| Link Between Money and Health |
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By Bruce Hilton
Scripps Howard News Service It didn't look like a story about our health. There were no quotes from doctors, public health consultants or ethicists. Television snubbed the story; there wasn't anything close to a miracle cure in it. But there are those who will argue that the story had more meaning for your health and mine than anything in the papers so far this millennium. The headline: "Rich-poor gap widens, U.S. reports." OK, so it made our eyes glaze over, the way they always do with those economics 101 stories. On the other hand, you might have picked up on the underlying pain in the piece, without tying it to health. The story, based on a report from the non-partisan Congressional Budget Office (CBO), covered the way the people of the world's richest nation divided up their wealth in the years from 1979 to 1997. The era was the longest period of economic growth in U.S. history. Here, the study says, are some of the conclusions: - Annual income for U.S. households during those 18 years grew 30 percent, even after taxes and an adjustment for inflation.
- The most wealthy households -- the top 20 percent -- had a raise in annual income of 50 percent in those years. (All figures are after taxes, and inflation-adjusted.) Their average income was $121,000 by 1997.
- The household income of the top 1 percent did even better: Their average annual income grew from around $250,000 to $677,000.
- During the same years, wages of the middle 20 percent rose just 10 percent.
- Annual income of the poorest 20 percent actually dropped a little -- from $10,900 to $10,800.
- The CBO estimates that the trends continued in 1998 and 1999.
A researcher at Washington's s liberal Center on Budget and Policy Priorities told reporters it was "the most dramatic growth in income inequality since at least the end of World War II. "And it's certainly ironic that we've just approved a big tax cut in which the top 1 percent gains the most." Two reasons for the growth of income at the top were the rise in the value of stocks and the rapid growth in people who made multimillion-dollar salaries. Economics writer James Lardner says, "Bill Gates alone is wealthier than half the American people put together." It's pretty obvious, but here's the CBO's conclusion: "Distribution of income among households grew substantially more unequal during the 1979-1999 period." My neighbor asked, "Why the fuss? We all know the rich get richer and the poor get poorer." Lardner, a longtime student of the income gap, once said in The Washington Post: "Americans are famous for not getting excited about differences in income or wealth, but we have outdone ourselves lately." We have been "producing inequality ... greater than in any of the world's other rich nations (and many of its poor ones) today." Like many others, Lardner points out the instability that a widening gap causes. But in the Post piece and in writings for Inequality.org, a think tank and Web site he heads, Lardner says the most direct impact may be on our health and health care. Arriving "from a variety of angles and disciplines, researchers in the United States, Canada and Britain have found evidence that more unequal societies are more unhealthy -- not just in some highfalutin moral sense but in the plain old medical sense, and not just for the poor but for the bulk of the population." He adds that if you live in a place of wide inequality in wealth "your chances of escaping chronic illness and reaching a ripe old age are significantly worse than if you live in a place differences are not as large." Three professors from the fields of public health or philosophy said in a scholarly paper last year, "Our health is affected not simply by the ease with which we can see a doctor -- though that surely matters -- but also by our social position and the underlying inequality of our society." The article by Norman Daniels, Bruce Kennedy and Ichiro Kawachi, later published in the Boston Review, went on to speak to the obvious question thus: "If social factors play a large role in determining our health, then efforts to ensure greater justice in health care should not focus simply on the traditional health sector." Health isn't produced just by prevention and treatment, they warn us, "but also, to a measurably greater extent, by the cumulative experience of social conditions over the course of one's life." It's worth serious thought, if not for us, then for our grandchildren. Simple justice and true concern for others need to become basic once again for our nation. And for our health. (Bruce Hilton, director of the National Center for Bioethics, has been an ethics consultant to doctors, hospitals and patients since 1972.) (Distributed by Scripps Howard News Service, www.shns.com)
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