Emory Report

 December 8, 1997

 Volume 50, No. 15

First Person

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 could.

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.

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