How Could You Close "Needs" and "Wants" Gap in Low Socioeconomic Populations?
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deaths caused by factors such as tobacco, diet and lack of activity, and toxic agents. They noted the mismatch between the importance of these factors and allocation of health care resources, with most resources going to treat diseases and relatively few to modifying the predisposing factors. To modify these risk factors, one needs to look even further upstream to consider their “actual determinants.” Socioeconomic status is a key underlying factor. In this paper we examine multiple pathways through which it can influence health, and we consider the implications of these pathways for policy. While socioeconomic status is clearly linked to morbidity and mortality, the mechanisms responsible for the association are not well understood. Identifying these mechanisms provides more options for policy remedies. Given the pervasive effects of socioeconomic status, no single policy, or even one domain of policy, can eliminate health disparities. The Acheson Commission in the United Kingdom, which was charged with providing policy suggestions for reducing health disparities in that country, made thirty-nine recommendations, organized around key populations (such as children, older people, and ethnic minorities) and domains (such as income and tax benefits, education, and employment). If a U.S. equivalent of the Acheson Commission were convened, what policies should it consider on the basis of the empirical data? Below we consider policies addressing several areas for which the empirical evidence is strongest regarding the links between socioeconomic status and health.
These statistical indicators testify to income-caused disparities in health care access. Thus, inequalities in welfare and living standards predetermine disparities in using effective methods of completing emerging health care needs.
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