Health beyond the headlines
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America the Healthy

How greater tolerance improves health

By Patches Magarro

Published February 6, 2014

During the 2014 Olympic Games in Sochi, Coca Cola’s controversial Super Bowl ad “It’s Beautiful” will continue to run. As Team USA competes for our country, their diversity will be reflected in their sponsor’s visually stunning commercial.

Its cinematic sweeps of American landscapes, poignant images of faces in a wide spectrum of skin tones, cultural, religious, and LGBT diversity is accompanied by sweet voices carrying the high notes of “America the Beautiful” with angelic clarity, in eight different languages. The ad is apropos of our Olympic athletes. Among them, “Eddy the Jet” Alvarez is a first-generation Cuban, J.R. Celski is of Polish and Filipino descent, and one of Coca-Cola’s athlete-ambassadors, Michelle Kwan, spoke Cantonese and English at home as a child.

The U.S. Department of State issued a video that was similar in tone. It features openly gay hockey player Chris Brand and a fencer who wears a hijab. A statement by the agency explains, “‘We Are All Athletes’ showcases U.S. Olympians, Paralympians, and recreational athletes of various backgrounds, including gender, race and ethnicity, religion, sexual orientation, and abilities.” The video is available in five languages, including Russian. There was no social media uproar over this video, which is probably because it didn’t air during the Super Bowl.

As soon as Coca-Cola’s spot debuted during the big game, the social media comments started rolling:

One of the best ads I’ve ever seen!

ok- so i am not a person who gets all sappy and choked up about commercials- but this one got to me. ’nuff said

Thank you @CocaCola for a classy commercial which promotes our country’s #diversity!

The feedback was not universally positive, and the backlash has gotten media attention across numerous outlets. The offense most-cited by the anguished was that an emblematic song about America was sung in many languages as opposed to English-only. The negative comments are not worth repeating. The New York Times called the response “mixed” but reported that positive comments did in fact outweigh the negative. That’s good to hear.

I care about this topic because I care about keeping people healthy. Tolerance is good for our health and bigotry is not. I also reside in a place that is doing a pretty good job with peaceful living in a multilingual community.

My small town of Old Tappan, NJ has a school district that is about 30% Asian. Most of the Asian population emigrated from Korea. Many of them speak both English and Korean, some speak no Korean, and some speak no English. We have a general Parent Teacher Organization (PTO) and a separate Korean PTO. I’ve heard occasional grumbles about why “they” need their own PTO, but not often, and without the vitriol and name-calling I observed in the Coke ad responses. Lunch tables are not uniformly integrated, but they are to some extent, and even the students who are not fully assimilated coexist peacefully with their fellow students.

Fear not, xenophobes.

Although there are residents in my community who do not proficiently speak English, our town is not in tatters. We have enviable schools, safe streets, and pleasant-looking neighborhoods.

However, prejudice does exist throughout our land. Taken to its extreme, bigotry has lead to horrors like those committed by the Klu Klux Klan and Nazis.  Simon Critchley’s opinion piece in The New York Times serves as a reminder of historical tragedies that have occurred when people do not practice tolerance. Critchley includes a haunting excerpt from Dr. Jacob Bronowski’s “Ascent of Man” filmed at Auschwitz, where many of his family members were murdered. It is a riveting reminder of the worst, ultimate outcome that can result from intolerance.

Thankfully, violence on that scale is not a part of current day United States. But even post-slavery and post-civil rights, bigotry lingers, and it has harmed our health. Prejudice has contributed to poorer mental and physical health for many years. According to the National Institutes of Health, “Prejudice, discrimination, and racism could affect health in several ways… low socioeconomic status is one of the most important predictors of adverse changes in health status…That (discrimination) has historically had an effect on minority socioeconomic status is unquestioned.”

Black Americans have the lowest life expectancy overall. Perceived discrimination has joined conditions like obesity as a risk factor for disease. As one might expect, evidence shows that discrimination has harmful effects on mental health including depression and anxiety. For the LGBT population, more frequent substance abuse is added to the list of negative outcomes, and data is currently mixed on whether they also have higher rates of suicide.

The antagonist in our story doesn’t get away unscathed. As it turns out, discrimination is bad for the bigot. For prejudiced people, even every day interactions with the “other” they find offensive can result in a stressful fight-or-flight physical response. In The Unhealthy Racist, Elizabeth Page-Gould describes the acute stress reaction this way: “You experience a surge in stress hormones, and your heart pumps harder while your blood vessels constrict, inhibiting the flow of blood to your limbs and brain.” The perpetrator of discrimination harms himself by his own intolerance.

Let us note that we have made progress. Not as swift as most would like, but improvements have been made that have diminished discrimination and prejudice over the past several decades.  Recent legalization of same-sex marriage in some states, as well as the repeal of the military’s “Don’t Ask Don’t Tell” policy has improved the lives of LGBT Americans. I expect these advances to improve things for the nation as a whole, as the betterment of particular groups makes for a stronger country. For example, in one Canadian study, the presence of gay-straight student alliances in high schools resulted in unexpected improvements for straight students, such as the suicide rate for heterosexual boys plummeting by half.

The Centers for Disease Control and Prevention points to the Vaccines for Children program as an example of how racial and ethnic health gaps can successfully be closed. The Veterans Health Administration claims to now see “minimal racial disparities in most process-of-care measures, such as rates of screenings for cholesterol or colorectal cancer.” The American Cancer Society reports that overall cancer death rates have declined 20 percent, but the rates for middle-aged black men has been cut by half.

While the pace of change is slow, the attitudes of tolerance in the U.S. are moving in the right direction. Health disparities should, hopefully, follow suit, and in some cases are already improving. Just as the health of an individual is dependent upon the proper functioning of all of the body’s systems, our country’s health depends on the well-being of all segments of society. “America the Beautiful” celebrates the many physical, geographical attributes of our nation and serves as a graceful analogy for the beauty of our citizenry in all of our glorious diversity. As we grow more tolerant, we will grow more beautiful and more healthy.

Edited by Dana March

One Response to “America the Healthy”

  1. February 12, 2014 at 8:47 pm, Patches Magarro said:

    I’d like to go back and replace some instances of the word “tolerance” in my story to acceptance.

    Reply

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The views and opinions expressed on this website are solely those of the authors and do not represent those of the Department of Epidemiology, the Mailman School of Public Health, or Columbia University.