Greater Wealth, Greater Health: The Challenges Society and St. Louis Face

Illustration by Lily Xu

Illustration by Lily Xu

Those who live in the United States are told that they are lucky because of the multitude of opportunities and freedoms offered to them. The US is one of the wealthiest countries in the world, but despite this abundance of wealth, the nation falls short in terms of health. Even with one of the best healthcare systems in the world, the US has health statistics lower than those of many other nations, residing at the bottom among the Organization of Economic Cooperation and Development (OECD) nations. This lack of wellness can be attributed to the great income disparities in the US. The lack of redistribution, as well as the small amount of government assistance in care, are part of the reason why there is such a large wealth disparity in the US. This negatively impacts the health of a nation, and a variety of factors cause a nation to end up this way.

The political economy of a nation has a large impact on the health of its people. There are nations that require individuals to find their own healthcare and childcare, but there are also nations that provide these services to the masses. Nations that provide more to citizens have been found to have better overall health, and nations that redistribute more money, as well as services, typically experience better health metrics (3). This is due to the fact that citizens are receiving more aid from the government; therefore, they have to provide less for themselves. This causes the gap between the wealthy and the disadvantaged to decrease. According to Marmot, inequality rises from the “uneven distribution of goods and conditions of daily life” (4). Those who have more money have the ability to obtain better healthcare and live in nicer areas. As the amount of redistribution in a society increases, the health metrics improve (3). Overall, people are healthier, as the gap between the rich and the poor decreases. Those who are less fortunate can do a lot more with a small increase in the amount of money they have, which is why greater redistribution is crucial to the health and survival of the less fortunate (4).

There are many risks to an individual’s health. Getting sick is avoidable, but when someone is less fortunate, they are much more susceptible to disease. This is not because these individuals have genes that make them more likely to get sick, but rather, “most of these risk factors are related to people’s social circumstances” (4). If an individual has less money than those around them, they are more likely to live in a poorer and dirtier part of a city. This is known as differential exposure, as the amount of money a person has determines what toxins they are exposed to (3). Depending on the less fortunate individual’s susceptibility, this individual may end up getting infected. However, even if a wealthier individual had obtained the same disease, their consequences would be less severe because they can afford better care and treatment (3). The inequalities in exposure and outcome stem from the underlying social factors determining an individual’s status, so despite the great health care in the US, people still suffer.

This inequality in health is a great issue in St. Louis, especially near the Washington University in St. Louis (WashU) campus. The Delmar Divide is a well-known term on campus, referring  to the differences in wealth and race north and south of Delmar Boulevard. South of Delmar, home values average around $310,000 and 67% of adults have bachelor’s degrees. Most of the individuals living south of Delmar are white (2). However, it is a very different story on the other side of the divide. Only 1 in 20 adults have bachelor’s degrees and the median home value is $78,000 (2). This disparity makes St. Louis one of the most unequal and inequitable cities to live in. The lives of those who live north and south of Delmar Boulevard are drastically different, resulting in poor health metrics for the less fortunate.

Jason Purnell, an assistant professor at the Brown School at WashU, is attempting to solve this problem. For the Sake of All was started in 2013 by WashU and Saint Louis University students with the goal of “[reporting] on the health and well-being of African Americans in the St. Louis region by highlighting social, economic and environmental factors that drive differences in outcomes“. The report was released in 2014 and recommended increased attention in six different areas that, if improved upon, could lessen the inequalities in outcomes. These areas are economic opportunity, early childhood, school health, quality neighborhoods, mental health, and chronic disease (1). These are all social factors that prevent many individuals in St. Louis from thriving and living up to their potentials. The goal of the project is to “improve the health of all people by eliminating racial inequities that stifle our region’s growth.” Purnell and the rest of his team are attempting to bring the social factors of disadvantaged individuals in St. Louis up to an attainable level that will allow all individuals to thrive. The differences in the health of people living in St. Louis are due to their backgrounds, so by eliminating these disadvantages, everyone can strive to live a healthy life.

It is possible to minimize the social gradients of health, but society must work together in order to do so. If an effort is made to improve the lives of the disadvantaged by bringing them to an attainable level of wealth, all of society will benefit. Trust, reciprocity, and overall wellness will increase, thus bettering society and the lives of everyone.

Edited by: Lily Xu

Illustrated by: Lily Xu

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