poor social housing

Why is wealth important as much as health? what’s the link?

Wealth although not directly linked to health and longevity is also an important factor to consider. Wealth and how we spend our hard-earned cash is in a way a determinant of health and increasing household income is related to better health outcomes. This social determinant although sometimes ignored by public health authorities is becoming increasingly more important.

As countries develop so does the gap in health inequality.

In today’s world the richest among us live a life that is unparalleled while the poor are increasing as housing is getting more expensive and salaries are staying low. why is this happening?

Most ancient societies used to live on a meal to meal basis and had little time to worry about aesthetic and material goods. Most societies in the past were very rural-based and had little time to devote to other activities. The wealthiest person in the tribe probably was an elder or a chief. With the development of technology, we started to move from the middle ages feudal system and started living a better quality of lives.

As we move to ever increasing wealth discrepancy the open market forces push the ones in the top 1% even higher while leaving the others behind.

People from low socioeconomic backgrounds in fact have a higher risk of overall morbidity and mortality[1]

“Epidemiologic studies using a variety of SES measures have consistently shown that, in the general population, mortality risk increases as SES decreases (2,3). Furthermore, there is evidence that the influence of SES is cumulative over an individuals’ life [4]”

Wealth and overall mortality by age groups
Figure 1. Mortality rate (per 1,000 person-years) by age group for each site among women. [adapted from: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001179]

The above graph shows the association between age groups and overall mortality between different countries and locations. Between 2003 and 2005, a survey conducted on people aged 65 years and older living in Latin American, China, and India. After around three to five years the vital status of 12,373 participants was determined. The deaths were recorded and relatives questioned about the causes.

The crude mortality rates varied between 27.3 per 1,000 person-years in urban Peru to 70 per 1,000 person-years in urban India.

A three-fold difference in mortality rates seemed to persist (even after allowing for differences in age, sex, education, occupational attainment, and number of assets). When compared to the US, mortality rates were found to be much higher in urban India and rural China and much lower in urban and rural Peru, Venezuela, and urban Mexico; but similar elsewhere. Out of all socioeconomic factors associated with mortality a higher education status provided consistent and independent protection.

The main factors affecting the low socio-economic backgrounds consistently are related to chronic diseases such as stroke which was the leading cause of death at all the sites. [5]

What is the link between economic status and obesity?

The global increase in the prevalence of obesity is a public health challenge as this is associated with overall health and mortality risks (6) and increased health care costs(7).

The first to notice this association was Stunkard who in his review found a link between socio-economic background and obesity rates. Stunkard was also among the first to notice that obesity was more common among females in low socio-economic classes when compared to males within that same class(8).

But why does social class effect obesity rates?

obesity and the effect on health

Studies show that social class might determine obesogenic behaviors, such behaviors include plate size or portion, uncontrolled eating, eating low-quality foods that are cheap and easily available, and late-night eating. These behaviors were shown to be major contributors to obesity. [9]

Low social status which is often associated with lower household incomes results in an increased risk to children. As children living in poor income household face poorer nutritional choices and have higher obesity rates this poor nutritional status can impact their cognitive abilities as adults. [10]

poorer cognitive development can lead to poorer outcomes like mental health, peer groups and relationships and overall quality of life that will significantly effect the overall quality of living when they are adults.

The dangers related to obesity are huge and it does not just relate to looks and clothes size but has repercussions to the overall standard of living and quality of life and the quality of those years lived.

How can we target wealth?

as seen in studies education is still the sole determinant of health outcomes. if we educate parents, patients, children by providing free education services and nutritional advice we can create a healthier and happier society.

The solution is simple however not easy to implement as these discrepancies tend to fall on deaf ears! Awareness and promoting education to help low social classes manage their wealth better might help cut down the overall burden of disease and reduce a countries healthcare costs. !!

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