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Income Disparity and Social Determinants of Health

When looking for a topic to blog on, I stumbled upon a Ted Talk given by Richard Wilkinson titled the “How Economic Inequality Harms Societies”. Throughout his talk Wilkison discusses the social effects of income inequality and how social forces affect health. He illustrates this with statistical evidence that among developed countries, societies that are more equal (with a smaller income gap between rich and poor) are happier and healthier than societies with greater disparities in the distribution of wealth.

As a point of reference, please watch his talk here:

In his talk, Wilkison states, “the average well-being of our societies is not dependent any longer on national income and economic growth. … But the differences between us and where we are in relation to each other now matter very much.”

I feel these factors are fundamental social determinants of health. According to the World Health Organization (WHO) the social determinants of health are “the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.”

Poverty data explains what is going on at the bottom of the income ladder. But it is also important to understand the distribution of income, particularly as it relates to its effect on health and well-being. Wilkinson demonstrated that societal well-being bears no relation to per capita income.  He found that the symptoms of inequality trouble all levels of society. Across the board, mental health, levels of violence and addiction, even life expectancy are affected by the psycho-social stress caused by income gaps and status anxiety.

Among developed nations such as Canada, highly significant differences in health status indicators such as life expectancy, infant mortality, incidence of disease, and death from injuries exist. An excellent example is comparison of the social determinants of health differences among Canada, the United States, and Sweden.

Scholarship has noted that the USA takes an especially laissez-faire approach to providing various forms of security (employment, food, income, and housing) and health and social services while Sweden’s welfare state makes extraordinary efforts to provide security and services (Raphael & Bryant, 2006). The sources of these differences in public policy appear to be in differing commitments to citizen support informed by the political ideologies of governing parties within each nation.

What are your thoughts on his presentation? What are social determinants of health that affect your country?

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