Income Inequality: Its Impacts on Health

Over the millennium, researchers, scientists and governments have moved very far when it comes to the public health care provided. With education and high dominance of technology, mankind has developed marvels which ease the treatment and medication of those who are unhealthy. Although this strategy of development has been a blessing, it did not improve health outcomes due to other contributing factors including income inequality still poisoning the overall population health. Many researchers concluded that many diseases can be linked to economic inequality and that poverty and health outcomes do go hand-in-hand. There have been many World Leaders, for instance, the US President, UK Prime Minister, and the Pope, who stated that income inequality is one of the most important problems encountered in our time (Pickett & Wilkinson, 2015). There have been many studies which concluded the positive relationship between socioeconomic status and health outcomes, that is those who are at the top of the social ladder tend to experience a better health that those who are at the bottom (Präg et al., 2013). The idea that higher class individuals enjoy a healthier life compared to individuals who are from a poor family background, is nearly a universal one as the idea has been displayed in historical sources which studied the Egyptians and Greeks, and also comparative sources in which it is revealed that the association of income inequality and health is present in all countries (Präg et al., 2013). Due to high levels of income inequality, many individuals, especially those who are from a lower-class background, have developed severe health outcomes-obesity, lower life expectancy, depression, just to name a few-unreasonably because of the decrease in social cohesion, increase of social comparison and insecurity, and financial constraints opposed.

Income inequality has brought upon great geographical and financial barriers for those who have a low-income facility. Poor people tend to live in largely disadvantaged areas where they are being exposed to social determinants of health and have difficulty to access healthcare. It has been found that residential segregation between the rich and poor is the result of income inequality in many countries and those living in deprived neighborhoods have a poorer health because they are being disadvantaged of not getting interactions in a healthy environment (Pickett & Wilkinson, 2015), including access to latest health technologies or even access to healthy food and potent water. Due to this financial barrier and residential segregation, these people are more likely to be subjected to crimes and homicides (Pickett & Wilkinson, 2015). Children living in poorer areas were found to be more likely suffering from weight, dental and language problems while adolescents tend to have more health problems such as being inured more often or being overweight (Apouey & Geoffard, 2013). There have been suggestions that negative health outcomes are higher in rural areas. This is because rural individuals, especially students, tend to ignore education and they are more likely to adopt unhealthy behaviors (Long et al., 2018). In the United States where there is a higher income inequality at the state-level, obesity and lower physical activity were common when examining the behaviors of adolescents, while in Brazilian municipal areas where there is a high degree of income inequality, adolescents were observed to have the worse oral health (Quon & McGrath, 2014). Long et al., (2018) suggested that to reduce health outcomes, more intervention and awareness should be conducted in rural areas or deprived areas by tackling environmental exposures.

With an increase of income inequality, individuals are more likely to develop the concept of social comparison in their minds, that is they tend to compare their own opinions and behaviors with others like their peers or kin. With social comparison, individuals, as a consequence, may develop health problems, especially when they compare social status (Pickett & Wilkinson, 2015) and this is because the person tend to face materialistic deprivation, for instance, limitations at home, school, and leisure (Quon & McGrath, 2014). Through a study in Sweden, it has been observed that economically disadvantage adolescents who could not afford their leisure activities, tend to develop mental health symptoms (Kim & Hagquist, 2018). Social comparison may also result in the individuals, acquiring norms, values and unhealthy behaviors, for instance the use of alcohol and cigarettes or even pursuing a strict regime and diet unnecessarily (Präg et al., 2013). In addition to the adopted norms, the individuals increase their chances to get ill and moreover, if latter cannot afford same, he or she can develop the misconception that he or she is economically unfit to attain good health. Many are conscious that they are better than others and this state of mind increases self-esteem and reduces anxiety, but on the other hand those, especially a person with little income, may feel inferior, that is in a low position, and this leads to the decrease in self-esteem and causes of stress (Präg et al., 2013).

