As with individuals, research shows that low income communities and populations also have higher rates of morbidity and mortality. However, unlike individuals, absolute levels of income may not be the primary factor associated with the health and wellness of residents; in fact some findings indicate that income inequality within communities may have a more significant association with morbidity and mortality than income alone. If this is the case, it is possible that more equitable societies or communities also experience more favorable health outcomes. To the extent that policies can ensure equitable allocation and access to public resources such as: outlets for physical activity, fruits, vegetables, clean air, etc.; the more favorable health status will become in economically challenged environments.
Policy variables such as access to care, welfare spending, vocational and remedial training, unemployment compensation, head-start programs and food assistance programs can be used as indicators to measure community economic conditions in general, and more specifically income inequities.
Downstream Health Effects
Community resources are closely related to access to health care, environmental exposure to pollutants, outlets for physical activity, and access to nutritious foods, thereby impacting health conditions in the community.
Policies and Other Determinants
Economic policies that increase income inequality may also have deleterious effect on population health. In addition, policies that influence the allocation of public resources also affect neighborhood and community economic conditions. Such policies include:
- Mixed income and mixed use development, which allows residential, retail and commercial uses in close proximity to one another, sometimes in the same building, encourages people from different economic categories to interact more with one another while spending more time in their neighborhoods. Such environments help to ameliorate housing inequities and could possibly reduce the negative health effects associated with disparities
- Living wage ordinance policies that mandate pay rates for designated job categories have the potential to reduce mortality rates and their associated costs. Research shows that the associated health benefits from such ordinances are more cost-effective than equivalent wage increments. Income has also been shown to be a key determinant of educational attainment, which in turn is an important determinant of health. Similarly, there are potential health benefits stemming from increased income on childcare by making quality childcare more accessible
- Pedestrian-centered retail and commercial development, this is often combined with mixed use development to create informal opportunities for social interaction and equitable access to community beautification projects. Many of the “great places” that attract visitors and residents are those public markets and shopping districts that provide a pedestrian-centered environment with cafes and other spaces for social interaction (see the Project for Public Spaces website)