Sir, - Recent research shows that the extent to which income is distributed evenly is one of the most important determinants of health in the developed world. As a result, the recent ESRI report, Poverty in the 1990s, showing that the gap between rich and poor in Ireland is growing and the proportion of persons receiving below half the average income rose from just over 15 percent in 1973 to 21 per cent in 1994, is very disturbing.
According to the Harvard School of Public Health, the size of the income gap between the wealthy and not so wealthy, as distinct from the absolute standard of living enjoyed by the poor, is a key determinant of mortality rates. Other workers have shown that income inequality is significantly associated with homicide rates, violent crime, work disability, smoking, sedentary activity and poor educational performance.
The researchers in Harvard used a measure called the Robin Hood Index to measure income inequality. The higher the Index, the greater the inequality of income. They found that the level of the index was correlated with the overall age adjusted death rate so closely that each percentage point increase in the index was associated with an increase in the total mortality of 21.7 deaths per 100,000 population. The Index was also strongly associated with the infant mortality rates, deaths from cancer and heart disease and also deaths from homicide. The researchers believe that reducing inequality would bring important health benefits and calculate that merely reducing the index from 30 per cent to 25 per cent would cut the number of deaths from coronary heart disease by 25 per cent.
Given that health and general well being are more sensitive to income distribution than the absolute level of income, it is important to ask whether the advent of the EU's single currency will make the distribution of income more equitable or not. The danger is that inequalities will grow since economic growth, the main aim of European integration, generally concentrates wealth in the hands of a few, unless governments introduce re distribute mechanisms to prevent it doing so.
But a Catch 22 situation may rule such measures out since, as Professor Davey Smith of the Department of Social Medicine at Bristol University has pointed out, the only coherent argument against redistributive social policies is that they hinder economic growth. In short, a minority of people might get richer at the expense of the health of everybody else.
There is a great need to understand the links between economic policies and health. We should not rush to participate in the single currency until we fully understand the health implications of what is proposed. - Yours, etc.,
Spokesperson on Health,
The Green Party/
Comhaontas Glas,
Salthill,
Mountcharles, Co Donegal.