Your Health Checkup: Where You Live Impacts How Long You Live

“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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COVID-19 has disproportionately affected people of color and lower socioeconomic status, emphasizing the fact that who you are and where you live impact your health.

I was recently struck by what’s been called the “subway map” view of life expectancy. For example, people living in midtown Manhattan survive on average ten years longer than those living in the south Bronx. Chicago serves as an even more striking example. Life expectancy decreases by 16 years between living near the Chicago Loop versus the west side of the city.

There are few if any medical interventions that produce such astonishing differences in survival.

Many reasons exist to explain the impact of these socioeconomic factors on health, such as homelessness (almost 600,000 presently in the U.S.), hunger (40 million), poverty (40 million), loneliness (40 percent of elderly), incarceration in prisons with minimal health services (2.3 million), uninsured health care (30 million), crime, drugs, racism, air pollution, and other factors.

Many, if not all, of these issues can be reversed or at least minimized if we as a nation choose to do so.

Importantly, addressing them can overcome the negative impact of your genes. For example, lifetime risk for developing cardiovascular disease varies greatly depending on exposure to risk factors such as elevated LDL (bad cholesterol), blood pressure, and stress and the ability to resist its impact, regardless of your genetic predisposition.

To put it another way, nature loads the gun (genes) but the environment (your behavior) pulls the trigger.

There are some things you can do to reduce the negative impact of socioeconomic or genetic influences on your health.

To reduce risks of heart disease, consider the seven steps recommended by the American Heart Association that include not smokingexercising, and controlling dietbody mass index (BMI)blood pressurecholesterol, and glucose. The influence of lifestyle on heart disease begins at an early age so the sooner one practices these recommendations, the better.

I have repeatedly advocated for the benefits of vaccination to prevent a multitude of infections such as measles, mumps, rubella, whooping cough, shingles and other diseases.

In addition, recent information suggests that getting the flu vaccine not only reduces the chance of being infected by influenza, but also reduces the subsequent risk of heart disease. Obtaining the flu vaccine for everyone older than six months before the start of the flu season becomes even more crucial in today’s climate because of the COVID-19 pandemic and the impact of having both infections.

Many experts recommend patients get their flu shot in late September or early October to provide protection for the entire flu season since the benefits of the vaccine typically last six months. Seniors older than 65 should receive Fluzone High-Dose, or FLUAD, because it provides better protection against flu viruses by containing four times the antigen in a standard dose, which causes the immune system to have a higher response to the vaccine. Hundreds of millions of Americans have safely received flu vaccine over the past 50 years.

Vaccination is one of the landmark medical advances that has saved millions, probably billions, of lives. Get your flu shot and COVID-19 vaccination when available, as well as other recommended vaccinations.

Featured image: Khongtham / Shutterstock

The Party Planner: Celebrating the Birthdays of Disadvantaged Kids

Thirty-two squealing kids play birthday games on a basketball court in a Richmond, Virginia, community center. They’re smacking balloons with the party’s 17 volunteers, competing in sack races, shooting baskets, throwing footballs, jumping rope, and screeching and yelling and dancing, pausing only for face-painting before yelling some more. ­Remarkably, despite the chaos, only one balloon pops.


Make that two balloons.

No one is having more fun than the party’s jubilant host, 23-year-old Julia Warren. She’s the founder of Celebrate RVA, an organization that throws birthday parties for disadvantaged kids, most of whom have never worn party hats or blown out candles. (“Sometimes they’re confused about why I lit their food on fire,” she says.) The kids love her. When we entered an elementary school that afternoon to gather children celebrating April birthdays, her young admirers swarmed her, offering smiles, hugs, and high-decibel hellos.

“It’s my shining stars!” she said to the kids. “Are you ready to celebrate birthdays?”

Warren formed the nonprofit in 2013 when she was 16 years old. Since then, Celebrate RVA has hosted more than 280 parties for around 3,250 kids. “She’s younger than me and I look up to her — she’s done all of this on her own,” says Paige Sigler, 29, the organization’s part-time (soon to be full-time) program coordinator and its only other employee.

So what inspired Warren to become a Mother-Teresa-meets-Chuck-E.-Cheese do-­gooder when she was barely old enough to drive? As a junior in high school, Warren was tutoring kids at an elementary school. One day she was chatting with a child and asked, “How old are you? When were you born?” The response changed her life: “He looked up and said, ‘I think I was born when it was cold outside.’”

