He might not have known it, but Pete Seeger, who died last week at 94, was one of the great health advocates of our time.
Those of you familiar with the folk music legend may also be surprised to hear this. We think of his songs about the unions and workers’ rights, about racial justice, peace, and the environment. A folk music aficionado myself, I cannot think of a single song of his explicitly about human health.
Yet the rights of workers, racial justice, the environment, peace – these are all among the critical determinants of health that studies have shown accounts for our health even more than health care itself. Let’s look at these briefly in turn.
In the United States alone, well over 4,000 workers die on the job each year. By one estimate, that is also the number of workers will die constructing facilities for the World Cup 2022 in Qatar. It is as though the hammer of injustice is pounding upon the workers who hammer the nails. Where is the “hammer of justice” (Pete sings)? More than 2 million workers die every year – 2.3 million in 2012 – from occupational accidents or work-related diseases. To put that in perspective, that is approaching the total number of Americans who die annually — from all causes.
If we want good health, we need workers’ rights, from the most basic respect of health and safety standards in the law to strong unions able to be powerful advocates for the health and well-being of workers. “Strong unions” – can’t you hear Pete Seeger singing?
Moving from workers’ rights to civil rights, racial and ethnic health disparities continue to plague our country, despite progress. Infant mortality rates among blacks are double those among non-Hispanic whites and higher, too, among Americans Indians and Alaskan native communities. The life expectancy for whites is four years longer than for blacks. The disparities grow still worse for maternal mortality, which is more than three times higher among blacks as whites, Latinos, and Asian-Americans, and also elevating among American Indians.
In a measure of the health devastation of poverty and income inequities and its causes, bring socioeconomic status into the pictures, layering inequality upon inequality, and the differences grow even starker. Life expectancy varies by twenty years across the wealthiest and poorest neighborhoods of Baltimore. A study (p. 424) several years ago reported a stunning 32 year different in life expectancy between a white corporate lawyer and an unemployed black youth in Baltimore. This is similar to the difference in life expectancy of American Indians on the Pine Ridge Indian Reservation in South Dakota and the overall life expectancy in the United States (79).
These most extreme injustices within the United States are echoed in the vast health inequities globally – such as in life expectancy, 24 years lower in sub-Saharan Africa than wealthy countries, and with a 20 year difference between low- and high-income countries. The contributors to these disparities are legion. To take one, maternal mortality, the lifetime risk of death to a mother in childbirth is nearly 100 times higher in sub-Saharan Africa than high-income countries, and more than 20 times higher in developing countries as a whole.
Even as global action to respond to this massive level of avoidable death grows, it is hard not to see the overlay of race between these deaths — elsewhere — and the enormity of the meagerness of the response compared to the suffering — nor to recognize the role of the race-seeped history of colonialism and beyond woven into today’s continued disparities.
For more on the such global health inequities an effort to combat it, see information on the proposed Framework Convention on Global Health, to be based in the right to health, aimed at closing domestic and global health inequities, and enhancing accountability.
Health equity means that we must – we shall – overcome our country’s and the world’s racial and ethnic health disparities. See Pete and other civil rights advocates singing.
Onto a clean environment and environmental justice, another of Pete Seeger’s great passions. Several years ago, WHO estimated (p. 24) that 9% of all the deaths in the world have environmental causes. And environmental pollution contributes to 19% of all cases of cancers globally.
Indoor air pollution, chiefly from indoor cooking with solid fuels such as wood, cause 2 million deaths a year. Recent estimates reveal that outdoor air pollution, primarily from small particulates but also from ozone, brings with it over 2.5 million deaths. Water pollution – from human waste and a plethora of other biological and chemical pollutants – leads to a deluge of deadly and disabling diseases as people drink, bathe, and otherwise come into contact with these water – diarrheal diseases, hookworm, typhoid, arsenic poisoning, and more. Diarrheals diseases alone caused 1.4 million deaths in 2010, so many of them among young children. And this is on top of the risks from lack of fresh water for drinking and for growing food – and risk of conflict – that rises as water stables fall.
And from lead-acid battery recycling and lead smelting to mining and industrial dumping sites, toxic pollution from hazardous waste sites represents an underappreciated growing hazard to disadvantaged communities around the globe. Altogether, 125 million people are at great risk, with the damage to their health immense.
And of course, there is climate change, threatening our health, the health and very existence of countless species, our planet. Considered here from that narrow yet vital lens of human life, its toll is now, and it grows. A humanitarian NGO, DARA, calculates that climate change is already responsible for 400,000 deaths a year, on its way to nearly 700,000 by 2030. Hunger, extreme weather such as droughts and floods, superstorms and super heat, climates newly receptive to disease vector such as mosquitoes, water-borne and food-borne illnesses – all our in our future – and increasingly in our present. (Hear Pete talking about climate change.)
As our population climbs towards the 10 billion mark, the risks to our environment under ever greater stress, and ourselves, climbs too.
This land is your land, this land is my land (Pete sings). When will we treat this land – and all its and the planet’s seas, and the air that blankets it all, as though it were so? Our health depends upon it.
And peace, that speaks for itself. Today, from South Sudan and the Central African Republic to the streets of Chicago and Honduras, guns and other weaponry continue to take upon us their wicked toll. And let us not forget that even as the world — and our country — spends massive sums on guns and missiles, bullets and bombs, “[t]he world needs teachers, books and schools” (Pete again) – and nurses and doctors, medicines and health centers, research and public health campaigns.
If we want good health, we need peace. Today. When will learn, oh when will we ever learn (guns and flowers, war and peace, and Pete and his anthem of peace)?
As others who not only inscribe words on paper but who manage to inscribe them indelibly on our hearts, Pete Seeger will continue to influence generations yet to come in struggles old and new for peace, human harmony with each other and with our planet, justice — and health.
Signup for our mailing list and stay up to date on the latest happenings at The O’Neill Institute
Or sign up for our RSS Feed
The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.