Focusing On Health without Income Equality Is Not Enough

Ann Twomey is the HPEA president.
Ann Twomey is the HPEA president.

During the holiday season, families should be able to celebrate with loved ones –  yet for far too many working families, their economic insecurity instead brings not only anxiety and worry, but even ill health.

The gap between the wealthy and the rest of us is growing, and the ramifications for our health and well-being are enormous. Economic inequality is the highest it has been in our country since the 1920s, and the studies show that you are likely to have worse health if you live in a poor community, including higher risk of disease and shorter life span.[1]

Some of this can be explained by lower health insurance coverage in poor communities, or toxic neighborhood environments with pollution and limited access to clean water and healthy food. However, recent studies have also found that our society’s income inequality in itself may have a harmful effect on our health.

The Affordable Care Act has made an important contribution to improved health coverage, and my union continues to engage in efforts improve access to safe and affordable care. Focusing on health alone, without attention to income inequality, is not enough. We must engage ourselves in community fights for a living wage, retirement security and a reversal of the income gap in this country.

That because, countries with greater income equality do better in life expectancy, infant mortality, and self-rated health.[2] One study of  income inequality and mortality rates in counties across the United States showed such a close tie between health and income inequality that even wealthier people living in unequal counties had higher mortality rates than poor people living in more equal counties.[3]

As nurses and health care workers, we see first-hand how our patients’ illnesses are often connected to their poverty, or unsafe working conditions, or lack of access to primary care providers.  The surest way we can improve health disparities is to tackle income inequality together as unions, working people, and communities.

That’s why HPAE is working with other unions and low-wage workers to support a $15/hour minimum wage for all workers across our state.  That’s why we also support programs like the one  spearheaded by the Camden Coalition of Healthcare that  allows homeless people to move into a home before they receive healthcare and social services.  Housing First has been a success in other states, and once the program is off the ground in Camden, we urge state officials to expand the program across the state to expand housing and improve the health of our most vulnerable citizens.

Unmanageable debt has also made it difficult for working families to maintain a decent quality of life. Our national union, the American Federation of Teachers is supporting plans to rein in college debt.  Here in New Jersey, in another example, patients and families across the state are getting high and surprising medical bills due to ‘out-of-network’ insurance arrangements. Reining in these surprise medical bills through transparency and disclosure is one way to both protect consumers from getting caught in the middle of disputes between insurers and providers, and to keep them out of medical debt or even bankruptcy.

We also urge legislators to protect New Jerseyans from profit-driven companies that are trapping working people into debt through aggressive lending practices.  These companies use mounting fees and interest payments on college or mortgage loans to keep working people in a cycle of debt that they cannot escape. That’s why we are aslo partnering with NJ Communities United to expose the high costs and intimidating tactics of debt collectors – as well as the excessive profits being made by Wall Street companies.

Policies such as raising the minimum wage, making college affordable, improving health care access, and protecting working families from excessive interest payments will improve the quality of life and health for working people and help to rebuild the foundation of our seriously endangered middle class. This holiday season, let’s work toward creating income parity: it will improve health outcomes for all, which in turn strengthens our communities and workplaces.

[1] See “Sick of Poverty” by Robert Sapolsky


[3] State income inequality, household income, and maternal mental and physical health: cross sectional national survey by Robert S Kahn, Paul H Wise, Bruce P Kennedy, and Ichiro Kawachi. Focusing On Health without Income Equality Is Not Enough