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Independent Artists and Health Care in Oklahoma
-Leigh Perry, Norman, OK

For those of us in this state who are poor/working poor, access to health care is virtually non-existent. In a state that would rather spend money on football or luring an NBA team to the area, rather than on the arts or much of anything else, those of us in the arts are left completely out in the cold.

The local low-income clinic in Norman is a case in point. One morning a week, you stand in line from 8am-10am, and if you are lucky, you draw a number, they let you know when you can see a doctor sometime that week. I know of three departments for sure - general, OB/GYN, and pediatrics - and each of these sees only about 10 people per week. The dental clinic has been fazed out entirely.

The state has started an insurance program entitled Insure Oklahoma, which helps small employers get coverage for their employees - with the help of federal money - but it doesn't cover individual self-employed people such as myself. Given the number of health problems I have, the situation is life threatening.

Building the Movement
-Teach for America alum, Bronx, NY

The health of Teach for America staff seems to provide powerful anecdotal evidence for the "wealth-health gradient" that "In Sickness and In Wealth" introduces. In New York, where I taught, there was a marked difference in the health outcomes of corps members and college classmates in management consulting and other professions, both recruited under similar criteria.  Both groups share high-achieving educational backgrounds. Both groups had solid health insurance coverage on the job. And for the most part, both groups came into their respective organizations in excellent health: TFA staffers are young and unusually energetic, as the organization screens applicants in all capacities for their ability to achieve TFA's mission with "relentless pursuit of results."

The classroom, then, is perhaps their great un-equalizer. Under the chronic stress of school work, many first-year corps members develop physical and mental health conditions unlike any they'd experienced previously. I knew former college athletes who lost 20 pounds in six months, or gained 15. Friends who claimed no previous history of mental health problems joked about their first consults with psychiatrists. And just about everyone was down with something all year - and came to school anyway.

To some extent, this is just evidence of their transition to the working world. But I note the TFA corps in particular because the move to the new socioeconomic environment appears coincident to their rapid decline in health. Coming into the corps, these teachers are a more or less homogenous social group. Contrary to some press accounts, employees from a wide variety of socioeconomic backgrounds are represented at all levels of TFA. Their shared educational background, however, places them on a more level playing field, and all earn the same in the first year in the schools.

In the schools, there are obvious differences in the health of first-year teachers compared to principals and administrators. In fact, teachers in high-performing charter school networks in the same neighborhoods with higher incomes and more "corporate" working conditions seemed healthier. They were certainly happier. At TFA corporate headquarters, staff - corps alumni included - empathized with first-year corps members' health woes, but these employees also appeared to be in better health, if only because they had clearer skin and fewer colds.

In recent years TFA has made strides toward addressing corps member preventive health. But it is fascinating to witness this gradient at work there. Unfortunately, I do not give enough attention here to the poor health of many teaching veterans in low-income school districts. And that's not even to mention the vast disparities between teacher health and the health of the kids we teach - a horrendous oversight, but indicative of the magnitude of this public health crisis for everyone in the building.

An Environmental Hazard
-Marcia Moen, East County Health Department

Ceiling tiles made of slag wool (a by-product of the steel industry), gypsum and perlite - used in schools, offices, and homes - are linked to increases in cancer, asthma, hypertension.  They degrade over time and produce a fine fiber similar to asbestos.  They are banned in Europe. Respirators must be used when cutting them.

In my workplace, the dust has accumulated on our desks, ventilation system and lighting fixtures.  I can scoop the dust off with my hands and I breathe this dust daily.  Since moving into this building, I have been diagnosed with asthma and HTN, and also have symptoms related to sick building syndrome. 

While I can't speak for the other employees, I have noticed many many sick calls due to respiratory problems.  What can be done about the use of what I believe is a ticking time bomb - slag wool ceiling tiles?

A Pilot’s Tale
-Christine Herbes-Sommers, UNNATURAL CAUSES Series Senior Producer, Vital Pictures

Working on a series like UNNATURAL CAUSES requires passion but also detachment to get the job done. Sometimes, in the thick of production, it’s nice to be reminded how these ideas we’re working on actually matter in the world.

The day after we finished the series, I was on a plane from Boston to Florida, seated next to a uniformed pilot. He was one of those big-boned, open-faced, fair-haired guys whose voice calms us when there’s turbulence ahead. We got to chatting. His line of work was obvious, so he asked about mine.

