When will men live as long as women? By 2032, say experts

 

Women in developed countries have historically outlived men. But the life expectancy gender gap is closing.

In developed countries, the gender gap has long favoured women by one measure at least: life expectancy.

Throughout the past 100 years women have significantly outlived men, on whom war, heavy industry and cigarettes – among other things – have taken a heavier toll.

But this gender gap is closing – and a new statistical analysis of life expectancy in England and Wales since 1950 suggests that, by the year 2032, men can expect to live as long as women, with both sexes sharing an average life expectancy of 87.5 years.

The study, led by Les Mayhew, professor of statistics at Cass Business School, calculated how long a sample of 100,000 people aged 30 would live if they experienced the average mortality rates for each ensuing year, projecting forward until the male and female life expectancy curves intersected.

There are a number of factors that explain the narrowing gap, according to Mayhew. “A general fall in tobacco and alcohol consumption has disproportionately benefited men, who tended to smoke and drink more than women.

“We’ve also made great strides in tackling heart disease, which is more prevalent in men,” Mayhew said. “And men are far more likely to engage in ‘high-risk’ behaviours, and far more likely to die in road accidents, which have fallen too.”

The life expectancy gender gap appears to be closing faster than was previously thought: research published in 2015 by Imperial College had indicated it would narrow to 1.9 years by 2030. The UK as a whole has slightly lower lifespan averages, as life expectancy tends to be higher in England than the other constituent nations.

In the years immediately after 1950, women’s life expectancy increased faster than men’s in England and Wales, with the gender gap peaking in 1969, when women lived on average 5.68 years longer.

Majid Ezzati, professor of global environmental health at Imperial College, said the gap can be attributed largely to social rather than biological factors: “It’s actually the existence of the gap that is unusual, rather than the narrowing. It’s a recent phenomenon which began in the 20th century.”

In addition to the heavy male death tolls caused by two world wars, men started to smoke in large numbers before women did and women’s consumption never outpaced men’s. Male cigarette consumption peaked in the 1940s when tobacco industry figures revealed that more than two-thirds of men smoked. Female consumption peaked later, in the 1960s.

As well as changing attitudes to cigarettes and alcohol, the loss of heavy industry jobs – statistically more dangerous in both the short- and long-term – also disproportionately affected men.

“As the [life expectancy] gap narrows, our understanding of what it means to be a man and a woman changes,” said Danny Dorling, professor of geography at the University of Oxford.

“The difference between the genders also narrows because of the introduction of contraception and female entry into the labour market. But the really interesting thing is it’s actually a kind of reverse inequality: women have lived longer than men who are paid more throughout their lives and are structurally advantaged in any number of ways. We haven’t entirely worked out why that might be.”

Postcodes and poverty

While life expectancy is projected to improve for everybody in the coming decades, the rate of improvement varies significantly depending on where you live.

The Cass analysis projects that by 2030, men in the most deprived areas of England and Wales will on average die 8.8 years earlier than those in the least deprived. For women, the gap between rich and poor will be 7.3 years – with both these lifespan inequalities worsening from their current levels.

The research made use of mortality rates after age 30 in order to exclude instances of early death, which are becoming increasingly unusual. But dying young is also much more likely if you’re from a poor background.

“Early death will certainly become a rarer event, but higher mortality rates for younger ages will still be the norm in the most deprived decile in England and Wales, unless something radically changes,” Mayhew warned.

Even in wealthy areas, however, the rate of improvement in life expectancy appears to be slowing. In May, consultants at PricewaterhouseCoopers (PwC) predicted that pension funds – which consider mortality rates when estimating future payouts – might be able to wipe £300bn off their deficits.

“In the first decade of this century, there was a clear trend for improvements in life expectancy,” Raj Mody, global head of pensions with PwC, told the Financial Times. “Pension funds have typically been assuming this trend will continue when forecasting deficits. But over the last five years, that trend has changed and there is a growing view that it is not just a blip.”

