Income and Wealth Flashcards
what does it mean that “health is not randomly distributed”
- the idea that people’s health status is not determined by chance, but rather by various factors like SES, access to healthcare, lifestyle choices, environment, and genetics
- these factors contribute to a patterned distribution of health outcomes, meaning certain populations experience significantly better or worse health than others.
what is the difference between wealth and income?
- wealth = the monetary value of all possessions and assets accumulated by a person or family over time
- income = earnings over a specific time period
is income or wealth a better measurement?
- income is a less comprehensive representation of the economic resources available to a person/household
- income fluctuates so it only provides limited information about economic advantage or disadvantage that could influence a persons health
- classifying on income alone may provide a misleading picture of their economic resources!
however, wealth is harder to measure because it is hard to approximate without respondents accessing personal records (which can be seen as intrusive)
what is the distribution of income and wealth?
the gap between the wealthy and the poor is increasing!!
- while the shifts in overall distributions of income and wealth have increased, disparities between income and wealth when comparing subgroups defined by populations (i.e race, ethnicity, gender, disability, age) are even more significant
what is upward mobility?
- the ability to move up in socioeconomic status, such as by changing jobs, earning more money, or improving living conditions
- can also refer to an employee’s ability to advance to a higher position within a company
what is the black/white wealth gap?
- refers to the disparities in wealth and income when comparing African Americans to White people
- White people make far more $$$$ than African Americans
- the black/white wealth gap begins early in life and widens as people age
- this suggests that black people are more likely to be born into disadvantage and more likely to face barriers to home ownership, stable employment, and other opportunities associated with building wealth over a life time
what are the reasons for income and wealth gap?
wealth inequities persist largely due to systemic and structural racism
1) racial residential segregation
2) employment discrimination in hiring, pay and promotion
3) discriminatory policing and sentencing practices
how does racial residential segregation impact wealth?
- segregated urban neighbourhoods and Indian reserves are more likely to have concentrated poverty and limited access for upward mobility due to lack of good land, school, jobs and services
- redlining has lead to disparities in home ownership, home value and credit scores in original redlined communities are still apparent today
what is redlining?
- refers to the practice of banks drawing red lines on maps around urban neighbourhoods where people of colour reside
- redlining was used to define where loans would and would not be given to purchase homes or start businesses
how does employment discrimination impact wealth?
- racial discrimination in hiring, pay and promotion impacts ability to accumulate income and wealth (mostly due to implicit bias)
- people of colour are targeted by predatory financial services such as pay-day lenders, check-cashing services and pawnshops, and they tend to charge excessive fees/interest rates
how does discriminatory policing and sentencing impact wealth?
- black people are overrepresented in Canada’s criminal justice system
- a history of incarceration permanently stigmatizes young people, impacting opportunities of employment and economic success
how has the shift from a manufacturing to knowledge economy impacted the income/wage gap?
- over the last 5 years the focus of the economy has shifted from manufacturing to knowledge
–> manufacturing jobs have moved to jurisdictions where costs are cheaper
–> focus of economy is now on technology, healthcare, innovation, energy, tourism/service
–> this shift requires a need for higher education, therefore it is difficult to survive without education/credentials
what 3 factors can interplay with income and wealth
- gender
- disability status
- age
how does gender influence income and wealth?
despite increasingly more women joining the workforce, gender-based disparities in pay and advancement persist = impacts opportunities to generate wealth and build income
- women of colour face compounded disadvantages based on gender and race
- women do most caregiving, reducing paid work hours and job related pensions/retirement account
how does disability influence income and wealth?
people with disabilities face obstacles to earning income and building wealth
- the type and severity of disability and workplace accessibility impact an individuals capacity to participate in the workforce
- disabled people are less likely to have a bank account to build credit and savings
- healthcare-related costs, such as medications and supports, are costly
how does age influence income and wealth?
- wealth disparities across age groups have widened over past 25 years
- older individuals are favoured to have more wealth than younger people
what is intersectionality?
when individuals face multiple disadvantages (ex: black women) that shape their experiences
–> are not simply additive, but interact synergistixally
how does low-income and early life experiences affect health?
the effects of income on health begin early in life:
- children from lower-income households experience more negative health outcomes
- parental wealth impacts children’s future health by influencing conditions during critical developmental periods
how is economic inequality associated with population health?
there is an association between a society’s overall health and extent of economic inequality
- it is measure by the gini coefficient
greater economic inequality is linked to:
- poorer health outcomes
- reduced social cohesion
- lower public investment in health
countries with more equal wealth distribution have better health outcomes and less disease burden
*it is not overall levels of wealth in a country that matter, but also how wealth is distributed within a population
what is the gini coefficient?
