It has been well-established in the literature that wealthier people have greater access to resources and experience better health outcomes. This health-wealth inequality has been clearly demonstrated time and time again in many epidemiological studies worldwide, and the COVID-19 pandemic is highlighting this long-standing issue.
Although COVID-19 indiscriminately infects the rich and poor, people of colour and people in lower socioeconomic strata are more likely to catch the virus... and they are also more likely to die from it. Why? To start, preventative measures—such as avoiding crowded places, driving in a private car, and working from home—are more feasible for wealthier individuals. Benefits such as sick leave are also unavailable for low-income workers on the front-lines, such as retail, hospitality, and gig economy workers. The lack of benefits also makes it difficult for people to access necessary medical care in countries without universal health care. Staying at home to practice social distancing also means that people need to stockpile resources, such as food and necessary household items, but only higher income households can afford to do this.
Moreover, people of colour and those in lower socioeconomic brackets have a greater prevalence of chronic diseases, such as diabetes and heart disease, which are pre-existing health conditions that make people even more vulnerable to COVID-19 and more likely to die as a result.
The coronavirus is also more likely to exacerbate socioeconomic and racial inequality. A whopping 44% of Canadians have lost work as result of COVID-19. Financially insecure families are less able to recover from this economic shock, and are more likely to be tipped further into poverty and debt.
It's not just a lack of accessibility to health care that leads to worse health outcomes in poorer people; rather, it is the interconnection between low income, lack of resources, and the psychosocial stress of being poor starting from childhood that is linked to higher rates of disease and early mortality. In addition to poverty, other social determinants of health include race, ethnicity, gender, social marginalization, and physical environment. Therefore, improving the health of low-income communities requires a holistic approach that addresses the multi-factorial social and economic inequities in the current infrastructure.
In developing countries with less robust health system infrastructures, and crowded low-income communities with poorer sanitation, infectious diseases can spread rapidly and devastate these countries. Even if a vaccine were to be developed 18 months from now (scientists say this is the soonest a COVID-19 vaccine could be realistically produced), it seems unlikely that the vaccine would be distributed globally and equitably. Unless governments & organizations make concerted efforts to make global immunization a reality, the virus will not be eradicated and will continue to linger and ravage the poorer and more vulnerable communities who do not have access to the vaccine.
Why should we care about the health of low-income populations? The increasing health disparity between rich and poor has been shown to increase health care costs. Even if you do not care about the welfare of poorer people (although I'd argue, a little bit of altruism could do everyone some good), there is a financial and economic rationale for producing healthy populations. Everyone likes to save money right? And as COVID-19 has made clear, health and wealth inequities threaten the well-being of everyone.
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