From studies done in 2011 to 2013 over how the populations in the more developed countries of the world felt about their accessibility to healthcare, the United States was a leader in many different studies and surveys on multiple access of this inequality. The gap of not only the access but the quality, amount, and precision of healthcare between the rich and the poor in the United States is allowing the nation to be labelled as “a world leader” in healthcare inequality. One of the studies done and published by the Health Affairs noted that the United States inequality gap was one of the world’s largest with only Chile and Portugal (who are far less developed than the entire nation of the US) having wider gaps.
According to the World Health Organization (WHO), there are 5 major causes of these health inequalities. They include (but are not limited to) different levels of power and resources (which then, inversely impacts their degree of personal control over their life circumstances), different levels of exposure to health hazards ( which indicates that some people are at greater risk of experiencing factors that can negatively impact their health- such as poor housing or unsafe working conditions, have high demands or offer little to no personal control), different impacts of exposure to health hazards, different impacts of being sick, and last but not least, different experiences in early childhood years.
Early years of our lives can sometimes be seen as the pathway of how the rest of our lives are going to look. And more often than not, the disadvantage accumulates and is apparent in our much later years. These inequalities sometimes go hand in hand with race, ethnicity, and geography. With the 4th explanation, illness and chronic disease can have a much more different on impact on some groups in society. Hispanic and Natives are much more susceptible to diabetes and neurodegenerative diseases than other races.
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That is then inversely tied with the 3rd reasoning that although the same people might be exposed to the same illnesses, not everyone will respond to them the same way. To better understand this, a source has provided a “staircase” explanation of the inequality gaps. When the source described the situation of the people at the bottom of the staircase, they noted that those people’s accessibility to education is not only low, but the quality of the education they did have access to was inadequate. Not only the education but the housing and food standards were significantly lower than those for the other two staircase steps-the middle and the top social classes.
In the middle class, the resources, food quality, and control over life circumstances are much better than the lowest class. Or at least, they would be able to survive a crisis and not be completely devastated. The bottom class are actually described as being twice as likely to have a serious illness (which they are just as likely to not survive in both health and financial aspects). The middle class would also live a little bit longer than those at the bottom but still die a lot faster than those at the top. The people in the top class have it much better than those on the bottom two steps in all comparable aspects.
They have the best quality of food, housing, best access to a good education, and have the most financial security so that plays into having the longest lives and better health. Now these inequalities are not only tied into financial influence, they go hand in hand with many other disparities. Apart from wealth, disparities such as societal standards, age, race, and gender have contributed to the health inequalities of the classes. In the United States, the majority of the top class (as described in the paragraph above) tend to be skinny, rich, and white. Minorities, such as hispanics and blacks, tend to make up the majority of the other steps in the social staircase.
Parts of the nation have different socio-cultural practices, religious influence, growing populvation (another healthcare inequality: birth control), and market driven policies have thus widened the gap between the rich and the poor when it comes to these issues. With the example of a country that follows socialist mechanisms of how to take better care of its population, such as Canada, the United States trails tremendously. According to the Huffington Post: the nation of Canada provides its people with care distributed by not wealth but according to need. Canadians in the bottom step of the social staircase receive a little over 25 percent more care than those in the top staircase.
The Canadians in the middle step of said staircase receive 11 percent more than those in the top step but the top step isn’t left out. It’s important to note that although the other two steps receive more care, the top step isn’t left in the dark and Canada has done an amazing job of recognizing them. Through multiple studies, America’s ever growing inequality in healthcare and the access of it is reflected in the notably worsening outcomes for those with lesser incomes. Canada has been doing an outstanding job of not only recognizing the gap between the rich and the poor, but also closing it.
While their gap is closing, America’s gap has been steadily widening to the point where the Americans who live in the top step live up to 15 years longer than the bottom step counterparts. For some, that’s a lifetime. In a developed country like the United States, the combination of poor health and health related expenses is what keeps those in the bottom step there. Although there’s not very much access for the poor to obtain health care, those who do receive care are put into burdening debt for many years because most of them are forced to pay out of pocket for the healthcare.
