Richard Rathe, MD

Associate Professor of Family Medicine (ret.) and Medical Informatician

Health and Human Society

By •• Posted in Medicine

Source: Am Scientist

While searching for something else, I came across this important article from 2001 by Clyde Hertzman concerning the relationships between wealth, society, and health. One graph from the article says it all—the United States is deep in the “worse outcome, higher expenditure” quadrant. The author begins by defining the Socioeconomic Gradient as the relationship between social status and health…

The average health status of members within every society on earth increases in a stepwise fashion as one ascends from the bottom of the social ladder (defined, variously, by income, education or occupation) to the top.

He argues that the slope of this gradient depends on several non-healthcare factors within each society. The specifics of healthcare delivery and healthcare systems are less important!

Here is a summary of his conclusions with respect to wealthy countries…

  1. Increased life expectancy and other measures of health do not correlate with increased wealth.
  2. The character of the socioeconomic environment has a strong effect on health outcomes.
  3. Societies that are more socially just and egalitarian have better overall health outcomes.
  4. These factors determine the slope of of the socioeconomic gradient (the “spread” in health outcomes).
  5. To be effective, health policy should focus on flattening this gradient.
  6. In the modern world, socioeconomic boundaries are much more important that geographic boundaries when it comes to disease.

Food for thought as we move forward with “Healthcare Reform” in the US.

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