“Every child deserves the right to experience joy.”

Warren was stunned. She talked to the school principal. He said the school didn’t have time to recognize birthdays, though sometimes they might give a child a pencil. Sad, right? So Warren used babysitting money to host birthday parties on her own. Soon she was contacted by local agencies and nonprofits. “Having these professionals say, ‘This is a real need, and we’re willing to invest resources to make this happen,’ I realized that this was going to be a lot bigger than myself.”

As she served the city, she was also thinking about college and considering two options: 62,000-student Texas A&M, which was half a country away, and Randolph-Macon College, with 1,400 undergrads, about 20 miles from Richmond. If she went to Texas A&M, she would need to put Celebrate RVA on hold. Then, at a birthday party, a gentleman arrived to pick up a child and said, “We have to find a place for him to sleep tonight.”

The man was the boy’s counselor. A few weeks earlier, the boy had watched as his mother was shot and killed in their home. No family member had yet offered to care for him.

“It stopped me in my tracks,” says Warren. “I thought, this child has gone through more than I will ever go through in my entire life. And yet for the past hour and a half, we’ve been able to celebrate him and let him try and forget the horrific things he has seen, and just be a child. And I knew that this is where I was supposed to be.”

She attended Randolph-Macon for two years and then devoted a year to Celebrate RVA. Her parents were both proud and concerned.

“When this started and I was throwing a few birthday parties, they said, ‘Oh, that’s great, Julia!’ And then when I said, ‘I think I need to turn this into a nonprofit,’ my parents were like, ‘Well, shouldn’t you pass algebra first?’”

After attending a few parties, her parents became her biggest supporters. But Warren had much to learn. She was a privileged, private-school girl throwing inner-city birthday parties. “The first few parties, I felt like an outsider,” she says. “I had no relationships in this community. I hadn’t proven myself trustworthy.” She realized she needed to listen and accept feedback. Now, she says, she’s not only been accepted, but parents call her at all hours. She also learned that her parties could wound parents’ pride. “Most parents are truly hurt that they can’t provide their child with a birthday experience,” she says. To address that, she always seeks parental involvement, whether it’s decorating party rooms or lighting the candles.

Cynics may question her work. Cupcakes and streamers are great, the party poopers say, but don’t disadvantaged kids have bigger needs?

“Every child deserves the right to experience joy,” Warren explains. “But a lot of our kids don’t know how. We’ve got elementary schoolers being recruited by gangs.They’re rejecting the idea that happiness is something they can attain.”

Warren grasped the transformative power of parties at one of her first events, held at Safe Harbor, a domestic violence shelter. Members of the city’s pro soccer team, the Richmond Kickers, attended as volunteers, but their presence frightened the women and children. “The last time they were touched by a man, it was probably extremely violent,” says Warren. The players, however, spoke softly and bent down to eye level with the kids. They played in sprinklers, engaged in sidewalk chalk-drawing, and sang “Happy Birthday.” When the party was over, the women and children extended their arms for hugs.

“I had to hold back tears because I saw what an hour and a half of celebration and joy can do,” says Warren. “We’ve talked to teachers who say, ‘My kids keep their birthday card on their desk year-round. It’s their only birthday card and they love to look at it and read the special message.’”

“I said, ‘I think I need to turn this into a nonprofit.’ My parents were like, ‘Well, shouldn’t you pass algebra first?'”

Warren is finishing her education yet continues to expand the organization and recruit volunteers, such as Alisa Feliciano, who volunteers monthly with her husband, 11-year-old daughter, and 14-year-old son. Working with Celebrate RVA, Feliciano says, has strengthened her family. As the kids assume more responsibilities at parties, they’ve become more respectful and responsible at home.

“Julia knows how to empower people,” says Feliciano. “She can inspire a 5-year-old as easily as a 60-year-old.”

Next up for Warren: Celebrate RVA is building a community center that will open in 2020. But parties remain the organization’s focus, and for Warren, the most emotional moments come after the children make birthday wishes. Inevitably, one or two kids keep their eyes closed. “They keep making a wish for like 30 seconds,” she says. “And they’re muttering to themselves. All I can do is wonder what they’re wishing for.”

Warren knows she can’t rescue these kids. But she can give them moments of happiness and love that continue to burn, she hopes, like a candle on a cupcake. And that is Julia Warren’s birthday wish.

Featured image: Shine Photography.