Socioeconomic inequalities are strongly correlated with inequalities in human health outcomes. The Covid-19 pandemic provided stark examples of how this happens both within countries and among countries. Richer nations were able to secure vaccines faster and in greater quantities than poorer countries and wealthier people were able to shelter themselves and their loved ones more easily during the worst moments of the pandemic.
Besides the Covid-19 experience, the interaction between SDG10 and health is bidirectional and often affected by positive or negative feedback loops. The most obvious loop is determined by the wealth-health connection: healthier people tend to earn more, and wealthier people have access to better healthcare thus being relatively healthier. This loop is strengthened when considering mental health: greater economic inequality within a country is associated with a higher prevalence of mental illness that is in turn associated with lower incomes and increased risk of homelessness. Moreover, this loop starts with childhood: there is robust evidence that healthier children, especially those from poorer backgrounds, have better school attendance and grades and earn higher incomes later in life.
At the national level, wealth inequality impacts not only human health (.e., provision of better healthcare) but also the number of resources available to protect the environment, with the associated long-term benefits for human and animal health. Besides national parks, this means better water-treatment plants, pollution controls, safer agricultural practices, and the whole policy and infrastructure system that protects the health of the whole system.
A less obvious loop is the focus of this SDG on promoting inclusion and reducing discrimination. Lots of diseases and long-term conditions can result in discrimination and both, social and economic exclusion. For example, some chronic conditions might force people to miss work due to flare-ups. When proper legal protections are not in place, this could lead to people losing their jobs, thus reducing their ability to treat their condition, increasing the number of flares up in a negative spiral. Similarly, people with a disability might find it harder to work or even to take care of themselves when living in a society without the resources and/or the culture to accommodate them. Even though they could perform a job productively, if they are unable to reach the workplace, they would be excluded from participating in the economy of their country. At the same time, providing better and more opportunities for people to address their health issues or, even better, delay the onset of these conditions (i.e., early diagnostics for diabetes or cancer, hip replacements, prostheses) can help reduce the stigma sometimes associated with these conditions and foster a more inclusive society.
Finally, SDG10 has one target specifically dedicated to migration that monitors, among other things, the “Number of people who died or disappeared in the process of migration towards an international destination”. This should be expanded to include the number of migrants that are infected by contagious diseases, and suffer temporary or permanent disability, as well as the impact that all of this has on the origin and destination countries.
By: Dr. Luca Mantegazza | Research Program Coordinator