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APHA Scientific Session and Event Listing

Nancy Krieger, PhD, Dept of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Kresge 717, Boston, MA 02115, 617-432-1571, nkrieger@hsph.harvard.edu

Poverty and health. At one level, the connections are obvious. The consequences of embodying poverty are poor health and early death. But at another level, the connections are contentious. In the United States and globally, longstanding arguments continue to rage over whether “the poor” are poor and have poor health: (a) because of their own innate deficiencies, whether moral, intellectual, or biological; (b) because of social injustice, requiring redistributive justice; or (c) because the causal arrow runs principally from poor health to economic poverty, rather than the reverse, since being ill interferes with earning (and learning) capacity. Within the US and other wealthy countries, additional controversies concern whether poverty's impact on health is due to actual material want (economic deprivation) versus psychosocial stress, and, related, if the public health and policy focus should be on “poverty” versus the “socioeconomic gradient.” In this session, I will address these varied issues from an ecosocial perspective by presenting two case examples. The first concerns the contemporary social geography of premature mortality in Boston. The second concerns temporal trends in the socioeconomic gradient of premature mortality in the US from 1960 through 2002. Two stark findings are that: (a) despite marked declines in premature mortality death rates, socioeconomic disparities in early death persist, and (b) in Boston, nearly 1 out of every 3 premature deaths now occurring among people living in poor areas would not have happened if their death rates equaled those of people living in affluent areas. Poverty harms health.

Learning Objectives:

• At the end of this presentation, the participants will be able to discuss the importance of poverty as a social determinant of health.

Presenting author's disclosure statement:

Any relevant financial relationships? No