Income inequality and health status: a nursing issue

Headnote

KEY WORDS

socio-economic, nursing, population health, inequality

ABSTRACT

Objective

To review the association between income inequality and health status, and consider an appropriate nursing response.

Primary Argument

Nursing has a rich heritage of advocating for a healthy society established on a foundation of social justice. The future legitimacy and success of public health nursing depends on recognising and appropriately addressing the social, economic and political determinants of health in the populations served. There is an incontrovertible association between population health status, absolute income levels and income inequality. Thus, along with other social determinants of health, income differentials within populations must be a fundamental consideration when planning and delivering nursing services. Ensuring that federal and state health policy explicitly addresses this key issue remains an important challenge for the nursing profession, the public health system and the Australian community.

Conclusions

Higher mortality and worse health status occur in societies with higher income inequality. The relationship between income inequality and health appears to be determined both by relative access to resources for health gain and relative social position. The association between greater income equality and improved health may be explained by improved social cohesion. As social factors are at the root of much of health inequality, this knowledge needs to invoke political action and advocacy from the nursing profession to promote the development of healthy public policy.

Including indicators of income inequality when planning and monitoring nursing services will enable services to measure to what extent they are based on the principle of social justice.

INTRODUCTION

Nursing has a rich heritage of nurses serving as advocates for a healthy society based on the principle of social justice (Drevdahl et al 2001). The role of public health nursing in many countries, including Australia, is varied but the focus on the populations' health is central to its role (WHO 2001). This role includes action in the areas of preventative health services and public policy. The future legitimacy and success of public health nursing depends on recognising and appropriately addressing the social, economic and political determinants of health in the populations served. Most notably, the relationship between income and population health status should not be neglected.

The link between population health status and socioeconomic status has long been recognised....