One of the things few people notice, or want to make an issue out of, is the relationship between health and wealth. When reading the headlines, one looks for the culprit and not the root cause of the problem. For instance, the Opioids epidemic gets more press than the root cause of the problem — income inequality.
Everything is relative, and while you are living on pretty much the same level as your neighbors you are healthier, and less likely to abuse drugs and be involved in other high-risk activities. If not, you have fewer good choices to make. Income inequality is the leading cause of poor health. It is not access to health insurance and medical care which is paramount but maintaining good health and reducing the possibility of harm.
Therefore in unequal societies, like the United States, you have more sick people than you should. We already know that poor people smoke more, are more subject to violent crimes and are more likely to abuse drugs and die from various unnatural causes, even being murdered. The poorest also pay more regressive taxes, sin taxes, to subsidise the health of those who can afford to be healthy.
It is just as much a matter of where you think you stand in comparison to others. Take a recent study: “the researchers found that people in unequal communities were more likely to die before the age of 75 than people in more equal communities, even if the average incomes were the same.”
This may help explain why the US government is so scared of places where health care is relatively equal for all, as in many social welfare countries and even parts of the United States, like Massachusetts, whose universal health insurance coverage makes it the gold standard for access to care. It’s the last place in the country you’d expect to find, for example, a spike in HIV cases alarming enough to draw the attention of the federal government, regardless of the general lifestyles of its citizens.
It is well-established in the UK, and much of Europe, that there is a nexus between income, life expectancy, social problems and health. Poorer people experience worse health than the wealthy. A large and growing body of research suggests that this is because socio-economic inequality is itself a root or ‘fundamental cause’ of health inequalities and a plethora of social problems.
UK researcher Richard Wilkinson has demonstrated that societies with HUGE income gaps are somehow going wrong. He is emeritus professor of public health at the University of Nottingham and co-author, with Kate Pickett, of The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity and Improve Everyone’s Wellbeing. He has charted the hard data on economic inequality, and shows what gets worse when rich and poor are too far apart: health, lifespan, even such basic values as trust.
The frustrating thing, at least for Americans, is that more equal societies benefit from far superior health and educational outcomes all the way up the income scale, not simply at the lower end. So why is it that the powers that be in the US are not talking about such disparities?
Part of the answer is that it is easier to just provide food stamps and food kitchens as a stop gap measure and pretend that the root cause of the problem does not exist—as the rich get richer and the poor more depressed and sicker.
There are so many programs out there, but do they really want to address public health issues or create political capital for their authors? A few that come to mind include the Supplemental Nutrition Assistance Programs (Snape); Women, Infants and Children Programs (WIC) and other State Government-sponsored schemes which offer nutrition and physical activities to families of limited resources (they arew too scared of the connotations to call them “poor”).
These are sound programs in themselves, which provide a helping hand, but they only treat the symptoms, while the root of the problem lie deeper.
Wake up call!
The research from the UK is most revealing, and should send a wake-up call to politicians and health policy makers in the US. The link between income and inequality is not just about being above or below the poverty line but the distances between us within society, as these in themselves put many stresses on us.
Where we are in relation to each other now matters very much. The general well-being of our societies is no longer dependent on GDP and economic growth. They are very important in poorer countries, but not in the rich, developed world, as Wilkinson explains.
It is not simply that rich parents have rich children and poor parents have poor children. Fathers' income is much more important in more unequal countries like the UK, and the United States. In Scandinavian countries, fathers' income is much less important. There's more social mobility.
As Wilkinson and his researchers would like to say — "if Americans want to live the American Dream, they should go to Denmark.”