As life expectancy increases, the number of deaths per year tends to fall. Since 1980 the number of deaths has fallen for both men and women, but the decrease has been greater for men.

However, in 2012 the number of deaths per year started to rise again, peaking at 529,655 in 2015 – an unprecedented increase of more than 28,000 deaths on the previous year. This was the biggest jump in percentage terms in almost half a century. The number of deaths in 2016 was down by 0.9% year-on-year, but still represented a significant increase from 2014.

The Office of National Statistics believes the upturn in deaths might be because of an ageing population. “As people are tending to live longer, leading to the population increasing in both size and age over time, we may also expect the number of deaths to increase,” a 2016 report said.

But a number of academics have attributed the slowdown in improvement to government spending cuts, particularly those affecting social care and the NHS.

“There is no biological reason why life expectancy in Britain should level out rather than keep on improving. The UK is still some way behind Japan, for example,” said Mayhew.

“But improvement in life expectancy is becoming increasingly difficult to sustain in an economic downturn with an ageing population,” Mayhew added. “Austerity in recent years has affected the supply of social care, for example, and this may have caused mortality to rise in some instances.”

 

By            :               Niamh McIntyre

Date         :               February 13, 2018

Source     :               The Guardian

https://www.theguardian.com/inequality/2018/feb/13/when-will-men-live-as-long-as-women-by-2032-say-experts

Posted in Latest Post, Social and Economic Inequalities | Leave a comment

How higher education in Hong Kong reinforces social inequalities

 

Paul Yip and Chenhong Peng say the sub-degree programmes that tend to attract youth from less-privileged backgrounds cost more to attend yet offer less wage potential than a full degree. It’s time for officials to do more to help those who fail to earn a government-funded university place.

The higher education sector in Hong Kong has experienced substantial expansion in the past 30 years. In the early years of the colony, university education was aimed primarily at the Chinese elite who could take up a public service role after graduation. In 1965, just 2.2 per cent of the university-age cohort were enrolled in a degree programme.

It was not until the late 1980s that the government decided to expand the higher education sector. The first wave of reform came about by raising the number of publicly funded degree places.

The Hong Kong University of Science and Technology was established in 1991. And, in 1994, three institutions – Hong Kong Polytechnic, City Polytechnic and Baptist College – were granted university status. As a result, the participation rate of students in publicly funded first-year, first-degree programmes grew from 8.8 per cent in 1989 to 18.1 per cent in 1996.

Then came the second wave of reform in 2001, in which private education providers were encouraged to offer self-financed sub-degree programmes. Including these associate degree programmes, the tertiary education participation rate nearly doubled, from 33 per cent in 2000 to 64 per cent in 2006.

On the whole, this expansion has raised the education level of Hong Kong society. But how has the huge increase in the supply of tertiary graduates affected wages? And how have the returns to tertiary education in Hong Kong – both at the degree and sub-degree levels – changed over the past 20 years?

To find out, we analysed data from the 1996, 2006 and 2016 population census reports, based on male workers aged 24 to 35. In 1996, holders of sub-degree certificates earned 40 per cent more than their secondary-school-educated counterparts. However, the earning difference slumped to 13 per cent in both 2006 and 2016. The decreased returns to a sub-degree tertiary education partially support the argument of credential inflation.

A sub-degree certificate also appears to confer little advantage in the labour market compared to a secondary-school certificate. This echoes the findings of the Education Bureau’s most recent survey of employer opinion on degree and sub-degree holders who graduated in 2013.

According to the survey report, employers gave sub-degree graduates a performance rating of 3.35 out of 5 on average. Among the nine major aspects of performance, they performed poorest in management skills (3.13 out of 5) and proficiency in English (3.15). Moreover, there was significant discrepancy between employers’ expectations and graduates’ performance in analytical and problem-solving skills, work attitude and interpersonal skill.

Degree holders fared marginally better than their sub-degree counterparts in terms of wage returns. In 1996, degree holders earned 70 per cent more than their secondary-school-educated counterparts. The earning difference fell to 42 per cent in 2006 and further dropped to 37 per cent in 2016.