- a measure of how equally or unequally wealth is distributed within a countries population
- ranges from 0-1
0 = perfect equality and everyone has the same amount of resources
1 = the most unequal and all economic resources are held by one individual
what is the relationship between health and income?
- higher income = longer life expectancy (for men and women)
- the greater a families income = the healthier the adults are (decreased presence of chronic conditions)
- decreasing economic resources of a household is associated with increased adverse childhood experiences
how are economic resources associated with health outcomes?
higher income correlates with:
- longer life expectancy
- lower rates of chronic disease
- better overall health
as a result, wealth provides a buffer against financial instability, mitigating (reducing) stress-related health risks
for example: families in upper/middle class have money to take vacation, live in nice neighbourhoods, go to nice schools to buffer stress of everyday life!
in what ways does economic resources influence health at an individual level?
- access to health-promoting goods and services
- psychosocial benefits
- cumulative effects of economic resources over a lifetime
how does income impact access to health promoting goods and services?
- higher income/wealth makes it easier to pay for medical expensese and insurance (deductible, copayments)
- more economic resources increase access to material conditions that prevent getting sick in the first place (housing, food, activities)
- wealth protects against adverse consequences of job loss
how does income affect psychosocial wellbeing?
- persistent stress can trigger long-term cortisol release into the blood stream which damages organs and organ systems in the body (inflammation and immune system dysregulation)
- higher income/wealth can protect individuals and families from the stress associated with financial hardship
- higher income/wealth helps improve access to activities and social networks (clubs, sports teams, recreational facilities)
- perceived social status and how one views themself is tied to health
how does wealth impact access to healthcare?
greater wealth helps facilitate access to:
- healthcare services (routine check-ups and specialized treatments)
- private health insurance/dental care
- prevents debt-related health compromises (those with less $$ may delay or avoid treatment due to cost)
how does wealth impact living conditions?
greater wealth means:
- safer homes and better quality
- fewer environmental hazards
- access to nutritious food and physical activity
- reduced neighbourhood violence and reduced overcrowding
what are the psychosocial benefits of wealth?
- reduces life stressors
- protection from chronic stress (wealth acts as a buffer)
- enhances social cohesion and fosters social networks (involvement in sports, social clubs)
how does intergenerational wealth affect education and health?
- parental income impacts the contexts that children grow up in, access resources and developmental stimulation they’re provided
- intergenerational positively influences health trajectories (can invest in preventative care, healthy living environments, other health practitioners)
- intergenerational wealth provides future generation with better educational opportunities (better schools, tutoring etc)
what did the study on low-income families and childhood development find?
the study found that children of low-income families have lower surface area in their brain compared to children of higher-income families
- income differences in brain development may reflect the fact that poorer families are less able to provide children with cognitive stimulation, enriching experiences and help with homework
- economically secure parents are more likely to provide better opportunities for development
therefore, income-related differences in cognitive stimulation that parents an provide impact academic achievements, educational attainment, future employment and income
what are some ways that parental income influences the health of their children?
- able to provide healthier living conditions for their kid
- increased stimulation and support for their child
- more likely to get higher quality education and support = better job opportuntieis
- increased likelihood of the child inheriting their parents wealth
what are epigenetic effects?
- refers to the bodily processes that do not change one’s genetic makeup but have powerful effects on whether any given give is expressed (“turned on”) or suppressed (“turned off”)
- are the result of interactions between one’s genes and their social or physical environment
what are some examples of interventions aimed at addressing income/health disparities?
- financial education
- subsidized saving accounts
- job training
- rental and home buyer assistance
- micro loans
- increase availability to financial services
what is required in order to reduce income-health dispairites within society?
in order to ensure that everyone has equitable opportunities to acquire and build wealth, changes at systemic and political level are needed!
–> interventions within multiple sectors
–> addressing just one this is NOT effective
what is the health-income gradient?
- the systematic relationship between income and health
- the idea that with every increase (or decrease) in income level at population level, we see a corresponding shift in health outcomes and life expectancy
- health improves as income rises!!!
why does the health-income gradient exist?
1) material factors
- access to nutricious foods
- safe housing
- access to healthcare
2) psychosocial factors
- stress from financial insecurity and job strain
- lower sense of control
- social support
3) behavioural factors
- differences in lifestyle choices (i.e smoking, exercise)
what are the Whitehall studies?
- a series of studies conducted on British civil servants
–> Whitehall I (1967) = focused on men only
–> Whitehall II (1985) = included men and women
what was the objective of the Whitehall studies?
to investigate the relationship between socioeconomic status (SES) and health outcomes
what were the key findings of the Whitehall studies?
