In the next installment of my as-yet-unfortunately named Why Am I (x)? Trilogy, I am going to address another of the biggest areas of socially defined health; lung disease. I am also going to introduce those of you who are unlucky enough to have never had much exposure to the public health sphere to a key idea. It’s called the social determinants of health. For those of you who are public health nerds or, more likely, who can’t be bothered to read several hundred words on a subject with so many syllables, skip ahead to the subtitle ‘smoking’ and save yourself what I can only assume is minutes of agony.

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Seriously. Minutes.

Social Determinants of Health

The basic idea of social determinants of health is something that I alluded to quite a bit in my last, seriously incredible, blog post. Essentially what it says is that whilst an individual can have a great amount of control over their lives, the biggest impact on any group of people’s health is environmental. In this context, environmental means everything to do with your lived environment. For example, a great way to get fit is to cycle. Not only is cycling a great way to get fit, it is increasingly being promoted as one of the best ways in which to increase the overall fitness (and therefore health) of the population. In a very real sense, having the ability to cycle can change your health for the better. Now, take a look at the cycling map of Sydney;

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Green is cycleway, grey is road, baby blue is oncoming Horde of the Unliving
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The rest of us will have to make do with the lesser known sport of chocolate smearing

Smoking

Smoking fits neatly into our social determinants of health. Things that make you more likely to smoke are very closely tied to social status. Education and income are two of the biggest determinants of whether you will end up coughing your life away at the age of 35 or having the lungs of a 35-year-old when you are on your deathbed at the age of 95. In some countries, being a woman makes you more likely to smoke, although in most it’s men who are the biggest smokers. Where you live effects your smoking chances, with wealthy inner-city suburbs as much as 4x less likely to smoke than less well-off regional areas.

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Smoking; crutch of the Poor and the Eyebrowed

Asbestos

Asbestos is one of those scary hangovers from the 70s, much like Mick Jagger’s increasingly creviced face. Everyone has heard of mesothelioma, which is surprising for a cancer with so many syllables. If they haven’t, they’ve definitely heard of asbestosis. And these are scary diseases. The survival time for both is often measured in months, not years, unlike Jagger’s face which is likely to outlive us all by centuries.

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Deep within those wrinkles lies the elixir of life

Other Social Causes

There are a myriad of other social determinants of poor lung health. Living near a motorway is more likely for low SES families, and has a serious impact on your long-term lung health. The school you go to as a child can be the difference between good lungs and bad later in life. It’s all too clear that where you are born, who your parents are and what you do can have a far greater impact on your health than any changes you make in your life by choice.

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