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Funda kabanzi apha

Iinqununu zezeNtlalo

By UKirstin L

Iimpawu zezentlalo zempilo - siva ngazo ngamaxesha onke, kodwa zithini ngokwenene? Ukubeka nje, zizinto ezisijikelezileyo - ngaphaya kwemikhwa enempilo - emisela iziphumo zethu zempilo. Ziimeko esizalelwe kuzo; apho sisebenza khona, sihlala, naxa siguga, oko kuchaphazela umgangatho wobomi bethu.1 Umzekelo, siyazi ukuba ukutshaya kwandisa amathuba okuba nomhlaza wemiphunga, kodwa ngaba ubusazi ukuba izinto ezifana nendawo ohlala kuyo, umoya owuphefumlayo, inkxaso yentlalontle, kunye nenqanaba lemfundo yakho nazo zinokuchaphazela impilo yakho iyonke?

Abantu abasempilweni 2030 ichonge iindidi ezintlanu ezibanzi zezinto ezimisela impilo yoluntu - okanye i-SDoH - "ukuchonga iindlela zokuyila imeko yentlalo neyomzimba ekhuthaza impilo entle kumntu wonke." Ezi ndidi zi-1) iindawo zethu zokuhlala kunye neendawo ezakhiweyo, 2) impilo kunye nokhathalelo lwempilo, 3) imeko yentlalo kunye noluntu, 4) imfundo, kunye ne-5) ukuzinza kwezoqoqosho.1 Nganye kwezi ndidi zinempembelelo ngqo kwimpilo yethu iyonke.

Masisebenzise i-COVID-19 njengomzekelo. Siyazi ukuba iindawo ezihlala abantu abambalwa ziye zabethwa kakhulu.2 Kwaye siyayazi ukuba olu luntu luyasokola ukufumana amayeza okugonya.3,4,5 Lo ngumzekelo wendlela indawo yethu eyakhiwe ngayo inokuchaphazela ngayo iziphumo zethu zempilo. Uninzi lwabantu abambalwa luhlala kwiindawo ezihlala abantu abangathathi ntweni, kusenokwenzeka ukuba banemisebenzi ebalulekileyo okanye “ephambili”, kwaye banofikelelo oluncinane kwizibonelelo nakukhathalelo lwempilo. Oku kungalingani kwe-SDoH konke kube negalelo ekonyukeni kwenani le-COVID-19 kunye nokufa phakathi kwamaqela amancinci e-United States.6

Ingxaki yamanzi e-Flint, eMichigan ngomnye umzekelo wendlela i-SDoH edlala ngayo kwiziphumo zethu zempilo zizonke. UMbutho wezeMpilo weHlabathi uxoxa ukuba i-SDoH ibunjwe kukusasazwa kwemali, amandla, kunye nezibonelelo, kwaye imeko yaseFlint ngumzekelo omangalisayo. Ngo-2014, umthombo wamanzi we-Flint watshintshwa ukusuka kwiLake Huron - elawulwa liSebe le-Detroit Water and Sewage - ukuya kwi-Flint River.

Amanzi oMlambo iFlint ayenomhlwa, yaye akuzange kuthatyathwe manyathelo okucoca amanzi nokuthintela ilothe neminye imichiza eyingozi ukuba ingavuzi kwimibhobho ukuya kumanzi okusela. Ilothe inetyhefu engathethekiyo, kwaye yakuba ityiwe, igcinwa emathanjeni ethu, egazini nakwizicubu zethu.7 Akukho manqanaba “akhuselekileyo” okuba sesichengeni selothe, yaye umonakalo wayo emzimbeni womntu awunakuguqulwa. Ebantwaneni, ukuba sesichengeni ixesha elide kubangela ukulibaziseka kuphuhliso, ukufunda, nokukhula, kwaye yonakalisa ingqondo kunye nenkqubo yemithambo-luvo. Kubantu abadala, kunokukhokelela kwintliziyo kunye nesifo sezintso, uxinzelelo lwegazi oluphezulu, kunye nokunciphisa ukuzala.8 

Yenzeka njani le nto? Ukuqala, amagosa esixeko ayefuna umthombo wamanzi onexabiso eliphantsi ngenxa yokunqongophala kwemali. I-Flint sisixeko esihlwempuzekileyo, ingakumbi isixeko esiNtsundu. Phantse i-40% yabemi bayo bahlala kwintlupheko.9 Ngenxa yeemeko ezingaphaya kolawulo lwabo - ikakhulu ukunqongophala kwemali yesixeko, kunye namagosa akhethe indlela "yokulinda kwaye ubone.10 endaweni yokulungisa umcimbi ngokukhawuleza - abantu abamalunga ne-140,000 bengazi, basela, bahlamba, kwaye bapheka ngamanzi afakwe ilothe unyaka wonke. Imeko yonxunguphalo yabhengezwa kwi-2016, kodwa abahlali baseFlint baya kuhlala nemiphumo yetyhefu ehamba phambili ubomi babo bonke. Mhlawumbi eyona nto ikhathazayo kukuba phantse i-25% yabemi baseFlint ngabantwana.

Ingxaki yamanzi kaFlint ngumzekelo ogqithisileyo, kodwa obalulekileyo wendlela iSDoH enokubachaphazela ngayo abantu noluntu. Rhoqo, i-SDoH esidibana nayo ayinzima kangako, kwaye inokulawulwa ngemfundo nangothethelelo. Ke, singenza ntoni njengombutho ukulawula iSDoH echaphazela amalungu ethu? Ii-arhente ze-Medicaid ze-State ezifana ne-Colorado Access ziyakwazi kwaye zibandakanya ngokunyanisekileyo kwimigudu yokulawula i-SDoH yamalungu. Abaphathi bokhathalelo badlala indima ebalulekileyo ekufundiseni amalungu, ukuchonga iimfuno zabo, kunye nokubonelela ngokuthumela izibonelelo ukunciphisa imiqobo ekukhathaleni. Iinzame zethu zenkqubo yezempilo kunye nongenelelo lukwajolise ekudambiseni imiqobo ekukhathaleni nasekuphuculeni iziphumo zempilo. Kwaye, umbutho uhlala usebenzisana namaqabane oluntu kunye nee-arhente zikarhulumente ukuxhasa iimfuno zamalungu ethu.

Ucaphulo

  1. https://health.gov/healthypeople/objectives-and-data/social-determinants-health
  2. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html
  3. https://abc7ny.com/nyc-covid-vaccine-coronavirus-updates-update/10313967/
  4. https://www.politico.com/news/2021/02/01/covid-vaccine-racial-disparities-464387
  5. https://gazette.com/news/ethnic-disparities-emerge-in-colorado-s-first-month-of-covid-19-vaccinations/article_271cdd1e-591b-11eb-b22c-b7a136efa0d6.html
  6. Iiyantlukwano zobuhlanga nezobuzwe kwi-COVID-19 (cdc.gov)
  7. https://www.cdc.gov/niosh/topics/lead/health.html
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309965/
  9. https://www.census.gov/quickfacts/fact/table/flintcitymichigan/PST045219
  10. https://www.npr.org/sections/thetwo-way/2016/04/20/465545378/lead-laced-water-in-flint-a-step-by-step-look-at-the-makings-of-a-crisis