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Can wealth affect health?

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By Kim Painter of USA Today | Thursday, March 27, 2008 10:02 AM CDT | () comments

A few years ago, psychologist Sheldon Cohen conducted an experiment. First, he asked adults a key question about their childhoods. Then, he squirted cold viruses up their noses and watched his subjects for several days to see which of them got sick.

As it turned out, the answer the adults gave to that question was ``a great predictor'' of whether they would develop the sniffles, says Cohen, a professor at Carnegie Mellon University.

The question: Did your parents own their home when you were a kid? Actually, Cohen asked that question once for every year from birth to age 18 and found that ``the more years your parents owned their own home, the less likely you were to develop a cold,'' Cohen says.

Though Cohen's findings might seem surprising, they are consistent with a mountain of studies, compiled over several decades, that show socioeconomic status can have a profound influence on health. That research will get a rare four hours of TV time in the next month as PBS stations air a new documentary, ``Unnatural Causes: Is Inequality Making Us Sick?

'' The documentary, which features Cohen and many other scientists and public health experts, concludes that, contrary to popular belief, your health is not just the sum of your genes, your health habits and the quality of your health insurance plan. Your income, education and race matter; so does your address, your job title and, as Cohen demonstrated, the status your parents had when you were small.

``We have very dramatic differences between the haves and the have-nots,'' says Adewale Troutman, director of public health in Louisville. Troutman and four other residents of his city star in the first hour of the program, airing Thursday. The residents, chosen to illustrate the ``health-wealth gradient,'' are:

Jim Taylor, the white CEO of a Louisville hospital. He's shown jogging through a lush enclave of stately brick homes. Average life expectancy in his neighborhood: 79 years, or two years beyond the national average.

Tondra Young, a college-educated African-American lab supervisor in the same hospital. She's shown tending the yard of the home she owns in a pleasant, middle-class neighborhood. Average life expectancy there: 75 years.

Corey Anderson, an African-American janitor in the hospital. He has high blood pressure. He lives in rental housing and mentions that he worries about the safety of his neighborhood. Average life expectancy there: 73 years.

Mary Turner, an unemployed white mother of three who, at age 49, has had a heart attack and has arthritis and other health problems. She lives in the poorest part of town, where the life expectancy is just under 70 years.

The point of the series and the research it draws on is not that we are powerless to improve our health: Whether you are rich or poor, it's a bad idea to smoke and a good idea to eat fruits and vegetables. It's also good to have health insurance.

But all those things are harder to sustain and may do you less good if you live in a dangerous, unwalkable neighborhood with lots of fast food and no supermarkets; if you have little control in your work life; if you are constantly worried about money, housing and safety; and if, on top of it all, you live with the lifelong stress of racial discrimination.

``Personal behavior and personal choices are important,'' Troutman says. ``But we also need to recognize that educational policy is health policy, economic policy is health policy, housing policy is health policy.''

And, at a time of widespread economic pain, when the ``poor are getting poorer and the middle class is being squeezed,'' in the words of one sociologist quoted in the film, there's plenty of reason to worry about the literal health of the nation.