Roos – how income affects health

One of the things which we’ve been very interested in is how do health differences, which we know exist across social groups, what’s their generation? And so one of the studies which we’ve been doing is trying to track people who always live in, or children who always live in low income neighbourhoods vs. those who always live in middle-income vs. those who always live in high-income neighbourhoods throughout their childhood. And what we find is that first year there are very big differences in hospitalization rates and in various health characteristics. First year, bit of the second year and then many of the health differences essentially disappear.  

Basically, kids are remarkably healthy from about age four through maybe age 10 or 11. When you get to the teenage years those differences start emerging again. You’re getting accidents, you’re getting injuries, depression. There are a whole series of things, which are beginning to develop. But what’s also very interesting is over this whole period, educational differences are widening. What we find is when we compare how kids do on the, I think it’s the Education Development Index, the EDI, which are administered to kids right when they enter school. There are differences across groups depending on whether you live in high-income areas or low-income areas in the direction in which you’d expect: high income area kids do better. But the differences aren’t huge. By Grade three the differences are larger, by grade seven and nine they’re getting bigger. By 12, I’ve just described, they’re terrible. And we know that health differences also start re-emerging in the teen years and are remarkably large as we go on.  

One of my favourite examples, which I think is enormously powerful, is there was a study at Duke a few years ago which looked at how many. . .  what would we add to people’s life expectancy if we could wipe out cancer. That is, I mean we hear about prostate cancer, we know breast cancer is a killer. I had a friend who recently died, I actually had a niece who died of cervical cancer.  Just an incredibly awful disease – cancer. What we would add to life expectancy would be almost three years if we could give every child at birth, a pill which would mean they didn’t have to worry about ever developing any type of cancer and you made the heroic assumption that they wouldn’t die sooner of something else, because we all do eventually die. At the time the study came out, we were doing a comparison across Winnipeg neighbourhoods, of life expectancy. The life expectancy difference across the poorest Winnipeg neighbourhoods, and that’s the 20% of people living in these neighbourhoods, so we’re not talking about narrow little neighbourhoods, so we’re talking about 20% of the poorest neighbourhoods, compared the 20% of the highest income neighbourhoods – for men there’s a 12 year difference in life expectancy. So in terms of understanding how important these differences are that to me says it all.