the underlying racism in our society for the sake of better population health. Almost all neighborhoods in this country are extremely segregated, and those which are heavily populated with minority groups tend to be very poor, with little room for economic growth. These neighborhoods usually do not have access to facilities that promote positive health behaviors such as supermarkets which make it easier to have access to healthy foods. In addition, most residents of these minority dominated neighborhoods are often not financially stable enough to afford medical care thereby further limiting their access to care. In order to improve our overall population health, we must structurally change our country getting rid of the embedded racism our neighborhoods are built upon.


Public health aims to improve population health for every person in America. One of the core values of public health includes social justice which means equality for all groups in every aspect of society from political rights to equal economic opportunity, and access to medical care. In order to attain this goal, we need to get rid of the racist conventions that dominate our society, and allow everyone to have equal opportunities to move up the social ladder. In addition, we need to install a national healthcare system that does not discriminate based upon economic status, race, gender, etc. to allow everyone to live a healthier life.

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Ann Arbor, MI, USA

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