We need to talk about how social and economic structures impact health.

lake in the woods

Within the fat acceptance and HAES movements, there has been a growing realization that health is much more complicated than personal diet and exercise choices–that we can’t talk seriously about health without talking about the social and economic barriers that affect it on both the personal and public levels. I’m really glad that we’re talking about these structural forces, and I’d love to see more in-depth discussions, both within and outside of our communities.

I’ve been thinking about this a lot lately, especially after a wonderful hike I went on last weekend. I just feel so in my element when I’m in the woods, and I get a great workout without consciously trying. There’s something so peaceful, so natural about being surrounded by trees, coming across everything from tiny frogs to wildflowers and heart-shaped leaves. There’s magic in the woods, the kind that doesn’t go away when you grow up.

Coming home from a simultaneously exhilarating and relaxing hike, I couldn’t help but think, contrary to conventional wisdom, how little of my health is actually within my control. Yes, healthy habits are still our best shot at improving and maintaining health. Yes, there are certainly things I can do differently, and I’m working on them. But there are so many structural limits that impact my health, and I imagine how they could be different:

– If working about 20 hours/week were standard, I could work mornings and then hike most afternoons. Or, during the winter, snowshoe or cross-country ski. I live in the city and don’t have a car (and don’t want one)–but if there were high-speed, frequent, reliable trains from the city to the woods, I could easily get out into nature on a regular basis, or even live out there and commute into the city. This would make it a lot easier to engage in the types of exercise that feel easy and natural for me, and I have a feeling I’d feel better all-around if I were getting a higher dose of Vitamin Nature.

– With a 21-hr workweek, it would be a lot easier for me to own a dog, and everyone knows about the major health benefits that pets can have. I grew up with dogs and I love them: their happy wagging tails, their adorable floppy ears, their unconditional love. I have such a deep need for puppy-snuggles in my life, but I can’t think of a way to make that work when both my partner and I work full-time, which puts us away from home for about ten hours each day. I’ve had a few temp jobs that were within walking distance of my apartment and had an hour-long lunch break, which would make it doable to feed and walk a dog during lunch–but the odds of finding a permanent job with that location and schedule aren’t great. I know that freelancing or working from home are great options for some people, but I need more structure than that would provide.

girl lying on one yellow lab with feet on second yellow lab

Not only are dogs good for your health, but they also make wonderful pillows and footrests. (With Dusty and Abby, circa 1996)

– The normalization of a shorter workweek would also reduce the amount of time that I spend sitting–which has been found to have health risks independent from the amount of exercise that one gets. I know I don’t feel great when I sit for eight hours, but at most of the jobs I’ve had, I don’t have much choice. Creating more physical jobs, such as through a green new deal, would also help.

-A basic income, job guarantee, or otherwise an economy where it was easy to get a stable, living-wage job with benefits, would seriously reduce my stress levels. I’d probably also get more and better sleep if I wasn’t constantly adjusting to the different schedules of various temp jobs and intermittent periods of unemployment. The stress of economic uncertainty also affects my eating and exercise habits. When I’m stressed out and exhausted, I have less energy to cook, less energy to get out and exercise, and more cravings for foods that aren’t good for me.

-Even if I had all the time and energy in the world, I probably still wouldn’t want to cook all the time. I enjoy cooking, but sometimes I’m just not in the mood to do it. If there were more options for cheap, nutritious food–such as community kitchens as Lori talked about here–that would make it a lot easier to eat healthfully without having to cook constantly or eat the same leftovers all week long.

small white and red flower in the woods

These things are just the tip of the iceberg. I’ve thought of these factors and potential solutions because they’re ones that impact me directly, but there are so many others: racism, sexism (especially against mothers, especially poor single mothers of color), homophobia and transphobia (especially against poor trans women of color), ableism, the prison-industrial complex, the ways that domestic violence and environmental racism can cause chronic illness…

And then there are the many ways that fat stigma creates barriers to access, such as harassment of fat people while exercising in public, and body-shaming within gyms and other fitness environments, which can make it really hard for fat people to find safe spaces to work out. I’m lucky that I haven’t dealt with this personally, but it’s an issue for so many fat people. Breaking down this stigma will do a lot more for their health then simply telling them to get more exercise.

I want to have these conversations. I want a broader health discourse that isn’t just about eating and exercising in certain ways, but about social and policy changes that can make health more accessible for everyone (keeping in mind, of course, that health is neither an obligation nor a barometer of worthiness).

How have the social and economic structures that you live within affected your health? How would you change them, if you could? What do you imagine?

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7 thoughts on “We need to talk about how social and economic structures impact health.

  1. Pingback: Sunday links, 5/25/14 | Tutus And Tiny Hats

  2. I love this! Sharing, shouting and prompting people to read you. You’re work is really good and your doggies are adorable ❤ Looks like our activism has a lot in common – let's join super powers! 😉

  3. Pingback: One last year in review post: my 10 favorite write-y posts of 2014 | Tutus And Tiny Hats

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