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- Social Structure, Injustice, and Global HealtSlide 1. The link between Poverty and III-Health Everybody knows that poor people are more likely to get sick, less likely to be treated successfully, and more likely to die sooner. In fact, Muenning’s 2010 study in the American Journal of Public Health found that poverty had the biggest negative impact on health – bigger than smoking, obesity, binge drinking, and other factors that are known to directly cause illness. The relationship between poverty and ill-health is a strong one – it holds across history, across cultures, across nationalities. But many people misunderstand WHY poor people are sicker. Let’stalk about a few of these misconceptionSlide 2. Poor people are more likely to get sick because they are irresponsible.The first misconception is that: “Poor people are more likely to get sick because they are irresponsible.” This argument is that if poor people made better choices, they would not get sick as often. Certainly there is evidence, as Lynch et al reported in 1997, that: “lower socioeconomic status is generally associated with … obesity, poorer dietary habits, [and] lower levels of physical activity”. It’s likely that some of these health risks could be improved with better decision making. Yet poor people can’t simply choose to live in neighborhoods that aren’t polluted, to work in jobsthat provide good health insurance, or to live in high-income neighborhoods with good-quality grocery stores and safe parks. Cerin and Leslie (2008) found in a review of the literature that lowincome neighborhoods have worse access to sport and recreational spaces, less safe and less attractive public spaces, and – ironically – fewer cost-free physical activity resources. Being poormeans that many of the amenities that help us make good, healthy choices are out of the reach for the poor.Slide 3. Poor people are more likely to get sick because they are lazy.The second misconception is that “Poor people are more likely to get sick because they are lazy”. Certainly it is true that poor people may not do some of the things that are recommended to stay healthy – things like cook healthy homemade meals or exercise. But, as de la Rocha explains, in her 2001 study of the working poor in Mexico, “the resources of poverty have traditionally been the hands and arms of the working poor”. What she means is that the only resource poor families have to try to improve their situation is their own labor--and being poor makes you very busy. Many poor people have to work longer hours or multiple jobs because they are paid so little. Andthey have to waste hours every day riding the bus, fetching water, cutting firewood, and doing other labor intensive-tasks that prevent them from earning more income. For instance, Zizilirmakand Memis (2009) that in South Africa “poverty increases women’s time spent on unpaid work by increasing their time spent on water and fuel collection”. Being poor typically keeps people very busy, but unfortunately usually not busy doing things that enhance health.