POVERTY AND ILL HEALTH - PHYSICIANS CAN, AND SHOULD, MAKE A DIFFERENCE

A growing body of research confirms the existence of a powerful connec tion between socioeconomic status and health. This research has implic ations for both clinical practice and public policy and deserves to be more widely understood by physicians. Absolute poverty, which implies a lack of resources deemed necessary for survival, is self-evidently associated with poor health, particularly in less developed countries. Over the past two decades, economic decline or stagnation has reduced the incomes of 1.6 billion people. Strong evidence now indicates that relative poverty, which is defined in relation to the average resourc es available in a society, is also a major determinant of health in in dustrialized countries. For example, persons in U.S. states with incom e distributions that are more equitable have longer life expectancies than persons in less egalitarian states. There are numerous possible a pproaches to improving the health of poor populations. The most essent ial task is to ensure the satisfaction of basic human needs: shelter, clean air, safe drinking water, and adequate nutrition. Other approach es include reducing barriers to the adoption of healthier modes of liv ing and improving access to appropriate and effective health and socia l services. Physicians as clinicians, educators, research scientists, and advocates for policy change can contribute to all of these approac hes. Physicians and other health professionals should understand pover ty and its effects on health and should endeavor to influence policyma kers nationally and internationally to reduce the burden of ill health that is a consequence of poverty.