September 27, 2012
Poverty and Health
• Black Report
• Social Exclusion
• Social Inequality
• Absolute poverty, Relative poverty
• Depth of Poverty
• Median share of income
• Gini coefﬁcient
The Black Report (1980)
•1977 – Sir Douglas Black commissioned by federal government (UK) to write report
investigating why NHS had failed to reduce inequalities in health
Main ﬁndings & recommendations:
•Poorest people have the worst health
•Mortality and morbidity not explained by lifestyles alone
•Recommendation that govt. increase beneﬁts to poor , change tax to restrict sale and
advertising of tobacco.
The Black Report: Main Findings
Trends: females death rates are lower than men for every grade.
ratio of the unskilled to the most skilled is about 2.5
- When was the Black Report Published? Why?
- Report completed in 1980, after the conservatives came to power under Margaret
- Report was never published widely! Results were suppressed.
- Recommendations not taken into consideration, despite evidence of persistent health
Canada & Poverty:
- When looking at poverty, we are looking at the bottom of the social gradient.
- Poverty is caused by social and political dynamics and policies that result in some
groups experiencing social exclusion.
The poverty-health link
- A “robust” association b/w poverty and ill health
- Poverty one of the strongest determinants of health status
- How can we study the poverty-health link?
- Correlation studies
- Longitudinal studies - which variables come ﬁrst, track relationships - Qualitative studies - deal with words, experiences, allow people to name experiences
in their own words.
- International comparison studies - allow you to look at poverty rates between
countries, why do some have higher/lower poverty than others.
- Different measures of poverty
1. Absolute Poverty - deprived of absolute human needs, food, shelter
2. Relative Poverty - refers to material and social deprivation that leads to the inability to
take part in activities customary in industrialized societies. Takes into account more than
just basic human needs. Need money to engage in social activities. Transportation.
- LICO (Low-Income Cut Offs)
- LICOs vary by the # of people in a family (from 1-7 or more) and by size of
community in which the family lives. (an income threshold below which a family is likely
to devote the majority of its income on basic necessities (food, shelter, clothing.) Set by
standards and family size. The government regulates these LICOʼs.
3. Depth of poverty - extent to which income falls below the LICO.
Poverty in Canada:
- 11% of all Canadians live below the LICO
- 12% of Ontarioʼs children live in poverty.
- Child poverty rates have held despite commitment to end poverty by 2000.
The poverty-health link:
- Infant mortality rates are 61% higher in poorest areas of Canada
- Low birth weight rates are 43% higher
- Low income women in Ontario are 4X more likely to suffer from diabetes compared to
women with higher incomes
- Prevalence of depression among low-income individuals is 60% higher than high
- Low income is estimated to predict 25 to 30% of mortality caused by cardiovascular
- Poverty tends to cluster in groups.
Who is Poor in Canada?
- Certain groups are at particularly high risk of living in or experiencing poverty, and are
particularly vulnerable to the health effects of living in poverty, including:
- People living in impoverished urban areas.
- Recent immigrants