Why Are the Wealthier Healthier?

Understanding and reducing health inequalities – which are present, to varying degrees, in all developed countries – remains a major public-policy challenge worldwide. Ultimately, however, one thing is clear: more equal societies have better health outcomes.

DURHAM – In 1842, the English social reformer Edwin Chadwick documented a 30-year discrepancy between the life expectancy of men in the poorest social classes and that of the gentry. Today, people in the most affluent areas of the United Kingdom, such as Kensington and Chelsea, can expect to live 14 years longer than those in the poorest cities, such as Glasgow.

Such inequalities exist, to varying degrees, in all developed countries. Poorer groups fare particularly badly in the neo-liberal system of the United States; gaps in life expectancy in some US cities, such as New Orleans, are as large as 25 years.

Understanding and reducing these health inequalities remains a major public-policy challenge worldwide. It is not only a moral issue; health inequalities carry significant economic costs. But the causes of such inequalities are complex and contested, and the solutions are elusive.

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