How Could You Close "Needs" and "Wants" Gap in Low Socioeconomic Populations?
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Differences in health by social class was examined by the Black Report, which investigated the problem of health inequalities in the UK and found that people of lower economic status were far more likely to experience ill-health and premature death than those of higher socio-economic status.
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.
Inadequate access to health care is one of the major social inequalities experienced by the United States’ low-income populations. Differences in welfare and living conditions generate reduced opportunities for needy individuals and decrease their abilities to cope with physical and emotional disorders. Approximately 20% of low-income people avoid care due to its cost (Griffith et al., 2017, p. 1506). The cross-sectional study pursued by Berkowitz, Traore, Singer, and Atlas (2015) has revealed that Americans living in poverty experience worse access to health care, including chronic disease management, “preventive service provision, resource utilization, and patient-centeredness of care” (p. 403). According to the research findings, economically vulnerable populations annually visit hospitals 5.4 times, while annual rates of visits of median-income individuals comprise 9.3 times (Berkowitz et al., 2015, p. 408). 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.
Berkowitz, S., Traore, C., Singer, D., & Atlas, S. (2015). Evaluating area‐based socioeconomic status indicators for monitoring disparities within health care systems: Results from a primary care network. Health Services Research, 50(2), 398–417.
Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It’s time to consider the causes of the causes. Public Health Reports, 129(1), 19–31.
Chen, J., Vargas-Bustamante, A., Mortensen, K., & Ortega, A. (2016). Racial and ethnic disparities in health care access and utilization under the Affordable Care Act. Medical Care, 54(2), 140–146.
Chetty, R., Stepner, M., Abraham, S., Lin, S., Scuderi, B., Turner, N.,… Cutler, D. (2016). The association between income and life expectancy in the United States, 2001-2014. Journal of the American Medical Association, 315(16), 1750–1766.
Griffith, K., Evans, L., & Bor, J. (2017). The Affordable Care Act reduced socioeconomic disparities in health care access. Health Affairs, 36(8), 1503–1510.