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Wednesday, 14 September 2011

Health Equity headed south. The Gini coefficient in action

One has to question the motivation behind a system that propagates failure and causes grief.  This blog has just discussed health equity and progress in Canada when the US Census Bureau announces 2010 information on poverty and health insurance US Census Bureau statistics 2010.   While the focus of this blog is on Canadian public health, such activity lives in the shadow and influence of our great neighbours and partners to the south.  
What is wrong with the picture of 50 Million Americans who do not have health insurance?   Or the 15% who live in poverty?   While achieving balance in the US political system requires incredible intellect and tact, what system allows so many individuals to suffer at as a result of the social structures that it supports? 
Using the US as a comparison provides the opportunity to discuss what has been found to be an even better predictor of health than the absolute distribution of wealth, but the equitable distribution of health.  Countries where the rich carry more wealth, tend to have significantly poorer measures of wellbeing.  Countries with more equitable distribution of wealth tend to have better measures of health (and various other civil society measures).  One measure of equitable distribution of wealth is the Gini coefficient of income.    

The global picture in 2009 looks as follows and can be found in that excellent resource of general knowledge called Wikipedia (link below).  The findings suggest excellent income distribution in nordic and mid European countries.  Canada fairing reasonably well.  Very poor performance from some South American and African countries and moderately poor from the major entities of the US, Mexico and China.
Just as interesting is what has happened to income equality over the past 60 years and this is also found in the Wikipedia article. Long term trends are a good measure of the general cultural direction and influence within a nation.    Countries like France, Mexico, Norway are leading the charge in the “right” direction.   China, US, and UK are perhaps headed in the wrong direction.  
Canada’s performance is neither commendable nor embarrassing.  In 2009 the coefficient has slipped back up to about the same point it was at in 1952.   The US’s consistent trending upwards has continued.
I’m reminded of the saying by Baron Acton “Power tends to corrupt, and absolute power corrupts absolutely.”    

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