Читать книгу Wealth - Yuval Elmelech - Страница 26

In a thorough review of the literature on the role of socioeconomic status differences in shaping disparities in health outcomes and mortality, Elo (2009: 553–572) found consistent evidence that health status and mortality vary according to socioeconomic status, although with the caveat that the actual mechanisms behind this relationship are less clearly understood (Attanasio and Hoynes 2000). Explanations for the wealth–health nexus focus on the cost of healthcare services and on people’s ability to afford or access a healthy lifestyle, which includes the availability of healthy food (often scarce in “food deserts”) and the degree of access to green spaces, adequate housing, and good air quality (Woolf et al. 2015; Adams et al. 2003). Research suggests that the effects of asset holding on health outcomes are mediated by demographic and socioeconomic characteristics. According to Pollack et al. (2013: 439–445), wealth has a significant effect on the health status reported within racial and ethnic groups, even after accounting for education and income.

Other studies, however, have shown weaker support for the role of wealth on health outcomes. Studying the effect of socioeconomic status on health across the life course in the US, for example, Smith (2007) concluded that socioeconomic status does affect future health outcomes, but the principal reason for this trend is education rather than income or wealth. It is likely that the effects of assets and wealth on health status vary across the life course, but establishing direct causal relationships between the two variables remains a challenging task (Adams et al. 2003; Gibson et al. 2011; Lerman and McKernan 2008).