Summary: While the relationship between poverty and health outcomes are clear, the overall level of class inequality (i.e. the relative gap between the rich and poor) also shapes health outcomes and this relationship tends to be less intuitive. For example, we know that people with low incomes in the US often lack health insurance, cannot afford to pay for medical treatments, lack education associated with better health, and so on. However, regardless of the level of a person's income, the gap between a person's income and the upper tier of society also affects health outcomes in unique ways. This PBS video examines this complex relationship. For example, drawing upon medical researcher Michael Marmot's The Status Syndrome: How Social Standing Affects our Health and Longevity (2004) it documents the link between high status differentials, stress, and health. In highly unequal societies, individuals judge each other more by status and feel more judged by others. Richard Wilkinson, quoting from his research (with co-author Kate Pickett) in The Spirit Level: Why Greater Equality Makes Societies Stronger (2010), notes a strong correlation between high income inequalities in a society and many negative social factors, including health, more violence, drug problems, child well-being, and mental illness. It tells the story of one high school student who is from a poor area and was able to test into a high-achieving school attended by mostly wealthy students, but shows how much stress she experienced in comparing herself to other students. In each of these instances, the emphasis is not on the lack of resources, but rather how the extent of inequality within a society leads to health outcomes in unique ways. The video also explores racial differences in one health outcome: high blood pressure. While some famous commentators have incorrectly argued for a biological explanation, the video links this to social factors. It notes that this racial disparity exists in the US but, when we look globally, black individuals have high blood pressure rates similar to whites. The biological explanation of racial differences in health outcomes has been soundly refuted. At the end of the video, commentators debate possible positive dimensions of inequality. While one poor African-American student and an economist argue the inequality gave motivation to work harder, Wilkinson argues against this interpretation.
Submitted By: Paul Dean