The poor state of U.S. healthcare

Times Television Critic

A four-week, seven-part series that begins Sunday night on KCET, “Unnatural Causes” asks the sub-titular question, “Is Inequality Making Us Sick?” It comes at the issue from several angles, but the answer, again and again, is “yes.” (It would be a strange waste of time if the answer were “no,” although it would be better news.)

That the rich and otherwise socially advantaged enjoy better health than the poor and disadvantaged is almost tautologically obvious, and much of the data here is not new, nor is it presented as such. But there are refinements: We learn, for example, that these advantages increase by degrees, so that (in the general way that statistics represent) the CEO is physically better off than the middle-manager, who is better off than her assistant, who is better off than the person who comes in to mop the floors after they’ve all gone home.

(To illustrate this “ladder” effect, one commentator holds up . . . a little ladder he has made from what appears to be tongue depressors and modeling clay.)

The old image of the Type A executive dropping dead from stress as his heart or head explodes in the boardroom is also shown to be false: Medically speaking, there is less stress at the top than at the bottom.


This is because the executive has more “control of destiny” -- power and choice and the means to change his life -- while powerlessness itself creates chronic stress, subjecting the body to a kind of hormonal acid bath of adrenaline and cortisol that wears it out before its time.

Although every episode of “Unnatural Causes” has its own subject -- the way racism bears upon pregnancy, the health benefits of urban planning, the ill effects of government policies on Native Americans and Marshall Islanders, the physical toll taken by factory closings -- they all support the same point, that a feeling of powerlessness takes years off a life, and that the feeling is spreading as the middle-class disappears.

As a whole, the series is a quietly withering attack on American values -- the cult of the individual that fractures any sense of community, the fetishistic worship of the so-called free market that increases the distance between the poor and the tax-averse rich.

According to this series, co-produced by the San Francisco-based California Newsreel and Boston’s Vital Pictures, it’s not just the lack of general access to medical care that has increased the rate of “excess death” among the poor and marginalized: American culture is in itself toxic. Even the rule-proving-exception “Latino Paradox” -- recent immigrants from Latin America not only test healthier than groups of similar income but also surpass affluent whites -- fades with time and exposure to the local diet and way of life.

While the series doesn’t exactly call for revolution -- a not unreasonable response to the facts as it presents them -- it does make clear that only political will can provide a remedy, and does suggest that the answer is to take from the rich to help the poor, and to lessen the overall cost to society.

“Economic policy is health policy” says Harvard sociologist David Williams. “Everyone benefits if no one is left behind,” says the series narrator.

Four hours seems longer than was needed to make this point -- some identical information recurs from episode to episode -- and spreading it across a month is possibly not a favor to its audience. (I would expect some dropping off over its course.)

Then again, there are things you can’t repeat too often.



‘Unnatural Causes: Is Inequality Making Us Sick?’

Where: KCET

When: 4 p.m. Sunday

Rating: TV-PG (may be unsuitable for young children)