Wealth Inequality Effects on Health

Introduction
         Wealth inequality harms people's health. For example, according to a 2015 study published in Nature, air pollution is associated with 3.3 million deaths worldwide yearly.1 Another 2017 study published in Lancet found that air pollution caused approximately 4.4 million deaths worldwide in 2015.2 Another 2018 study found that 8.9 million people died of air pollution in 2015.3 A 2009 study published in the New England Journal of Medicine found that if the United States reduces air pollution, life expectancy will increase by 15%;4 reductions of air pollution however does not address the issue of wealth inequality. A 2019 study published in JAMA found that individuals in lower socioeconomic classes have higher mortality rates from air pollution.5 This is likely due to higher exposure to air pollution.6 This paper argues that universal health care would address the issue.


The health effects of air pollution and its link with COVID-19

         Air pollution is linked with numerous adverse health effects. Sanidas et al.7 found in their 2017 meta-analysis published in the Journal of the American Society of Hypertension that exposure to air pollutants is associated with arterial hypertension. Additionally, a 2014 cohort study published in Environmental Health Perspectives found that long-term exposure to air pollution increases blood pressure,8 thus confirming the conclusion of Sanidas et al.7 Eze et al.9 found an association between long-term exposure to air pollution and type-2 diabetes in their 2014 cross-sectional study published in Environmental International. A 2022 study published in Environmental Research replicated Eze et al.9 findings.10 Rasschou-Nielsen et al.11 found an association between long-term exposure to air pollution and type-2 diabetes in their 2013 study published in Lancet Oncology. A 2014 and 2015 meta-analysis replicated Raaaschou-Nielsen et al. findings.12,13 Hoffmann et al.14 published in Circulation found an association between exposure to air pollution and coronary atherosclerosis in their 2007 study. A 2014 study published in European Heart Journal replicated Hoffmann et al.14 findings.15 Leary et al.16 found that high air pollution exposure is associated with right ventricular hypertrophy in their 2014 study published in the American Journal of Respiratory and Critical Care Medicine. Ho et al.17 found an association between exposure to air pollution and adverse cardiovascular events in their 2022 meta-analysis. A 2021 study published in Environmental Pollution found an association between exposure to air pollution and adverse cardiovascular events.18 A 2022 study replicated the finding of the 2021 study.19 Darrow et al.20 found an association between exposure to air pollution in late pregnancy with reductions in birth weight in full-term infants in their 2011 study. Nishimura et al.21 found an association between exposure to air pollution and childhood asthma in their 2013 study. A 2021 meta-analysis found an association between exposure to air pollution and childhood hypertension.22 A 2020 meta-analysis reached the same conclusion as the studies cited in this paragraph.23 This paper stated in the introduction that individuals in lower socioeconomic classes suffer from higher exposure to air pollution, and individuals in lower socioeconomic classes suffer more negative effects. These principles apply to the illness discussed in this paragraph.

         According to the CDC, approximately 1.1 million people died due to COVID-19.24 Many diseases related to air pollution exposure could worsen COVID-19. Raj et al.25 found a robust association between COVID-19 mortality and hypertension in their 2022 study published in Medical Sciences. Williamson et al.26 found an association between hypertension, diabetes, severe asthma, chronic heart disease, and stroke with COVID-19 mortality in their 2020 study published in Nature. Grasseli et al.27 confirmed the association between diabetes and COVID-19 mortality in their 2020 study published in JAMA. A 2021 meta-analysis also confirmed the association between diabetes and COVID-19.28 In summary, diseases associated with air pollution are linked with COVID-19 mortality. The diseases are seen more in individuals living in socioeconomic class, as they have higher exposure to air pollution.


Insurance's health effects

         Galvani et al.29 estimated in their 2022 study that approximately 41 million people needed access to insurance in the United States in 2019. A 2017 meta-analysis published in the Annals of Internal Medicine found that individuals without insurance have a higher mortality rate than individuals with insurance.30 Egan et al.31 found that individuals with insurance have higher control over their cholesterol level than people without insurance in their 2017 study published in the Journal of the American Heart Association. Ayanian et al.32 found that individuals without insurance are more likely to be unaware of their hypertension or high cholesterol than individuals with insurance in their 2003 study. Another 2010 study published in the American Journal of Medicine also found that uninsured individuals have less control and treatment of hypertension and high cholesterol than insured individuals.33 Research clearly shows that insurance helps reduce mortality in chronic diseases associated with air pollution and COVID-19 mortality. Research shows that insurance helps reduce chronic diseases associated with air pollution and COVID-19 mortality.

         According to a 2020 Gallup poll, 14% of individuals with possible COVID-19 avoid seeking medical care due to cost.34 A 2020 study found that individuals living in lower socioeconomic classes are more likely to delay getting a diagnosis.35 The delay in diagnosis proves deadly, as many treatments for COVID-19 are effective during the early stages.36 The 2020 study previously cited also found the delay in diagnosis a risk factor for COVID-19 mortality.35 The same study also found that people in lower socioeconomic classes suffer from higher rates of COVID-19 mortality. A 2022 study published in the Lancet Regional Health found that the lack of health insurance is the main reason for the disparity in the mortality rate of COVID-19; the same study also found that lack of insurance contributed to 60,000 deaths from COVID-19.37


         Universal health care would address the problem by providing insurance to individuals who cannot afford it which improves access to care. Again, individuals without insurance have a higher mortality rate from chronic illness. In addition to the studies this paper previously cited, a 2016 study published in the American Journal of Public Health found that individuals on Medicaid had higher awareness and control of chronic illnesses.38 Universal health care will save lives in the United States. A 2022 study found that universal health care would have saved 212,000 lives in 2020 alone.29 Another 2020 study published in Lancet found that universal health care would have saved over 68,000 lives in 2017.39 Another 2013 randomized controlled trial published in the New England Journal of Medicine found that medicare help increases the detection and control of type 2 diabetes.40 Evidence shows that universal health care saves lives.




Conclusion
         
          In summary, the evidence shows that wealth inequality has an enormous negative impact on individual health, and universal health care would help address it. One limitation is that the studies this paper cited are not experiments, meaning they can only provide an association, and association does not equal causation. However, the amount of evidence allows this paper to reasonably infer that universal health care would work and that wealth inequality harms health. Another limitation is the Tenth Amendment. A national universal health care policy would not be possible due to the Tenth Amendment. The United States Supreme Court struck down former president Barack Obama's attempt at universal health care in 2012 under the Tenth Amendment.41 Therefore, the effects of universal health care might be limited as some states might not adopt it.




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