US : the country of inequalities US : the country of inequalities
Health Care « If you want to get an idea of the gap between the world’s sickest and healthiest people, don’t fly to a faraway... US : the country of inequalities

Did you know that the poorest half of the US owns only 2.5% of the country’s wealth? How much do you think the top 1% owns, then? Try 35% of the national wealth.

The Stanford Center for the Study of Poverty and Inequality published an article called “20 Facts About US Inequality that Everyone Should Know”. This facts are really 20 categories in which inequalities are raging in the country, from education to health care or even race (surprised?).

We all know the so-called “American Dream”, a delusion of an utopian version of democracy. The United States might once have been a land of opportunities, but it stands now as the richest and one of the most unequal country of all.

Let’s have a look at four of the categories at the core of the issue (Income and poverty, Health Care, Education and Incarceration) :

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Health Care

« If you want to get an idea of the gap between the world’s sickest and healthiest people, don’t fly to a faraway land. Just look around the United States. »

– Fourth, a series on what Harvard scholars are trying to identify and understand inequality, in seeking solutions to one of America’s most vexing problems.

Health inequality is deeply entrenched in America, linked with other social problems such as disparities in income, education, housing, race, gender and even geography. Inequality in health can be subdivided in three categories:

  • disparities in health itself: rates of asthma, cancer, heart disease, diabetes, drug abuse, violence etc
  • disparities in care: access to hospitals, skilled professionals, medical technology, essential medicine etc
  • inequality in health insurance: the financial means to pay for the care needed in order to stay well.

These three problems require interlaced solutions. President Obama’s Patient Protection and Affordable Care Act (ACA) has taken huge steps in narrowing the gap in health insurance coverage, but those gains haven’t had a significant impact on the other two health care disparities, leaving diverse groups unequally healthy so far.

Disparities are built into the health care landscape, but it seems that life expectancy is increasing for African-Americans and the poor. Although stark disparities remain, the overall health picture is one of improvement. Still, the remain disparities are daunting: life expectancy, which depends on resident’s race and ethnicity, varies as much as 30 years between the richest and poorest US counties.

And what it worse, a study by the Brooklyn Institution found that the gap has widened considerably. This is a major reason why US life expectancy trails many peer nations: according to a 2014 report by the OECD (Organization for Economic Cooperation and Development), US life expectancy in 2012 was 78.7, 27th out of the group’s 34 industrialized democracies.

It is obvious that disparities of any kind mostly begin at birth for many African-Americans or the poor share of the population, but one would hope that the health care system would be part of the solution. Instead, what is found, over and over, is that not only does it not do that effectively, sometimes it makes disparities worse.

At the core of this poignant issue are, once again, the soaring costs of health care in America (heart bypass in the US cost $75,354 in average, compared to $42,130 in Australia, the second-highest amount). Evidently, when you live in a country where you have to choose between paying your medical bills or your rent, the ones that get evicted are not the top 1%.

Surprisingly, the US spends an average of $9,000 per person on health care, which translated to more than 17% of gross domestic product. (at least 50 percent more than any other country). However, plenty of other countries see much better outcomes in their citizen’s actual health overall.

We can only hope that the recent path towards universal health coverage will grant a better place in the life-expectancy scale for the US.

Ichiro Kawachi, John L Loeb and Frances Lehman of Public Health’s Department of Social and Behavioral Sciences:

« If you’re born a black man in, let’s say, New Orleans Parish, your average life expectancy is worse than the male average of countries that are much poorer than America. »

But Ichiro Kawachi also adds that

« It’s not only a question of racial disparities. At the root of it are unequal economic opportunities and unequal education. »

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Violeta Campos

étudiante à HEC Paris. J'ai passé toute ma scolarité au Lycée Français de Madrid, puis j'ai intégré Janson de Sailly (Paris) en prépa ECE. Mon amour pour les maths, l'éco (un peu) et les langues me poussent à écrire pour vous aujourd'hui !