In the employers’ survey, about 75 per cent of employers said they were satisfied with the performance of the degree holders they hired.

The transition from elite higher education to mass higher education in Hong Kong has primarily been achieved through the expansion of self-financed sub-degree programmes. The intake of full-time sub-degree students skyrocketed from 2,600 in 2000/2001 to 19,800 in 2014/2015.

A recent study found that in 2013, 30 per cent of the young people enrolling in a sub-degree programme came from families living below the poverty line. As sub-degree programmes are mainly self-financed and the annual tuition fee can be as high as HK$40,000 to HK$50,000, these young people would probably have to take out a loan to pay for their education. Despite such hefty investment, however, the returns are low.

By contrast, the increase in the publicly funded degree programmes has been rather stable. The student intake increased from 14,200 in 2000/2001 to 17,500 in 2014/2015. Almost half (48.2 per cent) of the young people enrolled came from the wealthiest 10 per cent of families, and only 7 per cent came from families living below the poverty line.

In summary, our analysis suggests that the higher education system, to some extent, exacerbates the level of inequality in Hong Kong. Students from rich families are more likely to enrol in publicly funded degree programmes and enjoy the higher returns they generate while students from poor families are more likely to enrol in a self-financed sub-degree programme, which only generates low returns.

It is the time for government to take a hard look at its higher education policy. It should try to improve the quality of self-financed sub-degree programmes, which would help to raise wage potential in the labour market.

Furthermore, some form of subsidy or compensation is necessary to enable children from disadvantaged families to enjoy greater access to publicly funded degree programmes.

In view of the substantial financial surplus this year, we should provide education and training for those who did not make the cut to a government-funded degree programme. Flexible financial support should be provided to the young people who want to improve their skills and education.

The window of opportunity for skills enhancement closes fast, especially for those aged 15 to 24. If they aren’t helped to improve themselves, they will find it hard to enjoy upward mobility. At the end of the day, Hong Kong will lose its edge if its young people don’t advance themselves.

 

Paul Yip is a chair professor (population health) and an associate dean (research) in the Faculty of Social Sciences at the University of Hong Kong. Chenhong Peng is a PhD student in HKU’s Department of Social Work and Social Administration

 

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Persistent inequality: disputing the legacy of the pink tide in Latin America

 

Under the title ‘Persistent inequality’ we are launching a series of articles that analyses why the advances in the struggle against inequality in the pink tide cycle have been much more limited than expected.

In this election year in Latin America, when it is possible that the tide will confirm its turn and may strengthen conservative forces, time is ripe to reflect on how progressive governments failed to reduce inequality during the virtuous decade of progressive governments throughout the region that managed to remove millions of citizens from extreme poverty.

But new measurements, no longer based on household surveys but on income tax declarations, have shown that the impacts of leftist governments in Latin America on income redistribution and wealth were less than assumed.

It has been found that these governments were able to significantly reduce poverty, but not decrease the concentration of income and wealth among thesmall group of millionaires located at the peak of the social pyramid in each country. This argument has been used to undermine the credibility of the leftist governments, alleging that they were not efficient, not even in the objective for which they have said they are essential, which is the reduction of inequality.

To address this controversial question, and on the year of key presidential elections in major Latin American countries like Colombia, Mexico and Brazil,The Institute of Latin American Studies of the Freie Universität Berlin and DemocraciaAbierta are launching a series of articles.

The objective is to propose solid arguments and analysis to be considered and discussed in the Latin American and international public sphere in times of rapid political change that often neglect the lessons of the recent Pink Tide.

The pink tide and the struggle against inequality

It is true that inequalities and poverty have decreased more in the countries that, in recent years, were or continue to be governed by leftist forces, and particularly Argentina, Brazil, Bolivia, Chile, Ecuador, El Salvador, Nicaragua, Paraguay, Uruguay and Venezuela, than in the Latin American countries not governed by leftist forces.

Nevertheless, it cannot be denied that advances in the struggle against inequality in the pink tide cycle has been much more limited than expected from governments that were elected based on a promise of reverting inequalities accumulated since the colonial period.

