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Social and Economic Disparities in Health: Thoughts about Intervention
Author(s) -
Syme S. Leonard
Publication year - 1998
Publication title -
the milbank quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 101
eISSN - 1468-0009
pISSN - 0887-378X
DOI - 10.1111/1468-0009.00100
Subject(s) - poverty , inequality , destiny (iss module) , intervention (counseling) , psychological intervention , phenomenon , social inequality , economic inequality , disease , development economics , demographic economics , economics , sociology , psychology , economic growth , medicine , psychiatry , mathematics , epistemology , pathology , astronomy , philosophy , mathematical analysis , physics
It is now well established that inequalities in income lead to high morbidity and mortality rates. Certain explanations for this phenomenon are explored: (1) Instead of income inequalities causing disease, the inequalities are determined by powerful cultural forces. (2) The rich get richer and the poor get poorer. (3) Wealthier people can buy the means to protect their health. (4) Poorer people suffer not from poverty, but from relative deprivation. (5) Those with the weakest genes drift into the lower income groups. It is difficult to develop interventions directed to these possibilities. The concept of “control and destiny” is a possible explanation for the relation between inequalities and disease; unlike the other explanations, this idea is amenable to intervention.