INTL 340 Lecture Notes - Lecture 10: Tuberculosis, Structural Adjustment, Neoliberalism

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Week 5 Class 2
Relative Income Matters:
beyond a certain level of absolute economic productivity (@GDP $5,000 per capita),
economic growth (overall income) matters less to population health than economic
distribution or inequality
After the epidemiology transition, population health is associated with relative income
distribution
strong correlation between percent of national income head by bottom 70% of population
and life expectancy in 9 OECD (developed) countries = stronger predictor than GNP per
capita
Relative income hypothesis:
relative income hypothesis: that income inequality effects health; not just absolute or
individual income but relative social position
in fact, health is one of the most sensitive indicators of the social costs of inequality
“The burden of ill health, we shall argue, is a major reason why we should care as a society
about the growing economic distance between the top and bottom” (Wilkinson et al. 1999)
Possible mechanisms (for the relative income hypothesis)
access to opportunities
social comparison; social support, cohesion
public participation, collective efficacy
stress of relative deprivation; “social meanings of deprivation” (Wilkinson p 42)
Inability to achieve social role/status & mental health consequences
less investment in public infrastructures
“competitive spending,” stress
Global Inequality
nearly 1/2 the world’s wealth is owned by 1% of the population
the wealth of the top 1% = $110 trillion = 65 x the wealth of the bottom 50%
7 of 10 people worldwide live in countries where economic inequality has worsened
since the economic crisis of ’08-’09, more than 90% of economic growth has gone to top 1%
Impacts of inequality on health population
social cohesion, trust, civic engagement and participation
sense of insecurity, instability, uncertainty
los of work —> loss of identity, mental health consequences (violence, depression, suicide)
resurgence of infectious diseases/diseases of poverty (when people lack basic social
determinants of health)
popular protest & mobilization
What can be done?
government action on economic policy
policies that promote employment
progressive taxation
supports for working families (child care)
higher minimum wage
“health policy should not be separated from social and economic policy. Indeed, health
leaders might find themselves becoming involved in issues ordinarily viewed as distant from
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Document Summary

Beyond a certain level of absolute economic productivity (@gdp ,000 per capita), economic growth (overall income) matters less to population health than economic distribution or inequality. After the epidemiology transition, population health is associated with relative income distribution. Strong correlation between percent of national income head by bottom 70% of population and life expectancy in 9 oecd (developed) countries = stronger predictor than gnp per capita. Relative income hypothesis: that income inequality effects health; not just absolute or individual income but relative social position. In fact, health is one of the most sensitive indicators of the social costs of inequality. The burden of ill health, we shall argue, is a major reason why we should care as a society about the growing economic distance between the top and bottom (wilkinson et al. Stress of relative deprivation; social meanings of deprivation (wilkinson p 42) Inability to achieve social role/status & mental health consequences.

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