April 28, 2009

The Truth about Health and Social Problems

Filed under: Uncategorized — admin @ 3:08 pm

There is a fundamental truth about health and social problems that we in America seem completely unwilling to face up to. It is that the magnitude of the disparity between the income of the wealthiest twenty per cent and that of the poorest twenty per cent in a nation correlates directly with the health of the population (as measured by such things as life expectancy and infant mortality), violence in the society, the quality of education, teenage pregnancy, drug abuse, and many other problems that we seek to address in an ineffectulal and piecemeal way. This is true across the board among the developed nations and between the states in the US.   

Among developed nations the US has the largest disparity between rich and poor. Japan, the Netherlands, Sweden, Norway, Finland have the least. The UK, Australia, Italy, Switzerland and Canada are somewhere in between. If you look at not just physical health but mental health (including drug and alcohol addiction), obesity, childrens educational performance, teenage births, homicides, imprisonment rates, and social mobility the US has the worst statistics, the countries with the narrowest gap between rich and poor have the best. Interestingly while the US prides itself as being the land of opportunity it in fact now offers the poorest opportunity for social mobility. On a scale that measures happiness on the part of the average citizen, while the US ranks relatively high, it is exceeded by Sweden, Australia, Switzerland, Canada, and Norway. Perhaps most important, particularly in understanding why income inequality so impacts these other social issues, Americans have a very low level of trust in their fellow citizens. Those peole who live in the countries with a small gap between rich and poor have a far higher degree of trust. 

                         If we look internally in the US we find the same correlation between rich states and poor states and health and social problems. Those states such as New Hampshire, Wisconsin, Minnesota, Vermont and North Dakota that have the narrowest range between rich and poor also have the best scores on health measures and social problems while states like New York, Alabama, Louisiana, Florida, Texas and Tennessee that have the biggest gap between rich and poor have the worst health, the most violence, the most obesity, the most divorce, the most teenage pregnancies, and the lowest levels of trust among their citizens. With the exception of New York the states with the highest levels of distrust, social problems, violence, poor health, low educational accomplishment were states that mostly voted overwhelmingly Republican in the last presidential election. To learn more and to see the data in far greater detail read the recent excellent book The Spirit Level by Richard Wilkinson and Kate Pickett published by Allen Lane and also go to the website of the World Health organization ( and click on the report of the Commission on the Social Determinants of Health.

                         Unless we as a nation are willing to come to grips with the central role that our skewed economic system has in effecting all these quality of life factors for the population as a whole we will remain at the bottom of the international scale for developed nations by almost every measure. No amount of tinkering around the edges, no amount of health insurance plans, no amount of drug treatment centers, no amount of putting more people in prison, no amount of talking about improving education, no amount of diet or exercise plans will solve society’s problems in this country unless we are willing to addresss the fundamental economic inequality that underpins all these problems.


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© Peter G. Bourne - 2008