Income inequality takes a toll
If all were as healthy as the wealthiest, there would be fewer premature deaths, Dennis Raphael and Toba Bryant write.
The crash of an airliner is a tragic disaster that triggers major investigations and quick action to make sure the same problem doesn’t occur again. Imagine the response — from industry, government and the public — if a plane was crashing every day. If there were something that killed as many people in a day as this kind of disaster, you’d expect it to provoke a similarly concentrated response.
A report by Statistics Canada highlights a preventable cause of premature death having exactly that kind of impact. This study demonstrates that income inequality is associated with the premature death of 40,000 Canadians a year — that’s 110 Canadians dying prematurely each day.
The study followed 2.7 million Canadians over a 16- year period and calculated death rates from a range of diseases and injuries as a function of the person’s income. It compared the number of deaths of the wealthiest 20 per cent of Canadians to the other 80 per cent of Canadians. It found that if all Canadians were as healthy as the top 20 per cent of Canadian income earners, there would be 40,000 fewer deaths a year.
The report also calculated the likelihood of death of someone in the poorest 20 per cent versus someone in the wealthiest 20 per cent of Canadians. Poor men and women are, respectively, 67 and 52 per cent more likely to die each
Politicians at all levels ignore the relationship between income inequality and health.
year than their wealthy counterparts.
The study goes into further details. Poor Canadian men have a 63 per cent greater chance of dying each year from heart disease; the figure is 53 per cent for poor women.
For diabetes, the figures are more striking. Poor Canadian men have a 150 per cent greater chance and poor women a 160 per cent greater chance of dying from diabetes than wealthy Canadians.
If all Canadians were as healthy as wealthy Canadians, there would be 40 per cent fewer deaths from diabetes and 20 per cent fewer deaths from cardiovascular disease every year. Similar numbers showing a profound difference between wealthy and poor Canadians and between wealthy and all other Canadians appear for cancer, respiratory disease, injuries, and HIV- AIDS, among others.
In the United Kingdom, the publication of figures like these has led to media coverage, responses from health- care and community leaders, and even public outrage.
In Canada there is little media attention to these studies, and major disease associations refuse to acknowledge their implications for preventing heart disease, diabetes and cancer. Politicians at all levels ignore the relationship between income inequality and health. There is reluctance to talk about the distribution of wealth, and the efforts required to address these health inequities. Instead, we are distracted by health care, which precludes consideration of broader determinants of premature death.
These differences in health are due to the material living circumstances associated with not being as well off as the wealthiest Canadians: “Income influences health most directly through access to material resources such as better quality food and shelter.” Income inequality is not only bad for our quality of life and economic productivity, it is directly related to the deaths of Canadians on an almost unimaginable scale.
Canadians are increasingly concerned about income inequality and its health effects. It’s time for a serious response from policy- makers. Otherwise we’ll simply continue to watch 110 Canadians falling out of the sky each day, every day, 365 days a year.
Dennis Raphael, PhD, is a professor of health policy and management at York University in Toronto. He is co- author of Social Determinants of Health: The Canadian Facts, available f or free download at thecanadianfacts.org. Toba Bryant, PhD, is an assistant professor of health sciences at the University of Ontario Institute of Technology and author of An Introduction to Health Policy.