Health, Income, & Poverty: Where We Are & What Could Help

The purpose of the paper was to investigate income-health relationships and discuss
policies that can reduce income-related health disparities.

I found three main arguments about how health is determined. First, the authors argue
that income is strongly associated with morbidity and mortality across the income
distribution. For example, a landmark study found that while life expectancy has
increased by 2.5 years for the top 5 percent of the income distribution, there is no life
expectancy increase for those in the bottom 5 percent.¹ According to the study, these
disparities started in 2001 and seemed to grow over time. I believe that this stark disparity
is due to poverty and limited access to healthcare, especially in rural areas. Furthermore,
low-income Americans have higher rates of chronic conditions, such as heart disease and
diabetes, than high-income Americans.

Second, the authors explained that behavioral and environmental risk factors such as
smoking, substance use, and lack of physical activity affect health. In addition, if these
people have limited access to resources, such as cessation services, they may experience
higher levels of chronic stress, making it more difficult to change their lifestyle
behaviors.¹ Other environmental risk factors that lead to chronic stress are pollution, lack
of housing, and less access to fresh food or water.¹

Third, the authors argue that racism is also a social determinant of health and influences
socioeconomic factors, such as income. For example, the article suggests that black
Americans have lower incomes and shorter life expectancies than white Americans
because of the chronic financial hardships caused by segregation and the effects of
discrimination on mental health.¹

There were three parts that I found most interesting. First, the article mentions that for
residents with a home, the “threat of eviction is commonplace, as more than one in five
renting families in the United States spends half of its income on housing” and that
financial hardship increases the risk of chronic disease.¹ I believe that housing should not
be so expensive and that the government should solve the supply and demand problem.

The article mentions that low-income workers are more likely to be employed by
organizations that do not offer health benefits, which is unacceptable. Federal law should
require all companies to provide health insurance to their employees. I am curious to
explore this further and learn more about policies blocking this intervention.

References
1. Khullar D, Chokshi D. Health, Income, & Poverty: Where We Are & What Could Help. Health Affairs.
Published October 4, 2018. Accessed August 14, 2022.
https://www.healthaffairs.org/do/10.1377/hpb20180817.901935/full/