Living here in Australia, we tend to take for granted the relative freedom, safety, comfort and wealth we have relative to many parts of the world.
So just for a moment, stop and think about the 2 billion plus people living in poverty across the world! Why is it that we live healthier lives than they do? Why is it that we have significantly longer life expectancies? A range of factors in fact: disparities in infrastructure, healthcare, education and of-course, gross income have significant connections to overall health outcomes in a population.
But what is health? The definition of health has evolved greatly as our understanding of what influences health has improved. It has become glaringly apparent that health is not just the outcome of genetic or biological processes, but is also influenced by the social and economic conditions in which we live. These influences are known as the social determinants of health.
You might then assume that the wealthiest nations are the ones with the best health outcomes; this is anything but the truth.
The USA , with the world’s highest GDP of 17.4 trillion USD (IMF World Economic Outlook October 2014) has a life expectancy of only 79 (WHO World Health Statistics 2014) compared to Australia’s 83 with a GDP of 1.4 trillion USD. Perhaps one would argue that this is because Australia has a higher GDP per capita. What if we look at the USA compared to the Czech Republic? The USA has a GDP per capita of 54.7 thousand USD, while the Czech Republic has one of 19 thousand USD, yet despite this drastic difference, the life expectancy of the Czechs averages at 78, only one year less than that of the USA. A small difference maybe, but a significant one nonetheless, and shows that a nations health is not directly related to its wealth.
What is the cause of this disparity? The social determinants of health can possibly explain this through inequalities that exist in a country such as the USA which are less pronounced in a country such as the Czech Republic, or Sweden. These factors are described in the World Health Organisations (WHO) definition of social determinants as “the social conditions in which people live [which] powerfully influence their chances to be healthy… factors such as poverty, food insecurity, social exclusion and discrimination, poor housing, unhealthy early childhood conditions and low occupational status are important determinants of most diseases, deaths and health inequalities between and within countries”.
Indeed, when comparing these factors in the US compared to the Czech Republic, we can see why the US presents with poorer health outcomes relative to their stronger economy. In the US 15.1% of the population live below the poverty line compared to the Czech Republics 9%, not only does this drastically lower the health of that group (it is well known that poverty and poor health go hand in hand), but it also affects the health of the whole population, as a larger population stricken by poverty means weaker social cohesion, which often grows stress, fear, greed, violence and crime, all of which negatively affect health outcomes.
Poverty is a highly influential factor of inequality on health, so much so, that year after year its reduction is made an important goal for global health organisations such as the WHO, and it is important that we as capable and blessed people do everything we can to assist those in need, not just in poverty stricken countries such as in Africa, but in your own communities and cities.
It is also important to consistently remind the government of the plight of the less fortunate, as the mouths of the rich are always at the governments ear for their own benefit. Should you see inequality in your own nation, let your government know! Let your representative bodies know! In Australia there exists much inequality between the Aboriginal People of Australia, and the non-Aboriginal People of Australia. It is up to each and every one of you to remind the government to make the closing of the gap a top priority, as the spill over effects from the reduction in inequality and improvement of social cohesion would be significant in improving national health outcomes.
The issue is not just one between rich and poor, but that bridging the levels of inequality across a range of indicia within a nation are vital in improving the health outcomes within it.
For now , here is a TED talk which puts things into perspective and shows us just how important minimizing inequity is !
Leave a comment if you agree or disagree with what has been said, as feedback and debate on the matter are encouraged and appreciated!