To Be Healthy Is To Be Privileged

Creative Commons photo.

Health is something we take for granted until the precise moment happens when we must consider it.

I’ve written previously about how fortunate I feel my twin and I are that after being born premature, and surviving the fact of prematurity, we grew up healthy, without any long-term health complications, such as cerebral palsy, asthma, hearing loss, problems with our intestines, eye disease, and so on.

Thing is, a lot of people have what is considered “generally incurable and ongoing” chronic disease in the United States: 133 million Americans, and a large number of those Americans have more than one chronic disease. Some of the chronic diseases recognized by the Centers for Disease Control and Prevention include arthritis, cancer, chronic obstructive pulmonary disease, coronary heart disease, current asthma, diabetes, hepatitis, hypertension, stroke, and weak or failing kidneys.

There is bound to be some overlap here, but also according to the CDC, about 61 million Americans live with a disability. Disabilities include a few different categories. Mobility, or seriously difficult walking or climbing stairs, accounts for the most at 13.7 percent, with cognition, or serious difficulty concentrating, remember, or making decisions accounting for 10.8 percent. The rest are independent living, or difficult doing errands alone (6.8 percent); hearing, or deafness or serious difficulty hearing (5.9 percent); vision, or blindness or serious difficulty seeing (4.6 percent); and self-care, or difficulty dressing or bathing (3.7 percent).

Intellectual disability is the most common development disability, affecting about 6.5 million Americans. Weirdly, today I learned, we don’t actually know how many Americans have Down syndrome because the number typically cited (400,000) is based on faulty assumptions, according to the Global Down Syndrome Foundation.

Then there are the one in every 33 babies born in the United States, or three percent of all babies, who are born with birth defects (the leading cause of infant deaths, accounting for 20 percent of infant deaths), such as those affecting the brain/spine (like spina bifida), eyes, heart, mouth/face, stomach/intestine, muscle/bone, and chromosomes (genes).

Lest we forget that mental health is physical health, nearly 53 million Americans have some sort of mental illness as well, which is separated into two categories by the National Institute of Mental Health: any mental illness, and serious mental illness (just what it sounds like: serious functional impairment). The most common mental illnesses Americans are experiencing are anxiety disorders at 48 million people, and major depressive episode at 21 million people. In addition, there are those afflicted by schizophrenia (1.5 million), bipolar disorder (7 million), posttraumatic stress disorder (9 million), obsessive compulsive disorder (3 million), and borderline personality disorder (3.5 million).

Other things that come to mind include limb loss (2 million Americans), cancer (1.6 million, and I just realized I already mentioned cancer, but now, with the statistic), and something we don’t think about as often, but about 115,000 Americans suffer a non-fatal firearm injury each year in the United States.

Finally, we could down the road of how many Americans eventually die due to these chronic issues (about 4,761 Americans die each year waiting for a kidney), have shorter life expectancy (a person with Down syndrome on average only lives to be about 47 years old, which is actually, thankfully, up dramatically since 1960, when the average life expectancy age was 10-years-old), and die by suicide (nearly 46,000 in 2020).

We could also keep going down a rabbit hole here, with how privilege in other terms affects health outcomes.

Or heck, I’d be remiss if I didn’t mention the ultimate privilege: historical privilege. Most of us didn’t live long lives prior to relatively modern times. About 25 percent of infants died in their first year of life, and half died before puberty. Or developed country privilege, i.e., the privilege of being born in the United States, when you consider that 627,000 people died of malaria in 2020, a disease that doesn’t even affect the United States at anything remotely resembling a concerning number anymore.

I cover all of these statistics (and I’m sure I’m forgetting and/or missing some category here, so my apologies) to say: To be a healthy person, without chronic pain or disease, or a person with a disability, is not as common as one might think. It is quite the privilege.

And here is how I would define privilege, in part, going back to my first sentence: When you don’t have to think about your health. Your baseline is healthy. You only have to think about your health when something goes wrong.

On the whole, I consider myself quite privileged in that regard. I don’t want to minimize myself and stigmatize mental illness, because I am afflicted with clinical depression, and did suffer quite severely with suicidal ideation stemming from the depression, but thankfully, with antidepressants and therapy, I’m better now. Still, I do wake up every morning and take an antidepressant, which is something I have to think about.

But on the whole, I consider myself privileged that I wasn’t born with a birth defect, or a missing limb, or some other affliction or chronic disease where I would have to think about my physical health on a more constant basis, and my access to care (or lack thereof, as it were).

Think about just self-care: As mentioned before, nearly 10 million adult Americans are unable to take care of themselves (that difficulty dressing/bathing piece). I can dress myself (maybe not fashionably well, but ya know), and bathe myself. That’s quite the privilege!

And the reason I was even thinking about health privilege is because of my new career working for an organ procurement organization, and how many people are afflicted with some sort of ailment where they require a new kidney, heart, lung, liver, pancreas, corneas, skin grafts, and so on. That they only have a certain quality of life (and unfortunately, it’s not a good one), thanks to a machine keeping them going, in the case of dialysis.

It is humbling. It is a gift to be healthy. It’s a gift difficult to not take for granted. As I write this, I’m breathing on my own without any pain. Just by existing day-to-day, I’m bound to take my health for granted because I don’t have to think about it. Which is why I like to take occasions like this to consider it. And I hope you will, too.

No, that’s not to make you feel guilty for being health privileged. That’s missing the point. The point is to recognize it, be grateful for it, and where possible, work to dismantle barriers to health access and healthy outcomes for those who aren’t so privileged.

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