Features Public Health

Not by chance

By Kathryn Stroppel

What influences your health? Why do health disparities exist among people in the same community? What does a place have to do with health? What can we do to ensure health and well-being for all? 

CPHHS Assistant Professor Kari-Lyn Sakuma tackled these questions and more in “A public health crisis: Factors that impact your health outcomes,” which you can watch on the college’s YouTube channel as a part of the Public Health Insider series.

Our health is influenced by our past, she says, and also the “dirt” or environment in which we live and grow. “Consider where your children were born,” she prompted. “Do you have family support? Have you been pushed from housing? Why do you live where you live right now? What opportunities have led you here?”  

The answers are not random choices, she says. Instead, they are informed and influenced by the systems around us. These systems are the dirt, which includes economic, social, policies and political systems, which were passed down through history and shaped by white European ideals, she says. 

“Inequities are encoded in our policies and systems from the start and continue to impact us, whether we agree or not or even recognize their existence,” she explains. “White supremacy, racism and colonization are hard words but are connected and affect our health. Our past influences health today even more than individual choices.” 

Places and communities are built by purpose, not chance, and if we look at the causes behind the official causes of death, we’ll start unlocking answers to health – after first asking many questions. 

For instance, why are life expectancy rates different in Albany and Philomath than Corvallis? When we look at the leading causes of those deaths, are there any we can prevent? How? For whom? 

For public health practitioners, this is called going “upstream” to identify the factors that contribute to health. The factors themselves are called the “social determinants of health.” 

Some of these social determinants include access to health care, a public health system, affordable and nutritious food, jobs, education, affordable housing, safe and free transportation, public spaces and clean air. And they are compounded by money, power and distribution of resources. 

So, what can we do to affect these determinants of health and improve the health of our community? 

“Learn, listen and practice,” she says. “While we in public health work to identify and change the systems, individuals can also contribute to improving health for all. Find free resources, examine your own impulses, think before you speak, be an informed citizen, vote and help others vote, consider joining local groups and initiatives promoting causes you care about, think about how actions affect most marginalized groups and those without power – and don’t give up.” 

Like exercise, optimal health requires consistent application and commitment, she says. 

“There is no certificate or finish line. This is a long-term commitment to better health and justice for all.”