The explanations for this modest performance normally combine external andinternal factors. In terms of external factors, it is alleged that the cycle of economic growth that helped finance spending on the social policies of leftist governments was based on the exports of raw materials and agricultural products whose volatile prices have been largely declining on international markets in recent times.

From an internal perspective, the social central policy adopted by practically all the leftist governments has been criticized, that is, cash transfers to the poorest. It is known that these policies, unlike policies aimed at the formation of long-lasting structures of a welfare state (quality education and healthcare provided by state, public investments in professional training, etc.) have by the strength of their own design, a very limited redistributive impact.

The tax question has also been highly debated. After all, except in isolated cases, the leftist governments were not able to create progressive tax structures that could redistribute income from the top to the base of the social pyramid.

These explanations are solid and pertinent and deserve to be considered. Nevertheless, they only reveal the surface of the phenomenon that they study and do not elucidate the ultimate reasons for which the leftist governments tonot have gone much beyond the programs for distribution of money to the poor.

To understand these reasons, it is necessary to articulate the analysis of social inequalities with the study of power relations in each case. That is, it is necessary to understand the political circumstances that caused the leftist governments to be unable to go further in their concern for promoting income redistribution.

Six factors to be addressed

  1. The exhaustion of grand national narrativesthat at other moments of recent Latin American history have allowed uniting a nation around common objectives: This was the case, for example, of the national-developmentalist discourse that in the mid twentieth century helped to legitimate the decisive participation of the state in the socio-economic development of countries such as Argentina and Brazil.

Something similar is observed during the democratization process at the end of the last century, when groups with quite diverse interests joined around the common objective of re-establishing democracies in countries such as Argentina, Brazil, Paraguay, Uruguay or Chile.

The leftist forces that reached power in the twentieth-first century, even if they had been capable of winning elections, were not able to transform the fight against inequality into a national hegemonic project.

  1.  The erosion of the national public spheres:In the context of democratization in the various countries, public spaces were formed that were capable of promoting the effective interchange of ideas, interpretations and arguments of various social groups.

These arenas of debate allowed the governments to both promote and defend their policies as well as re-adjust them according to public reactions.

In recent years, the intensified concentration, and the increased partisan nature of mass communication media coupled with the rise of a multiplicity of forums and blogs that do not communicate with each other, have transformed the public sphere into a space of struggle in which insults and fake news have more weight than good arguments.

This new context creates insurmountable difficulties for the legitimation of proposals of substantive changes as are the profound programs for income redistribution that the Latin American left intended to implement.

  1. Volatile parliamentary base: Most of the leftist governments were only able to be established at the cost of alliances with conservative forces. If these alliances guarantee the formation of a legislative majority necessary to govern, they very often impeded projects for tax reform or bolder redistributive plans.
  2. Emergence of the so called new middle classesthat demonstrated greater commitment to individual upward mobility and to the broadening of their opportunities for consumption than with the promotion of social justice.

This obviously does not involve a moral condemnation of these strata for wanting material prosperity.

What it indicates is that the rise of the so-called new middle classes, typical voters for the leftist governments, forced these governments to correct their discourse and their more radical redistributive intentions, in favor of measures aimed at expanding the consumption possibilities and upward mobility of this segment.

  1. Resistance of the established middle classes: in many countries, the growing consumption capacity of the new middle classes was seen by the established middle classes as a threat to their class reproduction.

After all, their common marks of social distinction such as access to certain goods and services (cars, domestic employees, university education, etc.) were either no longer guaranteed or failed to be a privilege of the established middle classes.

This transformed the established middle classes into a large and powerful opponent of the leftist governments and their redistributive plans.

  1. Appropriation of the state and of politics by economic elites: in recent years, the wealthiest groups in Latin America were able to extend and consolidate their control over the states in the region, including those governed by the left.

Through strong and often corrupt influence over politicians and governments, these elites were able to instrumentalize portions of the state to serve their interests, as well as obstruct, in the legislative realm, laws and reforms that could limit their economic power.

