"Unnatural Causes," the four-hour documentary that begins tonight, plunges into the rather obvious idea that you are where you live in terms of health.
It is presented by the National Minority Consortia of Public Television, which pushes an agenda shaped by the health-care experiences of minorities in this country. Nothing wrong with that.
It asks, "Is inequality making us sick?" Well, of course it is. The challenge of this program is to rise above the predictable, and its performance in this regard is uneven. It is also too long by half and repetitive. It overwhelms us with a welter of statistics.
That said, "Unnatural Causes" offers nuances, provocative theory, and some arresting facts. Most interesting is what comes from the middle, not the extremes, of our pecking order. We are reminded what we intuitively know: that social isolation is a killer, most evident among the poor. We also learn that those who own their homes get fewer colds, due presumably to a sense of security.
A groundbreaking study 30 years ago among English civil servants demonstrated that the lower one's grade, the higher the risk of every major cause of death. If you're at the top of the food chain, you're least vulnerable. Those a mere one rung below are more at risk, and so on down the scale.
This is all about control. The lack of it creates stress and, in turn, contributes to a panoply of disease from heart attacks and strokes to diabetes. The elite have control of their lives. The middle class enjoys less and the poor almost none.
"Unnatural Causes" was conceived by Larry Adelman and co-executive-produced with Llewellyn Smith, who with Christine Herbes-Sommers formed the Boston-based Vital Pictures.
The first hour documents life expectancies in three Louisville, Ky., neighborhoods of different socioeconomic status. The next probes the controversial hypothesis that racism may account for the inordinately high levels of premature and underweight babies born to African-American mothers. It also looks at Latino immigrants who arrive here in good health only to see their children face higher risk of obesity, heart attacks, and diabetes.
The third segment includes a shorter piece on the horrific diabetes rate among the O'odham tribe in Arizona, which lost its agriculture and its way of life after the Coolidge Dam was built. There's also a comparison between the unremediated poverty in Richmond, Calif., and a poor neighborhood in Seattle that was turned around by a huge injection of federal money.
Finally "Unnatural Causes" looks at poverty on Ebeye Island in the Marshalls, close to an American military base, and the health effects on workers who lose their jobs when a big employer shuts a plant in a Michigan town.
The unspoken answers to virtually all the health issues raised in the series involve huge federal intervention, yet the subject of cost is completely ignored. The show's logic calls for radical social and economic policy changes, yet it never clearly says so. In the end, it demonstrates what we already know about health: that money, education, and environment change everything.