Income Inequality: The Real Cause of Poor Health

Contrary to popular belief, the primary determinant of your lifelong health status and life expectancy has nothing to do with your weight, fitness level and whether you smoke. According UW epidemiologist Dr Stephen Bezruchka, the most important determinant of your adult health status is your mother’s income level when you were born. Lifestyle factors (including smoking) only account for 10% of illness.

More than fifty years of epidemiological research bear this out. Yet it’s only in the last decade scientists have learned why this is – thanks to the new science of epigenetics. The term refers to changes in gene expression caused by external influences.

The stress of poverty causes an increase in maternal stress hormones, which causes variations in the way genetic code is transcripted into proteins and enzymes. These, in turn, can predispose the fetus to insulin resistance, obesity and immune problems, as well as emotional instability and mental illnesses.

The Link Between Income Inequality and Poor Health

The most important research finding, according to Bezruchka, is a more pronounced effect in societies plagued by income inequality. Study after study bears this out. In other words, a poor person’s health will be worse in a society with a wide gap between its rich and poor residents.

The US, which has the most extreme inequality, is near the bottom of the charts for indicators that measure a nation’s overall health. In life expectancy (according to the CIA), the US ranks 50^th, just behind Guam. In infant mortality, it ranks 174^th, between Croatia and the Faroe Islands.

A Mindset Driven By Social Service Cuts

In Sick and Sicker, Dr Susan Rosenthal notes a 30 year trend for policy makers – both conservative and liberal – to make sick people “take responsibility” for their illnesses. Epidemiological studies – as long as scientists have been doing them – have always shown a correlation between poverty and poor health. Even in Dicken’s time, it was taken for granted that the undernourished poor people living in cold, damp, overcrowded tenements were far more prone to illness than their middle class counterparts.

Rosenthal believes this shift to a “blame the victim” mentality has been deliberate – to justify aggressive social service cutbacks (by both Republicans and neoliberal Democrats like Clinton and Obama) that came into fashion with Ronald Reagan’s election in 1980.

The Role of Oppression and Exploitation in Illness

Although the link between poverty and inequality is unequivocal, epidemiologists have yet to explain why the effect is poor pronounced with extreme income inequality. Bezruchka puts it down to people in egalitarian societies looking after one another. I like Rosenthal’s explanation better. She relates it to high levels of oppression and exploitation in societies with extreme income disparity.

She points out that minimum wage workers aren’t just poor. They also work in exploitive, arbitrary and often punitive job settings which they feel powerless to change. Enduring this massive stress on a daily basis takes an enormous toll on the human body and psyche.

photo credit: AJC1 via photopin cc