This explains, at least in part, the inexistence in many countries of a fair taxation of capital gains or of large fortunes. It also explains why the peak of the social pyramid (the wealthiest 1% of each country) was able to broaden their participation in the appropriation of the wealth and income even in the countries governed by the left.

The combination of these six factors, and others that prove to be relevant for each country in particular, allow interpreting in a deeper and better-articulated manner the modest results of the leftist governments of Latin America in terms of the promotion of the distribution of income and wealth.

The meager results are not due to a lack of political will, technical incompetence or ignorance of the effective mechanisms for promotion of greater equality. Given the circumstances in which the governments took power, it seems that until now the leftist forces have lacked enough power to promote more radical reforms.

 

Sérgio Costa is Professor of Sociology at Institute of Latin American Studies and at the Instituite of Sociology of the Freie Universität Berlin.

Francesc Badia i Dalmases is Editor of DemocraciaAbierta. Francesc is an international affairs expert, author and political analyst. His most recent book, “Order and disorder in the 21st century”, has been published in 2016. He Tweets @fbadiad 

 

By            :               Sergio Costa & Francesc Badia I Dalmases

Date         :               January 22, 2018

Source     :               Open Democracy

https://www.opendemocracy.net/s-rgio-costa-francesc-badia-i-dalmases/persistent-inequality-disputing-legacy-of-pink-tide-in-latin-

Posted in Latest Post, Social and Economic Inequalities | Leave a comment

How Indonesia Can Use Urban Planning to Tackle Inequality

 

Gated communities in Indonesia have become a glaring example of how income inequality creates both spatial and social divides.

Income inequality creates both spatial and social divides and shows itself within cities in many ways. Gated communities in Indonesia have become a glaring example. However, legislation and urban planning can help bridge these divides and reduce inequality.

“Inclusionary planning instruments” are designed to do just that. But to be effective they need to be strongly enforced.

In Indonesia, there are two instruments that have the potential to create more inclusive societies. But power differences between rich developers and the urban poor, lack of expertise in how to implement inclusionary planning, and even insufficient awareness of relevant instruments, have hindered enforcement.

Rising inequality globally

A rise in inequality globally has been pointed out over the last five years by several organisations. Oxfam International has just published a report on inequality that highlights a significant difference in wages.

Between 1980 and 2016, the top 1% of the world population captured 27% of the total world income growth. The bottom 50% received only 12% of the income growth, according to the World Inequality Report 2018.

Indonesia is not immune to these global trends; both income and wealth inequality are rising in the country. The Gini index for Indonesia (a coefficient between 0-1 used to measure income inequality – the closer to 1, the more unequal) increased from 0.31 in 1990 (UNDP, 1990) to 0.41 in 2015.

What’s more, according to Oxfam, wealth inequality has increased to a level where the four richest men in the country have more wealth than the poorest 100 million people.

Inequality is one of our main concerns if we want to have harmonious and just societies. The mainstream international development agenda recognises this and the 2015 Sustainable Development Goals include a goal (SDG10) to “reduce inequality within and among countries”.

Inequality in cities

Income inequality manifests itself in cities. We can see clear differences between different social groups in terms of access to housing and basic services.

Houses for upper-middle-class families in Indonesia are spacious, built with good-quality materials and located in neighbourhoods with good services and infrastructure. In the case of gated communities, there are also security devices in place.

Conversely, poor housing lacks appropriate structural conditions. There is overcrowding, often with one family living in a single room. And there is no sanitation and access to basic services.

Gated communities are, especially in the Global South, the main housing option for upper-income groups. The rich justify living in gated communities to reduce insecurity and fear of crime. However, belonging and exclusion of the “unwanted” people are strong reasons behind living in closed enclaves.

Even when poor and rich groups might co-exist in the same territory they do not interact with each other, except for some formal work exchange between employer and employee, where there are strong power relations at play.