- lower SES is associated with worse health outcomes
- every employment grade from top (more $$) to bottom (less $$) was associated with a change in health status
- risk factors are more common amongst lower paid, lower status employees
- chronic stress and lack of control at work are significant contributors
- smoking, diet, physical activity and biological markers (blood pressure, cholesterol) mediate health disparities
- individual risk factors (smoking, blood pressure) does not account for differences in health status across grades
how is wealth/income related to areas of health?
- the self-rated mental health gap by income as widened overtime (low income = worsened mental health)
- poorer households report a higher percentage of having multiple chronic conditions
- those with lower income are less likely to follow up with their doctor after leaving the hospital for mental illness or addiction
what are the characteristics of health regions with lower life expectancies?
- higher levels of long-term unemployment
- lower proportions of high school and university graduates
- smaller immigrant populations
- larger indigneous populations
- rural/remote locations
- highest rates of smoking, obesity and heavy drinking
why is smoking, obesity and drinking associated with poor health?
- smoking is a risk factor for lung cancer, heart disease and stroke
- obesity is linked to chronic disease and hypertension, such as T2D, CVD and hypertension
- heavy drinking is associated with health problems like cirrhosis, heart disease, depression and social consequences (traffic accidents, lower productivity, violence)
what is the significance of toronto?
- Toronto is the world’s most economically powerful cities
- it is one of the fastest growing G7 financial centre
what are “The Three Cities Within Toronto”?
it describes the income polarization among different groups within Toronto from 1970-2005
1) city #1
- a predominately high income neighbourhood
- generally located in central city and close to city subway lines
- average income has risen significantly relative to rest of city
2) city #2
- mainly middle-income area
- average income has remained fairly close to the city average
3) city #3
- generally low income
- are generally located in the northeastern and northwestern parts of the city
- average income has fallen substantially over the past few decades compared to the average
why is Toronto referred to as the “city of disparities”?
- toronto is becoming increasingly divided by income and socioeconomic status
- toronto is so polarized that is could be described as 3 geographically distinct “cities”
- no longer referred to as “city of neighbourhoods” –> “city of disparities”
- this three-city disparity did not exist before!!! *
how has toronto changed from 1970 to 2000?
- the middle-class is shrinking
- the rich got richer
- the poor got poorer
how does mortality relate to wealth in Toronto?
there may be a correlation between mortality rates and income distribution
- lower income areas of Toronto coincide with regions with higher mortality rates (U shape around Yonge street)
- in fact, life expectancy varies by almost 12 years across Toronto neighbourhoods
- may be due to access to health, housing quality, environmental factors etc
how do health outcomes from the lowest-income group compare to the highest income group?
- men are 50% more likely to die before age 75
- women are 85% more likely to have diabetes
- young women are twice as likely to be reported with chlaymydia
- babies are 40% more likely to be born with low birth weight
what did the Wilkinson research study argue?
- he argued that its not just absolute income that matters, but rather how income is distributed in a society
- this means that the relative position of individuals on the income ladder significantly impacts health outcomes
what is the Wilkinson hypothesis?
- income inequality and health are negatively related to each other
- in developed economies, individual income isn’t the main determining factor of health but rather the degree of income inequality within a society!!!
based on the Wilkinson study, what happens when the gap grows between high-income and low-income groups?
as income and education gaps between rich and poor grow, we will find:
- lower societal levels of trust and mutual support
- lower levels of civic engagement and cooperation
- higher rates of violent crime
- increased incidence of racism, discrimination and social exclusion
- growth of hostile, marginalized sub-cultures
–> therefore, lower health status overall (with adverse effects concentrated for people at or near the bottom)
what are the components of the Wilkinson synthesis?
1) social capital theory
2) sociology and criminology
3) primatology
what is the social capital theory of the Wilkinson Synthesis?
- Robert Putnams argued that more equal societies have greater levels of solidarity, social support, trust and mutual assistance
what is the sociology and criminology component of the Wilkinson Synthesis?
- Durkheim claimed that social change is a major cause of stress, social dislocation, and dysfunctional behaviour
- societies that are too diverse and undergoing rapid change destabilize their populations
what is the primatology component of of the Wilkinson Synthesis?
- the study of monkeys, baboons, and chimpanzees, all of which
live in social hierarchies, shows that subordinate animals die
prematurely, mainly of stress, elevated levels of cortisol, and an
associated unhealthy inflammatory response - animals whose position in the hierarchy improves show improved health and vice versa
what are the main conclusions between health and wealth?
- the Whitehall Studies provide critical evidence linking SES to health outcomes.
- the health-income gradient demonstrates that health disparities are systemic and require multi-level interventions.
*key message = addressing socioeconomic inequalities is essential to improving public health
