Religion and health care share
a role in preventing disease
Gandhi once said we should strive for interdependence with the same tenacity
that we strive for self-sufficiency. A faith and health coalition is an
expression of Gandhi's observation. It's not bringing two worlds together,
but mending the division within one world. We need to realize that just
as many of our problems are linked, so are the solutions.
Even given the skills and the knowledge we have, we don't achieve the
health level that is possible. In 1993, an article in the Journal of the
American Medical Association revealed the leading causes of death in the
United States-not which organ systems fail but the leading causes of death.
The number one cause turned out to be tobacco, with 400,000-plus deaths
a year. Number two was diet, with 300,000 deaths a year. Number three was
alcohol, with 100,000 deaths annually.
The top three causes of death are things we could do something about,
and yet we view these statistics as acceptable.
Why? In part, we've simply become accustomed to it. But also, too often
we don't value health until we lose it. The day a person gets a diagnosis
of lung cancer, that person would give up just about everything if it would
allow him or her to go back 10 years and stop smoking. But two weeks before
hearing that diagnosis, it's not as important.
Another reason we accept such a high incidence of preventable death is
that we trust the free market system and think it will always work to our
advantage. However, the free market system may not solve all health problems.
It may not even solve all economic problems!
Smallpox vaccine was in the free market system for 170 years. But smallpox
didn't disappear until a deliberate decision was made to eradicate it. Polio
vaccine has been on the market for 40 years, and yet we still have polio.
With some problems such as tobacco, it's easy to see how the free market
system actually makes the problem worse.
We have a paradox in both health and in economics where the averages
keep improving, but the standard deviation keeps getting wider. For example:
The average income increases while the gap between rich and poor increases.
Today, 40 percent of everything in this country is owned by 1 percent of
the population. Put another way, more than 100 percent of all our country's
new wealth in the 1980s went to the top 20 percent of society. That means
the lower 80 percent actually lost 3 percent between 1980 and 1989.
Likewise, new medical knowledge in areas such as tobacco use, diet and
fat, exposure to the sun and mental health can help people make healthier
choices. But for some reason that information is not available equally to
all. We know that money is not distributed equally, but why should medical
information follow the same trend? The information that using tobacco causes
lung cancer is more available to the people in the upper socioeconomic groups.
Consider this: A man who makes $100,000 a year and smokes two packs of cigarettes
a day has a lower risk of lung cancer than a man who makes $10,000 a year
and smokes the same number of cigarettes a day.
The trillion-dollar medical industry has not figured out how to equitably
provide information and get people to take advantage of it-but faith communities
Faith communities could help instigate positive, healthy behavioral changes
by virtue of their focus on individuals and concern for equity. It's something
of a new role for faith communities but one for which they are ideally suited.
F. Scott Fitzgerald once said the mark of a first-rate mind is the ability
to hold two conflicting ideas in mind simultaneously and still function.
For us, that means we can say the health care system is hopeless-and this
is how we're going to fix it.
How do we act responsibly in promoting and maintaining individual health?
At the same time, how do we use the best of the market system without letting
it make poverty and disease worse? How do we as citizens, a coalition, get
government to represent our interest both in being good Samaritans and in
providing collectively what none of us can provide as individuals or groups?
How do we focus on current and local crises without losing sight of our
responsibility to the world and to the future?
These are great challenges that provide opportunities for creativity
and coalition-building between faith groups and health groups. Faith groups
have an unprecedented opportunity to get into the health arena, and health
groups have a great need for community help. There is no longer enough money
for everything, so their combined perspective provides the broader picture
necessary to establish priorities.
We will get more science and we will get more technology without doing
anything. But we will only achieve healthier communities-and more justice,
trust and ethics-with hard work.
William Foege is health policy fellow at The Carter Center and professor
of International Health at the Rollins School. This essay was excerpted
from an article in "Faith & Health," published by The Interfaith
Health Program of The Carter Center.
to December 8, 1997 Contents Page