Documentary Summary: Unnatural Causes

When sailing through the ocean and navigating to an ultimate destination, sailors must take into account not only the strength of their ship and supplies, but also simultaneously battle the strength of the ocean, its waves, rainfall, and other environmental cues which come in its path. Much like this ship, our health is influenced by several factors, many of which we cannot control. While we can control the cleanliness of our houses and our personal hygiene, we cannot control our socioeconomic status, our ethnicity, or the opinions and interactions of our community members. These issues are of the utmost importance because any deviation from healthy practices can create a ripple effect when combined with social determinants to negatively
affect health outcomes. Although access to healthcare is widely accepted as the principal health determinant, social determinants of health such as socioeconomic status, ethnicity and religion, and community relationships strongly influence health outcomes. The term community to me means the environment and all the factors external to an individual that directly or indirectly affects a person, a group of people, or an entire population.
It is a term inclusive of both physical and nonphysical factors. The physical factors include the people in our town, the town’s infrastructure, its services, its conditions such as level of sanitation, and more. The nonphysical factors include the amount of money earned by the population, the interaction and support the town offers, and other social determinants. This is a broader definition of community than offered by the documentary, Unnatural Causes. Unnatural Causes does not explicitly define “community” but shows through many examples that a community is one’s immediate surroundings, predominantly the group of people by which someone is surrounded. From watching the videos, a community to me became more than what is around someone’s house; it became everyone and everything that affects a group of people, whether connected through geography or
relationships. I grew up in three different types of communities. From birth until three years old, I lived in apartments in a lower class town surrounded by racial and ethnic diversity. From three years old to twenty years old, I lived in a twin-home with three bedrooms and one and a half bathrooms in a middle-class town with a lower level of racial and ethnic diversity. Along with my family of four, we shared the house with up to ten people for a total of fourteen. Since I was twenty years old, I have lived in an upper-middle class home with my family of four in an upper-class town with little to no racial and ethnic diversity besides my own Indian family. Growing up in three different communities, each at different socioeconomic levels, influenced my health positively by moving to more affluent communities. While living in a middle-class area with up to fourteen people at a time, health became secondary to providing everyone with food and clothing, similar to the mushroom farmer in Unnatural Causes. With fourteen people in close proximity, the house became dirty and unhygienic. Dirt, hair, and dust accumulated rapidly and the sink was full of dirty dishes. If someone fell sick, eventually, half of us would also become sick. In our community, dirty was normal and accepted. Wearing clothes multiple times before washing, bringing dirt into the house and waiting until Saturday to clean, and rarely cleaning the bathrooms were normal community practices. After only a few years, we practiced new daily tasks such as cleaning after ourselves, laundry, vacuuming, and washing our hands. Things that may normally be unnecessary on a daily routine became our norm, resulting in a lower frequency of sickness, especially compared to my friends in the community. While initially the community impacted my health negatively due to unsanitary conditions and practices, my family was able to make the necessary changes to become sanitary. Our health improved despite our immediate community. However, the community negatively impacted our overall health.
As the only Indian and darker skinned student in my class, going to school affected me emotionally. My classmates harassed me because of my darker skin. I thought the harassment would stop after elementary school, yet it only amplified. The September 11th attacks on America turned everyone with my skin tone into enemies. My close friends decreased their interaction with me while others threatened me. On the news, I would hear of attacks and murders of fellow Indians. Our house was egged, our cars were scratched, reminding us that at any point, the harm could be direct. Our family lived in constant fear of physical harm and we suffered emotional harm. Our family members became depressed, decreasing the children’s morale and spirit. This is when I first noticed that the surrounding community, using my broader definition, impacts the overall health of its occupants. I do not remember why, but our visits to the family doctor became more frequent. My father and uncle were both prescribed medication for high blood pressure. My cousins and I could not sleep at night, affecting us academically and making us tired in school. My family and I, deeply connected to Hinduism and Indian culture, felt we could not openly practice important aspects of our lives. We could not hold regular festivals without being tormented by others in the community. This continued for many years until moving to a new upper-middle
class town. After moving, I realized how one’s community impacts health. Our new community is predominantly white and upper-middle class. They have been friendlier, and more accepting of my religion and culture. Overall, my family is happier and healthier today than during our time in the previous community. Comparatively, our new community is cleaner, more active, and eats healthier. These factors have positively contributed to my family’s overall health. Three major social determinants of health that may have contributed to these health disparities are socioeconomic status, ethnicity and religion, and general relationships amongst peers. The major factor distinguishing these communities is socioeconomic status. My current community has a higher average household income than my old community. It is important to note that these three communities are all within eight miles of each other in suburban Pennsylvania. In my old community, houses were not cleaned or maintained, dishes remained unwashed, trash was not taken out, and laundry was reused many times. Health outcomes proved to be worse in my old community compared to my current community. My classmates frequently fell sick while I remained healthy by maintaining a cleaner living environment. Presently, my upper-middle class neighbors higher maids to clean their houses, dishes, laundry, and even maintain their house. This has shown a lower frequency of sickness than my previous community. Even though we cleaned and maintained our previous home, I have still seen an improvement in my own health after moving to a more affluent community. The mushroom farmer story from Kennett Square, Pennsylvania is very similar and touching because their situation is and amplification of my own. This leads me to believe socioeconomic factors alone do not determine health outcomes. My ethnicity and religion, as placed in the previous community, negatively affected my health. This was due to external events such as the terrorist attacks and the perception of Eastern religions. While my ethnicity and religion are not related to these attacks, I was still harassed and my health was affected. Unnatural Causes placed a higher emphasis on ethnicity than religion, but I feel through my experience and public interaction that religion is also important since many people across the country experience similar events. Lastly, relationships with the people of my current community positively affected my health. In Unnatural Causes, community support groups helped people solve their problems. These groups identify particular issues, but being open and friendly to our neighbors harbors similar support systems. In my new community, neighbors run together, walk their dogs, play sports, and barbeque at various houses. This friendly atmosphere leads to less stress and better health outcomes. Comparatively, in my old neighborhood, stress occurred because of unfriendly neighbors who usually shared a wall and backyard. When different families share communal space, tension builds and may continue for years, negatively impacting health by added stress. If I could change one of these social determinants, I would change the interaction of people with different ethnicities and religions. I would open peoples’ minds to become more accepting of all ethnicities and religions through educational programs for children and young adults. These programs would educate people on different religions to allow for open dialogue and interaction. I would not require people to practice other religions, but simply be open to the fact that other religions exists and people have a right to practice as they please. This would create a friendly community so people do not live in fear of harassment or harm. Social determinants of health such as socioeconomic status, ethnicity and religion, and community relationships strongly influence health outcomes. Just as a ship in the ocean is hit by wave after wave, my family was hit with financial trouble, religious isolation, and bad community relationships. Moving to an affluent community that is accepting of our ethnicity and religion, and works hard to build strong relationships, positively influenced our health. From a stressful family environment living in fear of abuse and harassment, our new community has transformed us into a stress-free family living healthier lives.

Bibliography

Davies, J. (Director). 2008. UNNATURAL CAUSES: Is Inequality Making Us Sick? [Documentary film]. United States: PBS.