Money and resources
There is a well-established link between money and resources and variations in health. Poverty in particular is associated with worse health outcomes, and this is especially the case for persistent poverty
Why money and resources matter for health
There is a strong relationship between money and resources (such as income or wealth) and health outcomes. In a market society, financial resources are a necessity for most areas of life, including those that influence a person’s health.
People in the bottom 40% of the income distribution are almost twice as likely to report poor health than those in the top 20%. Poverty in particular is associated with worse health outcomes, and this is especially the case for persistent poverty.
Explore the different ways in which money and resources can affect health outcomes below.
Financial or economic strain has been variously measured by reference to income or debt, but generally refers to financial pressure or inadequate financial resources. This may include debt or an inability to meet day-to-day living expenses. This financial strain can act as a source of stress for individuals, and has been described as one of the ‘hardships, demands, conflicts, and frustrations’ in life that can lead to a stress response and eventually harm physiological health.
The consequences of these stresses can also be amplified by insufficient financial resources to manage them. For example, caring for a relative with a long-term health condition can occur across the socio-economic distribution, but the consequences may be greater for those with either lower incomes or fewer flexibilities related to employment.
The persistence of financial strain matters for health, because those facing persistent financial strain endure worse outcomes than those facing intermittent strain. In addition, the damage caused by economic strain can accrue throughout life, lowering resistance to illness.
Poverty – defined as having inadequate resources to meet basic human needs – is associated with worse health outcomes. In childhood, poverty is associated with worse outcomes in infant mortality, low birthweight prevalence, obesity, asthma, tooth decay and accidental death. It is also associated with worse health outcomes in adulthood, such as premature mortality, diabetes and cardiovascular disease.
Poverty can affect health in the same way that different levels of income can lead to different health outcomes, but with poverty there is the additional difficulty of not having sufficient income to meet even basic human needs. The deprivation of necessities that sustain a basic standard of living affects health in several ways, including being unable to afford sufficient heating or a nutritionally adequate diet. Other factors that can directly harm health include low-quality housing and the lack of opportunity for social participation.
Poverty can also have psychosocial consequences that can eventually affect health, due to the stresses of living on a low income as discussed in more detail in the following section on financial strain as a source of stress.
There is also the potential for poverty to affect health through relative deprivation, which is the stress associated with lacking the goods, services and status of mainstream society. This can affect health, even if a basic standard of living is being met, by acting as a chronic source of stress that eventually manifests physiologically.
Research suggests that any exposure to poverty in childhood, compared with no experience of poverty, is associated with worse health outcomes. Persistent poverty is associated with even worse outcomes, such as obesity, mental ill health and long-term illness. The number of episodes of poverty accumulated over an individual’s life is also associated with worse health outcomes.
On average, people with a low income are more likely to engage in unhealthy behaviours, such as smoking, high alcohol consumption, inactivity, high calorie intake and not taking advantage of preventive health services. There is evidence of a ‘double jeopardy’ effect, whereby unhealthy behaviours compound the relationship between stress and ill health. The range of stressors associated with low income may encourage people to drink, smoke or reduce exercise to cope with these pressures.
There is also a link between the perceived permanence of income and healthier behaviours. There needs to be a perceived sustained improvement in prospects for adoption of healthier behaviours – a short-lived income boost seems insufficient. The financial cost of some activities or goods have also been found to be a recurrent barrier to healthier behaviours.