Izinqunto Zempilo Yezenhlalakahle

Izinhlaka zezenhlalo zezempilo - sizwa ngabo ngaso sonke isikhathi, kepha ziyini ngempela? Kalula nje, yizinto ezisizungezile - ngaphezu kwemikhuba enempilo - enquma imiphumela yethu yezempilo. Yizimo esizalelwe kuzo; lapho sisebenza, sihlala khona, futhi siguga, lokho kuthonya izinga lethu lempilo.¹ Isibonelo, siyazi ukuthi ukubhema kukhulisa amathuba akho omdlavuza wamaphaphu, kepha bewazi ukuthi izinto ezifana nalapho uhlala khona, umoya owuphefumulayo, ukusekelwa komphakathi, kanye nezinga lakho lemfundo nakho kungathinta impilo yakho yonke?

Abantu Abaphilile 2030 ithole imikhakha emihlanu ebanzi yezimo zezenhlalo zezempilo - noma i-SDoH - "ukukhomba izindlela zokwakha izindawo zenhlalo nezomzimba ezithuthukisa impilo enhle yawo wonke umuntu." Lezi zigaba 1) omakhelwane bethu nezindawo ezakhiwe, 2) ukunakekelwa kwezempilo nezempilo, 3) isimo senhlalo nomphakathi, 4) imfundo, kanye no-5) ukuzinza kwezomnotho.¹ Isigaba ngasinye kulezi sinomthelela oqondile empilweni yethu yonke.

Masisebenzise i-COVID-19 njengesibonelo. Siyazi ukuthi imiphakathi emincane ishayeke kakhulu.² Futhi siyazi futhi ukuthi le miphakathi ilwela ukuthola imigomo.^3,4,5 Lesi isibonelo sokuthi imvelo yethu eyakhiwe ingayithinta kanjani imiphumela yethu yezempilo. Abantu abaningi abambalwa bahlala ezindaweni ezicebile, banamathuba amaningi okuthi babe nemisebenzi ebalulekile noma "abaphambili", futhi banokufinyelela okuncane ezinsizakalweni nasekunakekelweni kwezempilo. Lokhu kungalingani kwe-SDoH konke kube nomthelela ekwandeni kwenani lamacala e-COVID-19 nokufa phakathi kwamaqembu amancane e-United States.⁶

Inkinga yamanzi eFlint, eMichigan ngesinye isibonelo sendlela i-SDoH edlala ngayo kumiphumela yethu yezempilo isiyonke. I-World Health Organisation ithi i-SDoH yakhiwe ngokwabiwa kwemali, amandla, nezinsizakusebenza, futhi isimo esiseFlint siyisibonelo esivelele. Ngo-2014, umthombo wamanzi kaFlint wasuswa eLake Huron - owawulawulwa nguMnyango Wezamanzi Nokuthuthwa Kwendle - waya eFlint River.

Amanzi eFlint River ayonakalisa, futhi akukho zinyathelo ezithathiwe ukwelashwa lawo manzi nokuvimbela umthofu namanye amakhemikhali abukhali ekuphumeni emapayipini nasemanzini okuphuza. Umthofu unobuthi obumangalisayo, futhi uma usuphuziwe, ugcinwa emathanjeni ethu, egazini nasezicutshini zethu.⁷ Awekho amazinga “aphephile” okuchayeka komthofu, futhi ukulimala kwawo emzimbeni womuntu akunakulungiseka. Ezinganeni, ukuvezwa isikhathi eside kudala ukubambezeleka ekukhuleni, ekufundeni, nasekukhuleni, futhi kulimaza ubuchopho nohlelo lwezinzwa. Kubantu abadala, kungaholela esifo senhliziyo nesezinso, umfutho wegazi ophakeme nokwehlisa ukuzala.⁸ 

Kwenzeke kanjani lokhu? Okokuqala, izikhulu zedolobha zazidinga umthombo wamanzi oshibhile ngenxa yezinkinga zesabelomali. IFlint idla imbuya ngothi, ikakhulu idolobha eliMnyama. Cishe i-40% yezakhamizi zayo zihlala ebuphofini.⁹ Ngenxa yezimo ezingalawulwa yibo - ikakhulukazi ukungabi bikho kwemali yedolobha, nezikhulu ezikhethe indlela “yokulinda nokubona¹⁰ esikhundleni sokulungisa inkinga ngokushesha - cishe abantu abayi-140,000 baphuza ngokungazi, bageza futhi bapheka ngamanzi afakwe umthofu unyaka wonke. Isimo esibucayi samenyezelwa ngonyaka we-2016, kepha abahlali baseFlint bazophila nemiphumela yobuthi obuholayo impilo yabo yonke. Mhlawumbe okukhathaza kakhulu iqiniso lokuthi cishe izakhamizi ezingama-25% zabaFlint yizingane.

Inkinga yamanzi kaFlint iyisibonelo esedlulele, kepha esibalulekile sokuthi i-SDoH ingabathinta kanjani abantu nemiphakathi. Imvamisa, i-SDoH esihlangana nayo ayinzima kangako, futhi ingalawulwa ngemfundo nangokukhuthaza. Ngakho-ke, yini esingayenza njengenhlangano ukuphatha i-SDoH ethinta amalungu ethu? Ama-ejensi we-State Medicaid afana neColorado Access angakwazi futhi asebenza ngenkuthalo emizamweni yokuphatha i-SDoH yamalungu. Abaphathi bokunakekela badlala indima ebaluleke kakhulu ekufundiseni amalungu, ekuboneni izidingo zabo, nasekuhlinzekeni ukuhanjiswa kwezinsizakusebenza ukunciphisa imigoqo yokunakekelwa. Imizamo yethu yokuhlela izinhlelo zezempilo kanye nokungenelela nakho kuhlose ukunciphisa izithiyo ekunakekelweni nasekuthuthukiseni imiphumela yezempilo. Futhi, inhlangano isebenzisana njalo nabalingani bomphakathi kanye nama-ejensi wombuso ukunxenxa izidingo zamalungu ethu.

Okubhekwayo

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. Ukungafani kobuhlanga nobuzwe be-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