SOCIOECONOMIC DETERMINANTS OF HEALTH .2. HEALTH AND SOCIAL COHESION -WHY CARE ABOUT INCOME INEQUALITY

Throughout the world, wealth and income are becoming more concentrated . Growing evidence suggests that the distribution of income-in additio n to the absolute standard of living enjoyed by the poor-is a key dete rminant of population health. A large gap between rich people and poor people leads to higher mortality through the breakdown of social cohe sion. The recent surge in income inequality in many countries has been accompanied by a marked increase in the residential concentration of poverty and affluence. Residential segregation diminishes the opportun ities for social cohesion. Income inequality has spillover effects on society at large, including increased rates of crime and violence, imp eded productivity and economic growth, and the impaired functioning of representative democracy. The extent of inequality in society is ofte n a consequence of explicit policies and public choice. Reducing incom e inequality offers the prospect of greater social cohesiveness and be tter population health.