Being poor should be included as health risk factor

Less well-off face reduced life expectancy of 2.1 years, new research shows

People just above the income threshold for a medical card see medical care as a luxury

People just above the income threshold for a medical card see medical care as a luxury

 

Doctors of all specialities can attest to the fact that low socioeconomic status is linked to a significant reduction in life expectancy. And the medical literature is full of evidence linking poverty and low social status with many illnesses, including the big killers – cancer and cardiovascular disease.

My own experiences illustrate this reality. The level of pathology I saw among patients living in poor circumstances was of an order of magnitude greater than that experienced by their more well-off peers.

Patients consulted with highly advanced cancers: I diagnosed one man in his 40s from the door of his bedroom – halted in my tracks by the huge tumour emerging from above his clavicle. He had an upper lobe lung cancer.

People just above the income threshold for a medical card see medical care as a luxury. I saw one man in his 50s who was reluctantly dragged to the surgery by his concerned wife; he had extensively disseminated tuberculosis and despite the best efforts of hospital colleagues he died three days later.

Literacy levels

It took some time before I realised that this was because of low literacy levels. There is a lot of important written information contained in packs of the pill; however some of it relating to what to do when you miss a pill or develop gastroenteritis is relatively complex and not easily absorbed if you struggle with reading or writing.

Advice to eat more fresh fruit and vegetables was largely met with polite indifference. The relative cost of fresh food for a single mother with two children was such that fresh fruit could only ever be an indulgence.

The authors of a major new study of 1.7 million people, published last week in The Lancet – who include Dr Richard Layte of the Department of Sociology at TCD – have called for low socioeconomic status to be considered a major risk factor for ill health and early death in national and global health policies.

Using data from the UK, France, Switzerland, Portugal, Italy, the US and Australia, the study is the first to compare the impact of low socioeconomic status with other major risk factors on health such as physical inactivity, smoking, diabetes, high blood pressure, obesity and high alcohol intake.

According to the research, when compared with their wealthier counterparts, people with low socioeconomic status were almost 1.5 times more likely to die before they were 85.

Deprivation

Commenting on the results, lead author Dr Silvia Stringhini of Lausanne University Hospital said: “Given the huge impact of socioeconomic status on health, it’s vital that governments accept it as a major risk factor and stop excluding it from health policy.

“Reducing poverty, improving education and creating safe home, school and work environments are central to overcoming the impact of socioeconomic deprivation. By doing this, socioeconomic status could be targeted and improved,” she added.

“Socioeconomic status is important because it is a summary measure of lifetime exposures to hazardous circumstances and behaviours that goes beyond the risk factors for non-communicable diseases that policies usually address. Our study shows that it should be included alongside these conventional risk factors as a key risk factor for ill health.” said Professor Paolo Vineis, Imperial College London.

There is really no excuse; socioeconomic adversity must now feature as a modifiable risk factor in local and global health strategies policies, and health-risk surveillance.

The Irish Times Logo
Commenting on The Irish Times has changed. To comment you must now be an Irish Times subscriber.
SUBSCRIBE
GO BACK
Error Image
The account details entered are not currently associated with an Irish Times subscription. Please subscribe to sign in to comment.
Comment Sign In

Forgot password?
The Irish Times Logo
Thank you
You should receive instructions for resetting your password. When you have reset your password, you can Sign In.
The Irish Times Logo
Please choose a screen name. This name will appear beside any comments you post. Your screen name should follow the standards set out in our community standards.
Screen Name Selection

Hello

Please choose a screen name. This name will appear beside any comments you post. Your screen name should follow the standards set out in our community standards.

The Irish Times Logo
Commenting on The Irish Times has changed. To comment you must now be an Irish Times subscriber.
SUBSCRIBE
Forgot Password
Please enter your email address so we can send you a link to reset your password.

Sign In

Your Comments
We reserve the right to remove any content at any time from this Community, including without limitation if it violates the Community Standards. We ask that you report content that you in good faith believe violates the above rules by clicking the Flag link next to the offending comment or by filling out this form. New comments are only accepted for 3 days from the date of publication.