Since society has been divided into strata and is always dynamic, every member is thriving to achieve a higher position on the social ladder by improving their income. Individuals are constantly competing for status and prestige and if they fail in the status competition, they tend to develop chronic stress by taking into consideration their failures (Präg et al., 2013). From studies of neuroscience, it has been deducted that since income inequality diminish a sense of social cohesion and generalized trust among members of society, income inequality is being considered as a social stressor which affects health and behavioral outcomes (Pickett & Wilkinson, 2015). Chronic stress is viewed as a fatal illness as it can in turn impairs blood pressure regulation or even contributes to the development of cardiovascular diseases. In many studies, individuals from a poor background have developed externalizing mental issues due to income inequality in society and deprivation, and these individuals tend to experience hyperactivity and property offences (Quon & McGrath, 2014), for example, bullying and juvenile homicides. Mental illnesses, such as depression, schizophrenia and psychotic symptoms, have a high prevalence in societies who face a high extent of inequality (Pickett & Wilkinson, 2015). In a society with more income inequality, there is the promotion of status competition and also integration of the social ladder where there is a strong division between classes, there is a clear picture of income inequality being a social determinant of health (Präg et al., 2013).

Many will argue that income inequality is not reflected as a health risk factor, because many nations including Canada and USA has opted for a free healthcare system where every individual gets equal access to healthcare. Despite the policy of free healthcare services has been emerging, income inequality still remains a threat to the population health. Many proposals have been made in regards of the unavailability of material living conditions, such as strenuous physical labor and less healthcare access, which has a negative impact on the health of the poor, but societies experiencing income inequality lack many resources and capital to invest in fields, such as education and public health (Präg et al., 2013). By analysing 11 studies on clubfoot, it has been found that in low and middle-income countries, health professionals lack specific equipment and space to attend patients, and also there is a shortage of labor force and healthcare professionals do not have the required training and qualifications to treat patients suffering clubfoot (Drew et al., 2018). Biggs and colleagues observed that in 22 Latin American countries, there is a significant relationship between income inequality, life expectancy, infant mortality and tuberculosis mortality rates, and they reported that since income inequality is on its rise in these countries, there is an underinvestment into health care occurring (Pickett & Wilkinson, 2015).

Income inequality has wrought havoc in the population health and also has compromised many countries’ public health policy. There has been a presence of strong association between family income and child’s general health in France and same has been observed in countries like Canada, Germany, and the UK despite having implemented healthcare accessible to everybody (Appouey & Geoffard, 2013). Governments and public health organizations should find corrective measures which would be the beacon of hope to eradicate income inequality risks to health as it is spreading like wildfire in many countries.

References:

• Apouey, B. H., & Geoffard, P.-Y. (2014). Child health and access to health care in France: Evidence on the role of family income. Revue d’Épidémiologie et de Santé Publique,62(3), 179-190. doi: http://dx.doi.org/10.1016/j.respe.2013.12.087
• Drew, S., Gooberman-Hill, R., & Lavy, C. (2018). What factors impact on the implementation of clubfoot treatment services in low and middle-income countries?: A narrative synthesis of existing qualitative studies. BMC Musculoskeletal Disorders, 19, 72. doi: http://doi.org/10.1186/s12891-018-1984-z
• Kim, Y., & Hagquist, C. (2018). Mental health problems among economically disadvantaged adolescents in an increasingly unequal society: A Swedish study using repeated cross-sectional data from 1995 to 2011. SSM- Population Health, 6, 44-53. doi: https://doi.org/10.1016/j.ssmph.2018.08.006
• Long, A. S., Hanlon, A. L., & Pellegrin, K. L. (2018). Socioeconomic variables explain rural disparities in US mortality rates: Implications for rural health research and policy. SSM – Population Health, 6, 72–74. doi: http://doi.org/10.1016/j.ssmph.2018.08.009
• Pickett, K. E., & Wilkinson, R. G. (2015). Income inequality and health: A causal review. Social Science & Medicine,128, 316-326. doi: https://doi.org/10.1016/j.socscimed.2014.12.031
• Präg, P., Mills, M., & Wittek, R. (2014). Income and income inequality as social determinants of health: Do social comparisons play a role?. European Sociological Review, 30(2), 218-229. doi: https://doi.org/10.1093/esr/jct035
• Quon, E. C., & McGrath, J. J. (2015). Province-level income inequality and health outcomes in Canadian adolescents. Journal of Pediatric Psychology, 40(2), 251-261. doi: https://doi.org/10.1093/jpepsy/jsu089