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Health Geo, lectures 11 and 12

Health Geo, lectures 11 and 12 - Income Inequality as a...

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1 Income Inequality as a Determinant of Health Readings Ross et al. (2000) Dorling et al. (2007) • Ross et al (2006) GEOG 303 Lecture Prof N. Ross Ross et al. OK Is it income distribution a key contextual property of place for the health of populations? GEOG 303 Lecture Prof N. Ross
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2 Wilkinson GEOG 303 Lecture Prof N. Ross 60 65 70 75 80 85 fe Expectancy 76 78 80 USA Luxembourg Japan Switzerland Iceland Greece Malta Australia UK Norway Sweden For 32 Countries with GDP/Head Above $10,000 GEOG 303 Lecture Prof N. Ross 35 40 45 50 55 0 5000 10000 15000 20000 25000 30000 Average Lif GDP per Head based on Purchasing Power Parity ($US) 68 70 72 74 10000 15000 20000 25000 30000 r = 0.51 United Arab Emirates Bahrain Saudi Arabia Korea Portugal Denmark Ireland From Lynch et al. (2001) It’s about our appraisal of place in the social order - the psychosocial hypothesis . Involves cognitive processes of social comparison social position affords an increased ‘host defence’ (Whit h ll) How Can Inequality be Related to Mortality? (Whitehall) hassles and frustrations of daily living more likely to become pathological when assessed against others’ more enviable situations poverty feels worse in areas where others around you have more
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3 Wilkinson There is . . . No shortage of evidence of th t lit f th f i l GEOG 303 Lecture Prof N. Ross the centrality of the sense of social status, feelings of inferiority, and relative deprivation in human social life (1994, pg. 72) It’s about exposure to the material conditions within jurisdictions: the neo-material hypothesis . It’s about the stuff available to people in places Systematic underinvestment in human capital How Can Inequality be Related to Mortality? low spending on public goods/infrastructure In the U.S., states with higher income inequality and poorer health outcomes generally spent less than their more equal counterparts on education, welfare, health care, and other public amenities (Kaplan et al.1996) How Can Inequality be Related to Mortality? It’s about the social distance between the haves and have-nots : the social capital hypothesis . GEOG 303 Lecture Prof N. Ross States with greater income inequality also had the lowest levels of interpersonal trust and participation in civic life, suggesting that income inequality erodes social cohesion (Kawachi et al. 1997).
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4 A Unique “Natural Experiment” Compare Canadian jurisdictions with their American counterparts to test the income inequality hypothesis GEOG 303 Lecture Prof N. Ross U.S. census data (1990), Canadian census data (1991) 3-year average mortality rates Canada – US Infant Mortality Comparison Infant mortality rate ratios Difference largely 1970 1.06 1975 1.18 GEOG 303 Lecture Prof N. Ross due to faster declines in Canada
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