Documentary -- Cooked: Survival by Zip Code | PBS Independent Lens

Cooked: Survival by Zip Code, premiered on the PBS Independent Lens documentary series a couple weeks ago.  

It's being repeated on PBS World Channel as well as stations, and is still viewable online.  (World Channel is carried by many PBS stations as one of their HDTV channels.  Unfortunately, it's not available in the DC area.)

The program is about the 1995 heat wave in Chicago, which killed more than 700 people, which was chronicled in the dissertation and later a book by sociologist Eric Klinenberg.

-- "Denaturalizing disaster: A social autopsy of the 1995 Chicago heat wave," Theory and Society, 1999, original journal article by Klinenberg, free to download

The documentary is about "natural disasters" that are in fact the logical outcomes of social disparities.

The filmmaker, Judith Helfland, is struck by the oddity of how the US emergency management and disaster response system is focused on catastrophic events -- earthquakes, tornadoes, hurricanes, etc. -- and not the kinds of socially determined "disasters" that are the result of economic, racial, and class disparities of the kinds that resulted in the heat related deaths in Chicago.  

According to the film, there are about 3,200 premature deaths each year in Chicago that for the most part, result from poverty.

-- Social determinants of health, CDC

What happened in Chicago was that poor people, mostly older, with fewer resources, in communities with fewer resources, died from heat-related causes as the temperature exceeded 100° for multiple days in a row in July 1995, while wealthier communities pretty much got through the heat wave unscathed.

One of the interesting findings in Klinenberg's book is that communities with the same kinds of demographics, but positive differences in social capital, community organizations and institutions, didn't have the same high rates of death.

The shaded areas in this map of Chicago neighborhoods show the high poverty neighborhoods, which pretty much track other high rates of negative indicators (health, low educational attainment, etc.).  They also track the neighborhood redlining maps from the 1930s.

Steve Whitman/Sinai Urban Health Institute.  One of the people featured in the documentary is epidemiologist Steve Whitman.  At the time of the heat wave he was a Deputy Commissioner of Health for the City of Chicago.  He left the city in 2000 to start the Sinai Urban Health Institute at Sinai Hospital.  He died in 2014 ("Steven Whitman, social epidemiologist, 1943-2014," Chicago Tribune).

SUHI conducts community health surveys and aims to address chronic health conditions and disparities resulting from poverty.

-- Improving Community Health Survey, 2004, SUHI

They published a book, Urban health: combating disparities with local data, which outlines the "Sinai model" which is based on the idea that by collecting health data at the scale of neighborhoods, effective responses can be developed to reduce health disparities. 

Interestingly, footage showing Mayor Daley at press conferences during the heat wave shows the same kind of blockheadedness demonstrated during the nation's most significant public health disaster--the response to covid19.

Daley downplayed the deaths, blamed the victims, etc.  The city does have a regularized response program for heat waves, so they don't experience the same level of premature death that they did in 1995, but they haven't extended the approach to poverty or chronic health conditions more generally.

I've written about this general issue in "More communities need to integrate health care and public health programming: Prince George's County, DC, etc." (2020).  It builds on a series in 2017 and follow ups, taking a "transformational projects action planning" approach to rebuilding the United Medical Center in Southeast DC, in a manner that would link public health and hospital care with a focus on addressing chronic medical conditions that tend to be a problem in low income communities.

The Sinai Urban Health Institute is another best practice program that should be incorporated into that concept.

Disaster response as a root of federal social welfare systems.  The documentary also interviews Stanford professor Michele Dauber, who's written The Sympathetic State: Disaster Relief and the Origins of the American Welfare State.  That's another book I need to track down and read.

The thesis is that FDR's New Deal used the long time examples of federal response to disaster and disaster relief as a way to justify the creation of social welfare programs like Social Security.

This lecture from 2013 outlines the arguments of the book.