Residents’ access to services and infrastructure is also divided along lines of wealth. This creates patterns of “splintering urbanism”, reflecting the unequal distribution of services and infrastructure in the territory.

Indonesia’s planning instruments

Inclusionary planning regulations can serve to reduce the gap between rich and poor, including disparities in the services and infrastructure available to them. These instruments require private developers to incorporate social housing or/and services and infrastructure for less advantaged groups when building housing for upper-income groups.

Indonesia has two potentially inclusionary planning instruments for new private residential developments. The first is the “1.2.3 Ratio” scheme and is included in national regulation. It says that for each house built for high-income residents, private developers should also build two houses for middle-income families and three for low-income families.

The second instrument is called “socialisation”, included as a stage of the Environmental Impact Assessment. The assessment is required when seeking planning permission for a new housing project. The “socialisation stage” requires developers that plan to build a project in an already urbanised area to obtain permission from existing residents for the project to go ahead.

Both instruments represent attempts by the government to reduce inequalities in the cities and to enforce some sort of “planning gain”. These could be seen as a positive step towards redistribution, with incredible potential to create positive change in Indonesian cities.

However, our research data from Jakarta and Yogyakarta show that “Ratio 1.2.3” is hardly being enforced. Land is scarce in many Indonesian cities and it is not profitable for the private sector to build houses for middle- and lower-income families. Additionally, many government officers responsible for the “Ratio 1.2.3” application are unclear on the enforcement mechanism.

In the case of “socialisation”, it has become a very limited process. It has turned into economic negotiations between powerful private developers and less powerful local residents who live close to the proposed project. The latter are usually represented by the neighbourhood association leaders.

In the best situations, the local communities manage to obtain a few new sources of employment, as security guards, cleaners, gardeners or builders.

They may also receive some funding for annual community events, such as the Independence Day celebration. The local roads and mosque might get spruced up.

But these benefits are not enough to reduce the gap between the two groups, nor will they encourage any sort of social interactions between new and old residents.

The lack of enforcement of “Ratio 1.2.3” and the limited scope of the “socialisation” process are missed opportunities for Indonesian cities. These instruments have the potential to decrease urban income inequality by “forcing” those who have more money to contribute to the public good for the benefit of poorer families.

How to get more out of inclusionary planning

To improve the benefits from these inclusionary planning instruments, the government should:

  • develop clearer and realistic guidelines and instruments that can be applied
  • establish clearer mechanisms for public officers to enforce these instruments
  • make society more aware of these instruments and, in particular, of the potential benefits of more harmonious and just cities

Rising inequality globally

How to combat the inequality gap is often a heated topic for governments. International organisations say that while world leaders now acknowledge inequality, not enough is being done to efficiently reduce it.

Other measures to reduce inequality include more progressive tax systems, as suggested in the latest World Inequality Report. Under this system, people who earn more also contribute more towards public services and higher public. This covers spending to provide education, health care and social protection for all. Policies for equal salaries between female and male workers are also promoted as key to reducing inequality.

 

Sonia Roitman is Senior lecturer in Development Planning, at the University of Queensland.

 

By            :               Sonia Roitman

Date         :               February 13, 2018

Source     :               The Wire

How Indonesia Can Use Urban Planning to Tackle Inequality

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The hidden health inequalities that American Indians and Alaskan Natives face

 

I was an American Indian student pursuing a doctoral degree in clinical psychology in the 1990s, when I realized the stark contrast between my life experiences growing up on my home reservation and those of my non-Native peers.

Many incredible family members and friends had sacrificed and broken a trail for me to realize my academic dreams. My rich and generous native culture and traditional ways helped sustain my family over the years.

However, as each year of school unfolded, I lost family members due to early causes of death, including homicide, suicide, motor vehicle accidents, cancer and pneumonia. I had to drive over four hours to the nearest Indian Health Service provider for prenatal visits for my children and nearly lost one child due to lack of access to proper medical care.

Unfortunately, my story isn’t uncommon for most Native Americans. As a collective, American Indians and Alaska Natives live more challenging and shorter lives. These are statistics I’m acutely aware of as researcher in clinical psychology. Understanding the sources of and solutions to these inequalities is the focus of my career.

