Economic inequality, the gap between the rich and the rest of us, affects every aspect of society, including our health.
As an illustration, consider child mortality, the proportion of children who die before reaching age five. Out of every 10,000 children born in the United States, an extremely wealthy country, 65 will not reach their fifth birthday.
Now consider child mortality in Slovenia, a middle-income country where our First Lady, Melania Trump, was born. In Slovenia, only 26 children will die in the first five years of life, much less than half the number of U.S. child deaths.
If the United States had Slovenia’s child mortality rate, a standard that certainly should be achievable, 42 fewer U.S. children would die every day. In other words, over 15,000 children die needlessly every year in the most powerful country on earth.
A large and growing number of studies link child mortality and many other mortality outcomes with income inequality. We know that the United States has experienced obscenely increased inequality over recent decades. How is Slovenia doing? See for yourself.
Steer your browser to the CIA World Factbook website’s section on the economy. Under Distribution of Family Income, a click on “Country comparisons with the world” will show rankings by Gini coefficient, a widely used indicator for measuring a society’s level of inequality.
A lower Gini coefficient connotes a lower level of inequality. What nation stands almost the lowest on the Gini rankings list? That’s right: Slovenia.
Take that reality in and then scroll up a hundred nations to find the United States, a land with almost twice the Gini score — twice the level of inequality — as Slovenia.
Could the quality of health care — and not inequality — explain the massive difference in health outcomes between Slovenia and the United States? Likely not. Slovenia offers only basic health care services, nothing like the Star Wars high-tech medical care available in the United States.
Could high mortality rates in the United States simply reflect high poverty? The United States does have much more poverty than other developed nations. But even upper-income Americans show higher mortality rates than their affluent counterparts elsewhere in the developed world.
The hard truth: By any mortality measure, Americans rank dead first, compared to other industrialized nations. Growing economic inequality in the United States has unleashed a force more powerful than a massive national tsunami.
Only organizing on a mass scale — to warn the public and confront the causes of our peril — can rescue us from this deluge. Either we see that organizing begin to gain momentum or we drown in a sea of inequality.
Stephen Bezruchka, M.D., M.P.H., teaches in the Departments of Global Health and Health Services at the University of Washington School of Public Health.
In a May 4, 2017 address at the University of Washington, Dr. Stephen Bezruchka explores the “structural violence” societies unleash when they tolerate staggering inequalities of income.