Life-Sustaining Equilibrium

By Nancy Lopez / Summer 2020 

“When social bonds are strong, individuals achieve a healthy balance between individual initiative and communal solidarity…a “life-sustaining equilibrium” – Émile Durkheim

It is the second week of June and I am sitting in my living room floor with my laptop staring at me waiting for me to type in something. The topic is plant diversity and the microbiome, but all I can think about is the chaos going on outside the four walls that surround me. There are students running around in a panic moving their personal belongings out of their dorms and into their parent’s vehicles. While at the same time, I can hear a symphony of car horns from right outside my window where a black lives matter march is taking place fifty feet away from me. I glance at my incomplete assignment and then the clock which shows me it is already 2:00PM. My assignment is due at midnight. I try to work up the courage to continue typing and ignore the honking outside my window. I type a few sentences, but I get distracted again by my own loud thoughts saying, “Are you really going to stay inside and ignore the bigger things going on around you?” Followed by, “Are you even made out to be a doctor?” After a few minutes of this, which felt like hours, I began to feel the four walls around me begin to close in on me. I quickly closed my lap-top and made my way outside of my apartment to join the march.

This was me this past June at the height of the spread of COVID-19 across the world. Anyone having access to the internet or a television could simply not get away from all of the news media surrounding this virus. It sent surges of adrenaline within me at times. It felt that people were getting ready for a zombie apocalypse. Roommates of mine who usually were very kind, soon began to lash out for no apparent reason. When I walked outside, normal day to day conversation began to shift from “Hey, how are you?” to “Hey, did you know that the government just ordered several more body bags for all of the patients dying of COVID-19?” At times people would even share misinformation with me from uncredited sources which really frightened me because I know this is how fear and panic spreads. This is when I began to realize that a mental health crisis was just around the corner. However, if I was feeling the psychological effects of the virus in my La Jolla dorm-room with insurance benefits and food on the table, what about those millions of people who just got laid off? What about those individuals who can no longer afford to feed their children and are living in low income areas? It seems that these individuals need help the most but are they getting it? I did some reading and reflecting in order to find out and see. 

Mental health programs with a variety of treatment options are a luxury for anyone these days. With the incredibly long wait times, sometimes up to 6 months just to get seen by a therapist for the first time. Not to mention the stress that comes from getting your insurance to pay for the appropriate number of pricy visits. It is no wonder that individuals who are already having a hard time putting food on the table are not thinking about booking their next therapy visit. However, this is a serious problem considering prior to COVID-19, approximately 28 million citizens and permanent residents were uninsured due to high insurance premiums (“Underserved Populations”). Therefore, it comes as no surprise that new data shows that African Americans and Latinos are getting hit the hardest by this pandemic. One of Dallas Texas Office of Equality reps, Lindsey Wilson, stated that pre-existing injustices are a contributing factor (Connelly and Chavez). This means that over 38 million Americans, not just minorities, have had to shift their priorities to securing their next meal and staying afloat. Ultimately, this supports the idea that this is not a new problem for these underserved populations. Unfortunately, this type of chronically chaotic environment causes unhealthy levels of stress on the human body. With no spare time, funds, or accessibility to a mental health specialist, this allows the stress to remain active for long periods of time with no treatment. With the body pumping tons of cortisol and adrenaline regularly, this can also lead to other health issues such as increased arterial plaque, high blood pressure, and a weakened immune system (https://unnaturalcauses.org/video_clips_detail.php?res_id=217). Making it the ideal environment for COVID-19 to easily invade these underserved populations. Especially if you are over 65 and have any underlying medical conditions.  However, it would be far too easy just to blame this issue on the pandemic or even our healthcare system alone. I believe that this problem has deeper roots and I would like to trouble shoot some of the possible culprits. Among some of the possible culprits for our countries mental health crises are: neoliberalism, a history of zoning and redlining, social structures, and the continuous underfunding in our healthcare system.

