Income only one variable [in poor health outcomes]
WinnipegFreePress.com – opinion/letters to the editor/have-your-say
09/11/2013. Harvey Stevens / Sid Frankel
In her Sept. 9 column, Social policy is strong health policy, Patricia O’Campo reasons that because low levels of income are associated with substantially higher levels of poor health outcomes, low income is the cause. Accordingly, she concludes providing higher incomes to the poor is the appropriate policy response.
But what if low income and poor health status are jointly determined by other factors, such as low levels of education, poor parenting, chronic health conditions and low levels of employment? If so, the correct policy prescription is investment in programs that address these deficiencies.
In my review of studies that adequately controlled for personal characteristics that jointly affected income and health status, the independent and unique effect of income was quite small. In other words, giving people a large increase in income through transfer payments would lead to small improvements in their health status.
There is no one magic bullet. Yes, adequate levels of income support are required for those unable to work. But the surer long-run solution is investments in programs that give children better chances at succeeding in school, in obtaining employment, in avoiding addictions, etc.
Given limited public funds, the really tough policy question is that of determining the right mix and level of investments in income transfers and social programs.
Harvey Stevens, Winnipeg
Patricia O’Campo very cogently demonstrates policy influencing income, education and the other social determinants of health is the most powerful means of decreasing premature mortality and disease morbidity. One important implication of this is government expenditures must increase in areas such as education, income assistance, child care, poverty reduction and social support services.
In addition, this growth must be financed through increasing the progressiveness of the personal income tax system and taxation yields from profitable corporations, because increasing the taxation load of low and modest-income earners will increase inequities in health. Is there a government ready to use this evidence from good science as a basis for taxation and health policy?
Sid Frankel, Faculty of Social Work, University of Manitoba
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