The Relationship between Economic Disparities and Health Outcomes in a Population

Considering that live in an extremely technologically advanced day and age and are capable of providing all types of media and consumer goods to the masses in great abundance, there still exists the striking and unfortunate truth that access to health is not considered a basic human right. According to decades of research, good health outcomes are based more on the facts of how much money one makes, where one lives and what connections one makes rather than on simple self-care. But what is good health, and how is it achieved? Which factors contribute to good health in a population, and what amenities and services are lower-income neighborhoods lacking in which, if provided, would be conducive to the good health of their residents?

Through examining how health disparities are related to measures of wealth, on average and in the Bay Area, in which economic disparities are at an extreme, it is possible to determine potential solutions to what should be an already extinct problem. A variety of economic disparities significantly contribute to health inequities and only by studying them in detail and applying the standards of good health in wealthier communities to the development of lower income communities that the issue can truly be addressed and resolved.

While major medical advances have been made in modern society, economics are still very much positive and negative outcomes in healthcare; the possession or lack of affordable insurance is as a particularly formidable cause of these disparities. This is most obviously evidenced by the fact that being in a higher income bracket gives one a significantly greater chance of being in good health, according to various studies conducted by institutions such as the Department of Health in April of 2015 in a study entitled 'How Are Income and Wealth Linked to Health and Longevity'. Despite the Affordable Care Act's passing during President Obama's term, insurance premiums and co-pays have proven to be a barrier to maintaining preventative and restorative health, according to the University of Oregon (Krois et. al, 2007).

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In their study," Insurance, Access, Healthcare: Typology of Barriers to Health Care Access for Low-Income Families," researchers seeking to identify the barriers to low-income families' good health found that lack of insurance and unaffordable healthcare-associated costs such as premiums and copays were two of the three most often reported reasons for concern amongst those polled, keeping them from attending appointments as often as wealthier patients in times of sickness and engaging less in preventative measures provided by medical facilities (Krois et al, 2007). Though the Affordable Care Act expanded healthcare access to millions of Americans, lower income individuals and families still struggle with medical costs on a regular basis.

Another key factor in achieving good health is found in an individual's diet, and often, social determinants such as wealth create disparities between higher and lower income neighborhoods, the latter of which have been deemed "food deserts" due to the lack of healthy food available in those areas, leading to poorer overall nutrition. Food insecurity, whether it is actual rates of hunger amongst those below the Federal Poverty Level, or in the form of so-called food deserts, is a prominent feature of those areas with higher rates of heart disease and obesity, as well as other serious conditions leading to lower quality of life and shorter lifeps amongst those falling within the affected areas (McMillan, 2014).

In "The New Face of Hunger," a feature in National Geographic, the severity of the gap in quality of health between richer and poorer Americans is highlighted through personal anecdotes told by those suffering from meager benefits, such as families who only buys vegetables and fruits at the beginning of the month as a type of luxury, but accentuated even more so through statistics, such as the fact that rates of hunger have risen over 57 percent just since the 1990s.

In short, the availability of filling but low-nutrition food often causes poorer families to spend the small amount of SNAP benefits they have on food which will last rather than an abundance of healthier foods, which are better for them and their families long term, because of necessity and willingness to make their benefits last so as not to go hungry. Aside from low-come, availability and convenience play a major part in determining what food to buy; people with busy schedules and little time to spare for cooking, often find themselves purchasing television dinners or fast food because they take less time and effort to prepare.

An unfortunate consequence of this pattern is that children and adolescents are disproportionally affected by these choices made by their parents out of necessity, causing lifelong patterns of unhealthy habits to be solidified, which when coupled with the lack of safe spaces for activity they also often suffer, perpetuating the cycle of poorer health over generations.

As detailed in the journal article "Social Class Gradients in Health during Adolescence," researchers found strong correlations between positive health outcomes and affluence in young people, suggesting that lack of access to regular preventative care and to resources which might make them healthier, such as safe walking spaces, bike lanes in their neighborhoods and the like, is not only unsatisfactory but rather may have more serious health risks in the long term, as healthy habits are often established and cemented in individuals as a young age (Starfield, Riley, Witt and Robertson, 2002).

If more community support, such as free or lost-cow exercise programs, for physically friendly spaces existed in stronger form, this negative trend might be ratified, but at present, the lack of community resources and healthy spaces in lower income communities contribute significantly to social differences in health.

In recent years, the Bay Area has been given increased attention on a national stage because of its alleged sharp rise in economic disparity between its wealthiest and poorest citizens, making it also a telling landscape for the existing health disparities in those populations as well. With the rapid expansion of Silicon Valley causing long-term residents to be displaced due to much higher costs of living have forced moves for those displaced people into areas which limit their access to resources such as health food stores and farmer's markets and support services that allow for healthier living.

In the comprehensive study titled "Healthy Inequities in the Bay Area," researchers went behind the startling figures of, for example, people in West Oakland living on average ten years less than those in Berkeley, and found that lower income neighborhoods often have extremely high densities of fast food and liquor stores in comparison with wealthier neighborhoods, and that this is a significant contribution to the poorer health statistics the lower-income communities yield (Starfield, 2002).

These features, combined with the lack of space, access to public transit and close proximity to sources of toxic exposures close to residences such as freeways, all make for unfriendly conditions to health which could, according to research, potentially be improved through public policy reform (Starfield, 2002). At present, however, there are no laws governing the amount of open space and similar positive attributions of healthy communities, so in the Bay Area, where disparities are generally increasing all the time, there is no respite for the communities suffering the most from the technology boom undergone in the city in recent years.

Though considering the statistics, the current health disparities in the United States, and also particularly in the Bar Area, are dire, there is hope in the form of public policy reform, a movement of which is just beginning to sprout. At present, simply taking a walk through neighborhoods of different economic levels in the Bay Area makes evident the vast differences which exists between wealthier and poorer citizens. On a larger scale, access to high quality healthcare services and social support is often less prevalent in lower-income communities; on a smaller scale, access to open space recreational areas and healthy food is at times limited in lower income areas, while access to unhealthier products such as tobacco, alcohol and fast food is readily available (Prentice).

Even the general state of our economy, in which people are often forced to work two part-time jobs rather than a full-time job which offers health insurance, contributes to poor health, showing that this is a multifaceted issue requiring an intensive and comprehensive solution (Redlener, 2007). Education in the form of community centers and widespread health promotions within communities would remedy this situation, since much of its most negative aspects are those which are solidified in youth and continued as a lifestyle pattern in those individuals as they progress throughout their lives.

It is indisputable at this point, after decades of research conducted within a variety of disciplines, that economic disparities essentially determine health outcomes. It is now necessary to move beyond the "Why?" and into the realm of figuring out how to reform our society into a place in which access to health is a right rather than a privilege.

Despite the inequities existing today, community involvement on both the part of policymakers and those within the communities impacted by this negative trend can make a key difference in bettering the lives of others, whether it is from the creation of safe, open spaces in which physical activity is encouraged and made readily available, or through limits on the amount of businesses providing unhealthy goods, or through other means. Because we have successfully figured out the contributing factors in poorer health and lower lifeps in people living in lower income communities, it is possible to figure out how to raise the levels of livability for people no matter what community they live in, and to consider it a necessity and a right for those people to have the same access to healthy living as their wealthier counterparts.

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