The history of zoning and redlining is something that was new to me up until recently. The reason I believe this information is relevant to the current mental health crises is because I believe it can help us understand how ghettos and low-income neighbor hoods were created in the first place. That’s right, created. Low income areas were not just created by their inhabitants from within, but from the outside. Before reading any literature on this topic, I just imagined that once upon a time there was a nice neighborhood and slowly it just started to get neglected by its inhabitants. However, there are more moving parts. Redlining and racial zoning policies made it impossible for minorities, especially African Americans, to live in nice middle-class neighbor hoods beginning around 1880 up to the mid-twentieth century (Rothstein 39). These policies were sometimes “off the record” but were enforced by police and organized mobs (Rothstein 42). Around 1934 to 1962, home loans and bank investments were going towards the suburbs and to people who were categorized as “non-colored” (http://roger.ucsd.edu/record=b10431667~S9). This left the rest of the people of color without funds to be able to live in these same neighborhoods. Thus, being forced to live in ghettos and neglected neighborhoods. As if this was not enough, not only were the banks not interested in investing in these areas, but so were other essential businesses. Let’s not forget that hospitals and schools are businesses too. Therefore, these individuals are not getting the same access to resources like those living in nice middle-class neighbor hoods. Mentally this must also take a toll on minorities with the loads of stress and feelings of hopelessness. Imagine not wanting to live in the ghetto but not having the proper education, funds or guidance in order to get yourself out? Although it may appear that “times have changed”,  these policies continue to have an influence on the socioeconomic status of millions of Americans today. In fact, according to an article from the Washington Post, low income neighbor hoods that were once marked as “hazardous” in maps created by the federal Homeowners’ Loan Corp. in 1935 to 1939, can still be used to locate “low income” neighborhoods today (Jan). How can this be if racial and economic zoning was discovered in 1926?

I believe that one of the reasons why these policies continue to bleed into our society today is because of neoliberalism. This ideology can be described as the political alignment towards private interest instead of the common good (Monbiot). Simply put, profits over people. So why is too much neoliberalism harmful for the 40% of Americans who aren’t filthy rich? Because it hurts the people who it is intended to protect; By ruining the security network that is supposed to be there when things like a pandemic occurs. Instead, we have a system that provides larger tax cuts for the wealthy and keeps the other 40% living just above broke. This argument is not just about having unequal wages among Americans or about asking for a “hand out”. It is about the persistent underfunding at the federal, state, and public health level year after year (Gaffney). This results in a heavy burden on Americans who must now pay for their own healthcare. Which means that healthcare access is not “equal” because if someone does not have the funds to cover a specific medication or mental health treatment, they are out of luck. Then when these same individuals end up homeless or in jail, they are labeled as “bums” or “druggies” by society labels.  However, how are they supposed to make it through a system that is making it so difficult for them what they need? Why are some Americans being forced to deal with a tooth ache because they don’t have the money for a dentist? Why are people being turned away at the doctor’s office because they cannot pay for their next visit and have accumulated so much debt they cannot pay off? That’s right, debt. Hospitals do offer payment plans, just like credit card companies because you guessed it, hospitals are businesses too! Need a kidney because yours is failing? Well, I hope you have five thousand dollars because if not, get ready to wait (sometimes years) until you find a donor, or you find a match. I know this sounds harsh, but it is the reality that we live in today. I think there is something wrong with turning away the same people away whose tax dollars are used to fund these expensive hospital buildings and the latest technology inside them. Does this sound ethical? No, because it is not. Taking my own personal stance on the matter and applying the principles of biomedical ethics by Beauchamp and Childress, we can see that these examples I have listed previously do not coincide with these the principle of justice and non-maleficence. The principle of justice states that any decision made regard people’s health should be made with an element of fairness and that there should be an equal distribution of scare resources and treatments (“How the Four Principles”). Secondly, non-maleficence essentially means “to do no harm”. It is intended to be considered when making decisions that could impact other people or society who could be harmed by a decision. I believe that when racial zoning and redlining occurred in the late 1800’s, from a bioethical perspective, these principles were not taken into consideration. It was not considered that the individuals living in poverty would be exposed to additional pests, rodents, mold, violence, additional traumas, etc. Which ultimately leads to poor overall health outcomes which do not match our countries wealth status.

