Unnatural Causes: In Sickness and in Wealth entwines the narratives of several individuals who work in a hospital in the Louisville area. Each individual hails from a different district that is characterized by their unique socioeconomic status and consequently, though their lives do converge at a single facet in their life, each individual tells a different story of what it is like to survive on a day-to-day basis given that they live in a certain income bracket in a certain neighbourhood associated with others like them. Those in the east end of Louisville were amongst the most affluent. Taylor comes from a racially privileged background and is making six figures as the CEO of the hospital; he is part of the elite 1% of Americans whose collective wealth exceeds the cumulative sum of the other 99%. He faces some daily stressors as a result of the high position he holds at his workplace, but it is often manageable as he does not experience stressors related to food scarcity, poor healthcare, job instability, or financial burdens. He, unlike his subordinates, is given a high level of autonomy in the work place and in his life as a result of his power and this autonomy affords him a more or less stress-free lifestyle whereas those who do not have as much control struggle with more stress. The straining of one’s stress response has been linked to accelerated, aging, chronic stress, high blood pressure, brain shrinkage, and increased risk of heart disease. As we move eastward, we begin seeing more prevalence of a lower quality of life with respects to health, education, jobs, and opportunities. We also see a rise in the phenomenon of excess death. While researchers can map the rate at which individuals in a given area will die, it is when residents of those areas begin dying faster and in greater numbers than the projected data that one observes what is considered excess death. In wealthy areas, this is rarely an issue. However, in lower income areas, excess death is not an uncommon occurrence. This is because those in lower income areas face significant and unequal struggles not shared by their wealthier counterparts that ultimately contribute to the decline of health. For example, those living in low SES neighbourhoods see lower rates of graduation or lower rates of attending college due to the costs and the lack of education tends to correspond to a higher incidence of unemployment, which can lead to one shopping for lower quality and less health food simply because it is the only thing within their budget. In fact, when asked to rate their health, 70% of those in wealthier districts rated their health to be very good and only 11% of this population has been affected by heart diseases. Whereas the former percentage declines and the latter percentage increases the less wealthy the population that is surveyed is. This proves the notion that social class is the most important determinant of health.
It was particularly striking to see four individuals who ranked from CEO, to manager, to custodian, to unemployed within the context of the same setting but having their struggles be so apparently different. What is even more striking is that these are real life narratives that tell of the socioeconomic loop that has been emphasized in our readings. Those who are born into a life of privilege often stay there and those who are born into the lower-class struggle to find the opportunities necessary in order to escape the cycle of poverty.