I set about explaining the series, especially the notion of the health gradient and how high demand-low control jobs turn the body’s natural threat response into chronic, toxic stress. As I talked, he nodded excitedly and finally burst out, “I never put it together that way…but that’s my life!”

For years, the pilot told me, he flew international routes. Notwithstanding the pressures of regularly shuttling some 300 passengers to safety in a metal tube 35,000 feet over the ocean, he liked his job. Although he was away from home half the time, his schedule was fairly predictable, he made a great salary with excellent benefits and he was moving up in seniority.

But he’d recently become a father, and now he hoped to be home with his new family more – or at least on the same side of the Atlantic. To do this, he’s had to give up seniority – and control of his schedule. In a profession where compensation and rank are based on flying hours, he’s forced to bank as much as he can however he can get it.

So now he’s on 48-hour call. If the airline needs someone for the red-eye, he gets himself to the departure destination, makes the flight, and returns home. To await the next call. He never knows where he’s going or when.

He told me that while it’s good to be closer to home, he can already feel the strain: waiting for a call; wondering if and when it’s going to come; worrying about how the uncertainty impacts his career, livelihood, and family; then when the call comes, dropping everything to respond – a recipe for chronic stress.

 “I’m no kid, so I’m trying all kinds of things to stay calmer: running, even suburban meditating,” he said, with a grimace of irony. “And you know, it’s hard on my wife too. How long can we keep this up before the heart attack?”

“The choices shouldn’t be this difficult," he mused. "But we’re all trying to manage our best with high demand-low control lives, aren’t we?”

A View from the Front of the Classroom
-a California teacher

The series’ discussion on work conditions contributing to stress immediately made me think of a large group of working professionals suffering from chronic stress: public school teachers.

I have been an elementary school teacher since the early 1970s. Teaching has always involved long hours and a certain level of stress, but it used to feel fun. Sure, there were always curricula to follow and standards to achieve, but we could take time to go deeper into a subject that interested students, and teachers were encouraged to use their personal strengths and creativity to develop activities for our classes. Good teachers could usually bring the majority of their class up to level by the end of the year.

These days, teaching has pretty much lost its fun. I can’t wait to retire, and I worry about new teachers coming in. Some of the best teachers I know are near tears in the staffroom and contemplating quitting. Why? Because standardized testing and lack of support for teachers has created a "high demand/low control" situation where it's impossible for many of us to succeed.

Many politicians and Op Eds blame bad teachers for low scores, and so many states have introduced standardized tests and rigid curricula. There’s certainly nothing wrong with setting standards and testing towards them, but many programs – such as No Child Left Behind – use test scores to “punish” or “reward” schools, rather than guide their improvement. Because funding is tied to these tests, administrators are constantly anxious to raise their scores, teachers must focus exclusively on preparing for the test with few resources, and students lose most opportunities for creative or spontaneous learning. The result is an entire school full of anxious, stressed individuals.

I work at a school in a low-income area, where the majority of residents don’t speak English as their first language. I enjoy teaching this group of kids, which is why I choose to stay in the district. But the state and federal tests don’t take into account that these kids have special needs; they are tested to the same standards as everyone else. Since many start out below grade level, even if I can raise their reading and math scores by more than a grade during a year, our school will still be labeled “low performing.” We can work and work and work and still “fail.”

And most of us do work and work and work. This year, I have been in my classroom six days a week almost every week. On weekdays, I work 10 hours at school and more in the evenings. I am lucky to have generally good health, but when teachers do get sick, it’s hard to take time off to get better. Though we are given plenty of sick days in our contract (unlike many professionals!), we have to create lesson plans for the days we are gone. And, since our kids need to learn whether we’re there or not, most teachers will come in anyway so they don’t lose valuable class time they need to prepare their kids for the almighty test. If I can get out of bed, I will go to school. Last week, a colleague of mine ended up in the hospital with pneumonia after pushing herself to work through a bad cold.

I am thankful to get two months during the summer to relax and prepare for the coming year. However, many of my colleagues, particularly those living on a single salary, work second jobs during these months.

Something that is lost in the debate about improving education is the simple need to support teachers more. A recent national survey (reported in Time) showed that teachers care more about getting more prep time, having opportunities to learn from each other, and gaining support from administrators than they do about earning higher salaries. Most of us don't want more money; we just want to enjoy our jobs again.

Having healthy, motivated, well-prepared teachers will help your kids learn, so how about giving us a bit more credit… and support?