Now that we have covered some of the culprits of our current dilemma, we can discuss some of the possible solutions that could help break down some of these barriers and build a more healthier society. Being that I am a Cognitive Science major, I would like to go over some of these possible solutions through the lens of a Cognitive Scientist. One of the first things that we are taught in introductorily research classes is to observe objects as if it were the first time seeing them. This is incredibly difficult for humans because our brain is programmed to ignore continuous stimulus. This is called sensory adaptation. I believe that something similar is occurring within society with neoliberalism being integrated in our everyday lives. This could look in several different ways but let’s take an example of a wealthy corporate business owner living in Calabasas. They are so removed from the slums of the ghetto, that some of them use their life experience as confirmation bias that our country is great like it is and that low-income individuals just need to work harder and contribute to society more in order to get what they want. However, this anti-solidarity mindset is what enforces an “us versus them” mentality. Clearly this type of mentality has not benefited our country as a unit. That is why I think it’s important to continue fighting against belief perseverance within minority communities. This is the habit of holding on to an initial belief on an idea regardless if new information is given that disproof’s that original belief. Being that I am a Latino woman, I will use examples from my community. An example of belief perseverance within Latinos is when they [we] begin to believe that they are lazy, ghetto, unintelligent, and unmarketable because they [we] hear these things all the time. I think it’s time to teach younger children who identify as minorities how to fight against these ideologies that are in integrated into our society. There could be early intervention programs for students going to schools in low income areas in order to help break down these barriers. I think most parents would be willing to sacrifice a few trips to a museum or state jail (my middle school did this) if they knew how powerful these coping strategies could be in the future. In addition, this puts the taxpayer’s funds into something more productive like teaching students how to fight against adversity by pairing them up with a good mentor or the appropriate resource center (depending on the need of the individual student). I remember growing up as a kid I felt generally anxious to be at school because I was poor and felt “different”. I am sure other minorities feel this same way too and I feel that young students could benefit more from these types of skills especially if they cannot express themselves yet. This way these students have the right tools and mental resilience ahead of time instead of having to wait until high school or college after they already have been diagnosed with depression, PTSD, ADHD, or anxiety.

Although I believe that prevention is ideal. It does not help the current mental health crises we have on our hands now. If our funds were to be redistributed fairly with bioethical principles taken into consideration, I believe that there would be more funds available for hospitals and underserved communities to get the help they need. If the second stimulus check were to be get approved, even with modifications, this would be a tremendous help for our hospitals and underserved populations. More funds would be able to go towards non-profit clinics, community clinics, and other state funded programs that help homeless communities and other underserved communities. Essentially serving as a real safety net for those who are funding the system. I feel that everyone would benefit from a healthier, stronger country. I believe that this current pandemic has taught me [us] the importance of this because we have witnessed that by just one person not wearing a mask could lead to countless deaths when transferred to the wrong individuals. Our future will never the same after this and this is only the beginning of my personal journey in attempting to find my place in improving underserved communities. As someone who wants to go into the medical field, I hope to make a change, no matter how small or large. My hope is that more people will come out of this pandemic with more of a solidarity mindset and I hope you did too.

Works Cited

Christopher Connelly, Stella M. Chávez. “Black And Latino Communities Hardest Hit By COVID-19.” KERA News, 21 May 2020.

Gaffney, Adam. “America's Extreme Neoliberal Healthcare System Is Putting the Country at Risk | Adam Gaffney.” The Guardian, Guardian News and Media, 21 Mar. 2020.

“How the Four Principles of Health Care Ethics Improve Patient Care.” Online.sju, 11 Feb. 2020.

Jan, Tracy. “Analysis | Redlining Was Banned 50 Years Ago. It's Still Hurting Minorities Today.” The Washington Post, WP Company, 28 Mar. 2018.

Monbiot, George. “Neoliberalism – the Ideology at the Root of All Our Problems.” The Guardian, Guardian News and Media, 15 Apr. 2016.

“Underserved Populations: What Nurses Need to Know.” Bradley University Online, 18 Sept. 2019.