The impact of Socioeconomic Inequality on Human Health in Canada In most of the world's developed nations, including Canada, economic inequality has been on the rise since the 1980's. Structural inequalities generate poverty from the unbalanced distribution of social and economic resources. Research has shown that, despite universal healthcare, income inequality and poverty are linked to poor health. This has become a critical issue for Canadians and as the socioeconomic gap continues to widen, so do the barriers to good health. It is important that Canadians realize the importance of decreasing the income gap and eradicating poverty. This paper will demonstrate that poverty and income inequality have a significant impact on the health of Canadians living below the poverty line.
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This essay will explore the impact of income inequality and poverty on the health status of Canadians in the low-income category. There is a plethora of literature and documentation to support the detrimental impact living in poverty has on both physiological and mental health. Income inequality, which generates poverty, is a product of the decisions made by governments and policy makers. Marginalized groups and vulnerable individuals tend to be the most affected. An overview of Canada's socioeconomic framework will be provided through a sociological lens. The four major theoretical perspectives in sociology including structural functionalism, social conflict theory, feminism and symbolic interactionism will be applied. Recommendations for addressing poverty and poor health are provided.
The rise in income inequality and poverty has led researchers to recognize that socioeconomic status has a significant impact on health status. Shimmin (2015) reported that the "World Health Organization has declared poverty the single largest determinant of health". According to structural functionalists, economic inequality benefits society as it ensures the best people, the rich, rise to the top. This enables them to acquire all that is necessary to achieve optimal health and life expectancy, supporting the adage, 'the wealthier, the healthier'. Health is the reward and the incentive for those that are most qualified. Whereas, the poor, who are less worthy, remain at the bottom and inevitably, are less healthy and live shorter lives. Furthermore, socioeconomic status divides the population and creates a dominance hierarchy leading to a contributor to poor health; chronic stress. Rowlingson (2011) stated that, "income inequality is harmful because it places people in a hierarchy that increases status competition and causes stress" (p. 37).
Social conflict theorists suggest that this competition driven system, combined with structural barriers, is what creates and perpetuates the inequality. Individuals trapped in poverty have limited social mobility making it difficult to break the cycle of poverty. Although structural functionalists may argue that poverty is the result of individual choices, other factors beyond one's control impact social mobility. Individuals with low income status have limited resources that greatly affect their ability to achieve best health outcomes. Furthermore, according to Max Weber, socioeconomic status is derived from both class and status group membership. Economic inequality increases when overlapped with other inequalities such as race or gender suggesting that other sources of inequality, such as race and gender, play a significant role in economic inequality (Corrigall-Brown, 2016).
Changes in the global economy have taken a toll on the increasing number of single parent households. These families are finding it increasingly more difficult to maintain a sustainable standard of living. Women are more vulnerable as they have less access to resources and equal opportunities. Research has shown that women earn far less than men and are more likely to live in poverty supporting feminist theory that poverty is gendered. Furthermore, Canada places 17th amongst industrialized nations with 59.2% of poor children living in households with single parents (Guttmann, 2001, p. 509). Poverty increases the likelihood of poor health as women struggle to provide nutritional foods, optimal healthcare, safe living conditions, and physical activities.
Symbolic interactionism suggests that people do not learn their roles as intended by society, rather their roles are constructed by interaction. They develop the definitions and reality of their situation and become part of a social group. The poor tend to lead their lives in silent desperation and search for a way to cope with their poverty leading them to choose friends and partners with the same socioeconomic status perpetuating the cycle of poverty. Poor health makes it difficult for adults and children to cope and learn, further perpetuating the cycle. Moreover, poverty causes chronic stress generating a multitude of social and mental health issues that influence a person's quality of life. Wilkinson & Pickett (2010) found a strong association between poverty and obesity, mental illness, drug abuse, and low social mobility (p. 494).
