Social Determinants: How class and wealth affect our health – The Conversation

Extract from an article by Sharon Friel, Director, School of Regulation and Global Governance (RegNet) and Professor of Health Equity, ANU, Australian National University

Inequities in wealth and income are one of the biggest social, economic and political challenges of our time. It’s important to address these inequities for three key reasons.

Economic costs: Inequity undermines the well-being of a nation’s economy and impedes efficient economic growth. Being financially reliant on and influenced by a small few also builds vulnerability into the economic system.

Social costs: Inequity erodes daily living conditions, wastes human capital and reduces social cohesion. Each of these is necessary for a flourishing, cohesive and secure society.

Health costs: Inequity harms people’s sense of self and prevents access to the conditions necessary for health. Poorer health results in greater health-care costs for the nation.

So how do inequities of wealth and income manifest in Australia? And what are the implications for the nation’s health?

A fair go for health?

Not everyone has a fair go at living a long, healthy and prosperous life. People at the bottom of the social hierarchy tend to have worse health than those in the middle, who in turn have poorer health than those at the top.

This observation, known as the social gradient in health, is seen in countries around the world including Australia. It applies to a number of health outcomes including depression, diabetes, heart disease and cancer.

“Who” you are and where you come from has a remarkable impact on your health. Take Anna’s story, for example.

Anna is 44 years old and lives with her elderly mother in one of the most socioeconomically disadvantaged urban areas in the country. She is quite overweight, smokes a lot and suffers from depression, but is not inclined to visit her doctor.

Like Anna, the poor consistently gain less from health services than the better-off, which leads to untreated disease. This is known as the inverse care law.

SOURCE: Friel, Sharon. “Social Determinants: How class and wealth affect our health.” The Conversation, 1 September 2016.

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