The Indian Health Service is in the position to change these trends for the better. Outside of Native communities, few Americans know what this agency does, that its leadership is under fire and that the current nominee to head this IHS is a controversial figure. There is much work to be done to reverse American Indian health problems.

Health inequality

The IHS is the primary health care provider for most American Indians. It is responsible for providing health care under historical treaty agreements between the federal government and tribes.

In many ways, American Indian health has improved under the IHS over the past 20 years. For example, infant mortality decreased 67 percent between 1974 and 2009.

But there are steep divisions between the health of American Indians and other Americans. American Indians continue to have lower life expectancies than other Americans and lose more years of productive life. They also have the nation’s highest rates of death due to suicide. High rates of premature death due to diabetes, cardiovascular disease, cancer and accidents plague Native Americans.

These disparities are shaped by social inequality, historical trauma and discrimination. Most American Indians live in chronic poverty, with limited access to health care, adequate housing, quality education and adequate law enforcement services.

Early exposure to traumatic events and losses, including sexual and domestic violence, are common for many American Indians. This childhood trauma can translate to a lower quality of life and a wide variety of poor health outcomes.

My home state of Montana includes seven reservations and multiple urban centers of American Indians, with tribal representation from many of the 657 federally recognized tribes. American Indians live on average 20 years less than whites in the state. Montana currently has the highest rate of suicide in the nation.

The IHS has historically been inadequately funded. Federal funding only provides for 54 percent of needed services. Recent estimates show increased patient use despite proposed funding cuts. What’s more, the majority of American Indians live in urban settings with very limited access to IHS facilities.

As a result, many American Indian patients receive health care that may be inadequate or of minimal quality. Others must wait a long time for urgently needed care. These experiences have collectively led to a distrust of institutions, including health care centers. Many will avoid or delay necessary screenings and care. It should be a priority to find better ways to create outreach and directly provide services.

Hope for health

These experiences have motivated many Native people to work toward health equity.

Native-led organizations like The National Council of Urban Indian Health, the National Indian Health Board and the National Congress of American Indians have worked to improve health for all Native people. The National Indian Health Board has a number of public health initiatives working to inform tribes on best practices in obesity, violence, suicide and substance abuse prevention. The National Congress of American Indians advocates policies to improve health by engaging elected tribal leadership.

To improve access to health care, some also call for change in the way tribal health is funded and provided. Many tribal communities have even taken over the health care provision structure.

Many tribes have worked to bring back traditional healing methods, education, languages and traditional foods. This revitalization is showing promise to improve health the entire family and community. For example, The Piegan Institute on the Blackfeet reservation created language and culture immersion schools to help restore these practices.

These efforts are important, due in part to the significant lack of Native American health care workers. Many Native patients respond better to Native providers. Some educational programs are working to increase Native health professionals, researchers and educators.

Personally, I have sought a career in public health to help communities explore potential solutions to the many challenges we collectively face as Native people. I sit in my office today, looking upon the photos of family members lost too soon, and reflect upon the hope of healthier futures for my daughters, my niece and all Native youth.

My late father wrote a poem some years ago, borrowing from the Minnie Louise Haskins’s poem “God Knows.” A portion of that prose resonates today:

I said to the old man who stood at the Door of the Lodge, “Give me a light that I may tread safely into the unknown.” He replied, “Go into the darkness and put your hand into the hand of the Creator. That shall be to you better than light and safer than any known way.”

It is my hope that leaders in health harness the many gifts we have as Native peoples to build a healthier future. Our children are worth fighting for.

 

By            :               Annie Belcourt

Associate Professor of Health Professions and Biomedical Sciences, The University of Montana

Date         :               January 25, 2018

Source     :               The Conversation

https://theconversation.com/the-hidden-health-inequalities-that-american-indians-and-alaskan-natives-face-89905

 

Posted in Health, Latest Post, Social and Economic Inequalities | Leave a comment
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