If the culprit of the decline in health is not health care, are individual health-related behaviors, often blamed for the high death rates in some groups, causing our low ranking in health? Apparently not. Americans smoke less than both men and women in the healthier countries, so tobacco, though important, is not a significant cause for our higher mortality. Diet and other similar individual behaviors prevalent in the United States also don’t account for our health disadvantage compared to other rich nations. When asked to identify solutions to our poor health status as a nation, many respond that we need more education. Many see education as the solution to a wide range of problems. But on average the U.S. population has more years of schooling than in any other country in the world. And while we spend a great deal of money on education, we don’t get much bang for those bucks.
There is growing evidence that the factor most responsible for the relatively poor health in the United States is the vast and rising inequality in wealth and income that we not only tolerate, but resist changing. Inequality is the central element, the upstream cause of the social disadvantage described in the IOM report. A political system that fosters inequality limits the attainment of health.
The claim that economic inequality is a major reason for our poor health requires that several standard criteria for claiming causality are satisfied: the results are confirmed by many different studies by different investigators over different time periods; there is a dose-response relationship, meaning more inequality leads to worse health; no other contending explanation is posited; and the relationship is biologically plausible, with likely mechanisms through which inequality works. The field of study called stress biology of social comparisons is one such way inequality acts.
The idea that income inequality leads to general poor health outcomes is brought to you by a Water is Wet grant from the No Sh*t, Sherlock Foundation, but I'm sure conservative blowhards will come into this thread with the "Poor people just don't work hard/Black people don't value education" bs like always.