However I am even more concerned about the number of kids who have to go to school or day care when they're sick because their working parents can't afford to stay home and have nowhere else to send them. In doing so, they will also expose all their child's classmates. Who, because their immune system is still forming, are very likely to develop the illness themselves and expose other children. Over the past decade, I have seen many children who suffer 12 or more serious (requiring antibiotics) throat, ear, sinus or chest infections a year.
This is a major public health problem, especially now that asthma (often triggered by chest infections), is reaching epidemic proportions among American children. Allowing children to suffer one respiratory infection after another can have permanent lifelong health consequences.
The reality is that illness both acute and chronic is fundamental to the human condition. In my experience, people willing to allow themselves to be ill and take time off to get well recover faster and cope better with other life stresses better.
Obviously adults have the choice whether or not they want to work when there are sick. Parents with sick children must make that decision for them. They are also entrusted with that child's future health and welfare. And I think they need to weigh that responsibility carefully in deciding to send a sick child to school or daycare.
The Myth That Lifestyle Factors Cause Illness
Good health is elusive. In general we have a very limited ability to stay well by eating right, exercising and reducing stress. Epidemiological studies show that only 10% of illness is accounted for by lifestyle factors (including smoking).
The University of Washington epidemiologist Dr Stephen Bezruchka has been writing and speaking for nearly two decades on the real cause of illness and poor health. As he repeatedly points out, lifestyle factors (including smoking) only account for ten percent of the causation of illness. According to Bezruchka, the single most important determinant of adult health status and life expectancy is your mother's income and social status during pregnancy and the first three years of life.
Although more than fifty years of epidemiological studies bear this out, it is only in the last decade scientists could explain why this is thanks to the new science of epigenetics. While the early Freudians used to make similar claims about unfavorable "psychological" influences on infants and young children, it is now clear the effect is biological rather than psychological. That it relates to "epigenetics" a term referring to changes in gene expression caused by mechanisms other than the underlying DNA sequence.
Numerous studies show that environmental stress and hormones (particularly stress hormones) produced during pregnancy can cause genetic code to be transcripted (into proteins and enzymes) in such a way to negatively affect the development of the immune system in addition to predisposing the fetus to biochemically based mental illnesses.
The Link Between Income Inequality and Poor Health
However the most important epidemiological finding, according to Bezruchka, is that the effect of low income status on health is much more pronounced in societies with extreme income inequality. Study after study bears this out. In other words, a poor person's adult status and life expectancy will be worse if he is born into a country with big gap between the economic status of its rich and poor residents (such as the US where 10 percent of the population controls 71 percent of the wealth). In fact the US is near the bottom of the charts if you look at statistical indicators that measure the overall health of a country. In life expectancy it rates 38th, just behind Cuba. In infant mortality it rates 30th, just above Slovakia.
These findings also belie the efforts of policy and opinion makers to convince us that class differences have disappeared in the US. For example, it's extremely rare to see working class families depicted on American TV. In fact some Republican commentators accuse their opponent of "class warfare" for even mentioning the existence of an underclass. Nevertheless with a double dip recession on the horizon, in the face of healthy corporate profits and CEO bonuses, American's class divide is receiving more and more attention.
A Mindset Driven By Social Service Cuts
Dr Susan Rosenthal, in Sick and Sicker, also points out that it's only in the last thirty years that politicians and policymakers on both sides of the aisle have made sick people responsible for their own illness. Epidemiological studies as long as scientists have been doing them have always shown that poor health correlates directly with low income and social status. Rosenthal notes that even in Dicken's time it was taken for granted that the poor undernourished and living in cold, damp, overcrowded tenements were far more prone to illness than their middle class counterparts. In her mind this shift to a new "blame the victim" mentality has been deliberate to justify aggressive social service cutbacks (by both Republicans and Democrats) that became fashionable with the election of Ronald Reagan in 1980.
The Role of Oppression and Exploitation in Illness
Although the data establishing the link between income inequality and poor health is unequivocal, epidemiologists are still at a loss to explain why poor people have poorer health in countries with more income inequality. Bezruchka relates it to the fact that people in more egalitarian societies look after each other more. I like Rosenthal's explanation better. She relates it to the extremely high level of oppression and exploitation in societies with extreme income disparity.
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