Researchers have proposed various mechanisms that affect health. Veugelers & Yip (2003) argue that, "Poor lifestyle habits such as smoking, poor diet, and physical inactivity are more prevalent in lower socioeconomic groups" (p. 424). The foundation for good health requires a good income to provide decent housing, healthy food, knowledge, education, safety and strong social connections. Furthermore, lower socioeconomic groups propensity to engage in preventative healthcare such as scheduled doctor visits and recommended screenings tends to be much lower. Mobility is an important factor whereby low-income individuals struggle with taking the necessary time off work for medical appointments or find it difficult to travel long distances to visit a specialist. Additionally, disparities in health are increased by financial barriers that limit the ability to purchase out-of-pocket drugs and healthcare services.
In order to improve the health of Canadians living in poverty, Canadians must advocate against poverty as it affects society as a whole. Poor health can impact an individual's productivity resulting in financial losses to them and society. Governments at all levels can improve the opportunity for better health by providing better education. Health education builds one's knowledge, skills and generates positive attitudes toward health. Furthermore, health education can enable individuals to cope with social, mental and emotional health issues. It is essential that individuals are motivated to improve and maintain a healthy lifestyle. It is equally important to recognize the importance of prescribed medication, medical specialists and recommended screenings. Veugelers & Yip (2003) found "…services were comparatively less used in lower socioeconomic groups, while their need is again expected to be higher" (p. 427).
In order to reduce poverty, governments must tackle the structural causes of socioeconomic inequality by enacting policies to control and reduce the growing inequality gap.
Economic equality is an essential ingredient for the physiological, social and mental health of all Canadians. Lynch et al (2004) state that "what matters in determining mortality and health in a society is less the overall wealth of that society and more how evenly wealth is distributed" (p. 8). Equal distribution of wealth must start with increasing the dismally low minimum wage and providing women and marginalized individuals with fair wages and job opportunities. Furthermore, corporations must be forced to pay their fair share of taxes. Taxes that can be funneled to finance health educational programs and eliminate the cost of out-of-pocket medical services to low-income individuals.
The detrimental effects of poverty and income inequality extend well beyond the health of Canadians. Poverty is a profound, complex problem that Canadians must no longer ignore.
Vast research supports that socioeconomic inequality creates a low-income class that face the consequences of poor health. Despite a universal healthcare system, deprivation of information, funds, access to specialized health services, and many additional factors all contribute to poor health. The four major theoretical perspectives in sociology provide a better understanding of the issue and, in order for things to improve, structural factors must be addressed to close the socioeconomic gap. Canadians must acknowledge that the health and mortality of a society is primarily determined by the equal distribution of wealth and not absolute wealth. Decreasing poverty and increasing health status will benefit all Canadians.
Corrigall-Brown, C. (2016). Imagining Sociology: An Introduction with Readings. Don Mills, ON: Oxford University Press.
Guttmann, A. (2001). Child poverty, health and health care use in Canada. Paediatrics & Child Health, 6(8), 509-513. Retrieved from https://doi.org/10.1093/pch/6.8.509
Lynch, J., Smith, G. D., Harper, S., Hillemeier, M., Ross, N., Kaplan, G. A., & Wolfson, M. (2004). Is income inequality a determinant of population health? Part 1. A systematic review. The Milbank quarterly, 82(1), 5-99. Retrieved from https://doi.org/10.1111/j.0887-378x.2004.00302.x
Rowlingson, K. (2011). Does Income Inequality Cause Health and Social Problems? Joseph Rowntree Foundation. 1-51.
Shimmin, C. (2015, April 15). We need to talk about poverty and human health. The Toronto Star. Retrieved from https://www.thestar.com/opinion/commentary/2015/04/15/we need-to-talk-about-poverty-and-health.html
Veugelers, P.J., and Yip, A.M. (2003). Socioeconomic disparities in health care use: Does universal coverage reduce inequalities in health? J Epidemiol Community Health, 57, 424-428. Retrieved from https://doi.org/10.1136/jech.57.6.424
Wilkinson, R., & Pickett, K. (2010). The Spirit Level: Why Equality Is Better For Everyone. London: Penguin.
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