The “double-blow” aspect of this is that inadequate health care can lead to other burdens such as disability, other consequences, or even death. That could potentially deprive a low income household of a source of income and further hurt their economic security. A study done in Texas, that adjusted accordingly with age, between 1900 to 2000 that reviewed the mortality of rural and urban populations suggested that the population that lived in rural areas suffered a lot more than the population in urban areas.
The rural population saw more diseases such as cancer, heart disease, stroke, and other respiratory illnesses compared to its urban population’s counterparts. The study also suggested that blacks suffered more death in metropolitan areas while hispanics saw more death in non metropolitan areas. Another cross-sectional survey saw that many other risk factors and chronic diseases were much more prevalent among the low socioeconomic status population.
Said population saw more obesity, smoking, physical inactivity, and high blood pressure compared to the high SES population. After all this research, one might think that a solution to this inequality is too far to grasp but it really isn’t. The inequality and its consequences are too extensive for a mere essay to capture but the solutions aren’t. There are at least 5 major solutions that have been proposed and some have been implemented to combat this inequality. The first step to fixing a problem would be to admit that there is one. Dr. David Butler-Jones stated: “We cannot rate our collective health and well-being by looking only at those who are healthiest.
We must also consider those left behind.” In that simple quote, he – as Chief Public Health Officer of Canada- recognized his nation’s rich and poor gap and noted that something must be done about it. America should follow suit. One of the solutions to fixing this inequality would be to raise awareness of it. How can we expect people to make change if they don’t understand how bad the current situation is? It’s ridiculous to expect people to understand something that isn’t explained.
Through raising awareness, we can push people to talk to other people who may have more power so they could make change. It’s one thing for those people to discuss the inequality amongst themselves, but it would prove to be more beneficial for them to have those uncomfortable conversations with people who can make a difference. Apart from raising awareness, we could add incentives. With the example of Saint Mary’s University, they implement marianist values into the education of their students.
Some of the courses the students take required service hours to be completed in order for the student to complete their courses. Apart from the students making an immediate difference in the community, they also take with them first hand experience of how bad things in the world are. It could ignite a spark in their character to want to make a difference and once they complete their education, some could use their advantages to help the areas that need it. Another solution could be to follow in socialist nations footsteps. If lawmakers could implement some socialist values into the way the nation is governed, there could be a huge difference.
Not meaning to completely change the democratic values already practiced, but to have more truth in the statement “power to the people”. Speaking of honesty, reforming the government would also be beneficial to nation. Right now, the saying “power to the people” has more advantage towards the rich. With the past election, the socioeconomic gap has been more evident and increasing at an alarming rate. If we were to put more people such as Bernie Sanders in higher positions of power, the gap would be able to start closing.
Taking those politicians who don’t have any knowledge of how things are conducted at the middle and bottom steps out of the government and replacing them with people who do would make some of the biggest changes. It’s impossible for the rich and advantaged to understand the struggles people in the other classes face.
Apart from political reform, reprioritizing the national budget would also be a great change. Right now, the majority of national spending is directed towards defense spending. If we were to take some of the money from defense and give it to programs that benefit the poor and middle class instead of giving the money to an already strong military, we could potentially close the gap. If we were to train policy-makers and health practitioners about how they could make a difference, and increase public understanding through awareness campaigns, we could teach the world of said issue and persuade them to donate/invest/sponsor towards relief efforts for the inequality.
References
- http://content.healthaffairs.org/content/36/6/1032.abstract https://www.washingtonpost.com/news/wonk/wp/2017/06/05/america-is-a-world-leader-in-health-inequality/?utm_term=.99dfa286d5f2
- http://publications.gc.ca/collections/collection_2012/aspc-phac/HP35-22-2011-eng.pdf
- McGehee, M., Hall, S. and Murdock, S. (2004) Rural and Urban Death Rates by Race/Ethnicity and Gender, Texas: 1990 and 2000. Journal of Multicultural Nursing & Health. 10 (2): 13-23.
