Map of life expectancy at birth from Global Education Project.

Monday, February 07, 2011

Another open door crashed through

This is kind of in the "well,duhhh" department, but it reinforces an important enough point that I'll subject you to it. As you probably know, Canada is a totalitarian dungeon where everybody gets health care. David Alter and colleagues, in the new Health Affairs, followed a cohort for 10 years to untangle the associations among health care utilization, socio-economic status, and health. (You're just common rabble so you only get to read the abstract.) While there are some details I won't go into, the main point is that lower income, and less educated people tended to be less healthy at baseline; they had more primary care visits and more specialist visits; they got more CABGs; and they were more likely to develop heart disease and diabetes, and to die.

Specific risk factors -- you know, smoking and what not -- could explain some of the effect of income, but interestingly, not much of the effect of education.

In other words, as we already knew, universal access to health care, while it's the right thing to do on numerous grounds, doesn't do a whole lot to make up for all the bad stuff that happens to people that damages their health -- and poor people and less well educated people have a lot more of that bad stuff happen. They're also more likely to be depressed, by the way.

So if we're going to invest in universal health care, we would be very well advised to invest even more in public health, and that means a more just and humane society. The fashion nowadays in the U.S. is that we owe no obligation to each other and them that's got should just get more and to hell with the losers. Sociopathy is the new morality. We can debate that but if you're a libertarian or a teabagger, that's what you believe. At least be clear about it.

Also in the new HA, it seems that newly minted female doctors are paid a lot less than newly minted male doctors in the same specialties. No idea why. Hmm.

1 comment:

kathy a. said...

yeah, boy, that last piece is a surprise. or i wish it was.