Effects of Income Inequality on Quality of Healthcare Essay

Positive rights are rights that everyone is entitled to including: the right to a public education, access to public roads, and the right to health care. There are no guarantees when it comes to life, but having health insurance makes a huge difference with preventing, diagnosing, and treating diseases. Of course having insurance itself is a great resource to ensure medical care and containing costs, but not all insurance programs are created equal. Insurance programs have caveats, exclusions, varying co-payments, and access to certain doctors and hospitals, which creates an ethical dilemma. Receiving the best care is subjective in most cases, but with money you can buy almost anything, including the best care. Although those living in poverty are given access to healthcare, that does not mean they receive the best or equal care as those who are wealthy.Effects of Income Inequality on Quality of Healthcare Essay

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Public health workers have long been witness to the inextricable links between poor health and poverty. Science consistently shows that low incomes are a significant risk factor in disease incidence and severity as well as life expectancy.

For example, in a study published in April in the Journal of the American Medical Association that examined more than 1 billion U.S. tax records from 1999 through 2014, researchers found that higher income was linked with longer life, with differences in life expectancy across income groups increasing over time.

In particular, the study found that the gap in life expectancy between the richest 1 percent and poorest 1 percent was more than 14 years for men and more than a decade for women. Inequality in life expectancy increased as well, with men and women in the top 5 percent of income distribution gaining about three years of life expectancy, while those in the bottom 5 percent gained virtually no additional years of life.Effects of Income Inequality on Quality of Healthcare Essay

However, the effect of income on health is much more nuanced than the divide between the richest and poorest Americans.

“Research also shows that at all levels of income, our health is affected by economic conditions, so even middle-class and upper-middle-class people are in worse health than richer people,” said APHA member Steven Woolf, MD, MPH, director of the Virginia Commonwealth University Center on Society and Health. “We’re all in this together — it’s not a problem restricted to the very poor.”

While higher incomes and wealth are linked to better health within the U.S., their protective nature does not perform as well in a global context. Woolf co-authored a 2013 report from the National Academies of Sciences, Engineering and Medicine that compared Americans’ health to counterparts in 16 other high-income nations, finding that Americans typically die sooner and incur higher rates of disease and injury than many of their peers. In fact, the report found that even rich Americans are less healthy than their global counterparts.Effects of Income Inequality on Quality of Healthcare Essay

Woolf noted that the reasons for such global difference are not entirely clear. But he said one contributor may be the growing gap between the high- and low-income people in the U.S. — otherwise known as income inequality. For instance, the “2015 County Health Rankings” report, which included income inequality measures for the first time, found that the unhealthiest counties also had greater income inequality.

“Unfortunately, I think the public health community is often marginalized in these discussions (about income) because we’re not often at the table where these discussions are happening,” Woolf told The Nation’s Health. “We have to get better at understanding the audience we’re talking to and raising awareness of health issues in a frame that makes sense to other sectors.”Effects of Income Inequality on Quality of Healthcare Essay

One of the more obvious ways to address income inequality is by raising the minimum wage, an issue currently at the forefront of national debate and finding success in states and localities across the country. In 2015 alone, 14 cities, counties and states passed a $15 minimum wage. The federal minimum wage still sits at $7.25. And as policy efforts on the minimum wage move forward, so too has the public health science. For instance, in a study published in June in APHA’s American Journal of Public Health, researchers found that if New York City’s minimum wage had been $15 between 2008 and 2012, 2,800 to 5,500 premature deaths could have been averted, with the majority of such prevented deaths realized in low-income communities.Effects of Income Inequality on Quality of Healthcare Essay

U.S. income inequality has been increasing for decades, and there are large wage gaps by gender, race and ethnicity, according to the Pew Research Center. Hispanic men earned $14 an hour in 2015, compared to $15 an hour for black men and $21 an hour for white men. Women’s wages lag behind men across the board, both when compared to white men and men in their own racial and ethnic groups.

Income inequality also persists by occupation. While retail sales workers and cashiers account for the largest occupations in the U.S., at 4.6 million and 3.5 million people, respectively, they are also low-paying jobs, according to the Bureau of Labor Statistics. As of May 2015, retail sales workers earned $26,340 annually and cashiers earned $20,990. Fast food and counter workers, another popular occupation, earned just $19,820 a year. The largest occupation with an above-average wage was registered nursing, in which workers earned $71,000.Effects of Income Inequality on Quality of Healthcare Essay

“Many people think the top three determinants are education, occupation and income,” said APHA member J. Paul Leigh, PhD, a professor of health economics at the University of California-Davis. “Over the past 40 years, median years of schooling for Americans have been increasing. Occupational injuries and diseases have been decreasing. But wages have been stagnant, and for those with only a high school education or less, inflation-adjusted wages have been dropping. Income inequality has been getting much worse. So these are good reasons to now focus on wages and incomes.”Effects of Income Inequality on Quality of Healthcare Essay

Leigh noted that people’s health is affected by where they fall along the income gradient. For instance, he pointed to the landmark Whitehall studies first published in 1978 that followed British civil servants over many years. Led by Michael Marmot, PhD, MPH, MBBS, chair of the World Health Organization Commission on Social Determinants of Health, the studies found a person’s relative risk of poor health and disease increased as socio-economic status decreased.

In the Journal of Occupational and Environmental Medicine in May, Leigh said that low wages should be considered a psychosocial occupational health hazard.Effects of Income Inequality on Quality of Healthcare Essay

“I believe income inequality rivals smoking and obesity in terms of its effects on overall health,” Leigh told The Nation’s Health. “We need researchers in public health to take a deeper look at the role of wages on health. And then, hopefully, advocates can use those studies to improve conditions.”

Income inequality also causes obesity however; we mostly blame individuals for being obese. Being obese can have a serious impact on mental and physical health. it is an illness that is associated with stereotypes. The biggest one is “if poor people become obese they cannot be not poor”. People in this mentality also exclude the structural and social conditions that cause illnesses such as obesity. Social life affects the health of people, especially the socioeconomic level. How much you earn monthly is a factor how fit you are. The risk of being an obese is lower for the wealthy individuals. Poor people are obese because they have no money to buy healthy food, they have no time to exercise, they have stress that causes them to eat constantly, they lack education, they do not have access to the healthcare, they do not have social support and so on. It is mostly about the income inequality.Effects of Income Inequality on Quality of Healthcare Essay

Living in a capitalist society, the richest Americans enjoy larger homes, nicer cars, better education and even health care. Even if we lived in a capitalist society where everyone had access to the same basic healthcare program, the rich would still be able to afford better care. The wealthy are able to pay more in co-payments, prescription costs, and the ability to go outside of the healthcare system in this country to seek help. When you have the disposable resources then the sky is the limit, where the poor have very limited options. They will be confined to their healthcare coverage program and do not have the luxury of seeking additional assistance. “Poor patients often receive less quality care in the hospital, have more barriers to recovery, and experience higher morbidity and mortality than do patients with higher incomes” (Dracup).Effects of Income Inequality on Quality of Healthcare Essay