Health: Why Universal Medical Care Only Go So Far By Andre Picard

Introduction
This essay will examine the article “Wealth begets health: Why universal medical care only goes so far” written by Andre Picard for The Globe and Mail in 2013. The article discusses various aspects of how an individual’s income can often be a crucial determinant of their health. It also discusses that even with equal access to healthcare, individual’s with lower incomes are more likely to experience health problems and are more likely to die at a younger age than those with higher incomes (Raphael, 2010). The main argument that Picard discusses in the article is that even with universal medical care there are still wide gaps between the health of low-income and high-income people. This is an important issue because many of

the people that experience this are children who are born into poverty without it being any fault of their own. Even if a child who was born into poverty earns a high income in adulthood, there are often irreversible health complications that develop during one’s childhood and adolescence from how they spent these years and with what environmental factors they were exposed to (Raphael, 2010). Another reason that this is an important issue is that if the problem of income-inequality continues to worsen it will put a heavy financial burden on the Canadian government whom is already trying to cut down on the growth and spending in the health care industry (Picard, 2013).
Discussion
Even with equal medical care to all, there are still widespread differences in the health outcomes of the rich and the poor.

To some this may seem odd as to how there is a consistent decline in the health outcomes and life expectancies as you go down the economic hierarchy even though everyone has access to the same medical care. This is because the role that medical care plays in in the health outcomes in individuals is much lower than many would expect. Researchers believe that health outcomes are related 25% to health care, 25% to genetics and 50% to socioeconomic status with aspects including income, education, housing, physical environment and community engagement (Picard, 2013). The reasoning behind this phenomena is that as you move down the income ladder, the amount of day-to-day stress a person is under increases. Stress is the body’s way of dealing with immediate threats, it affects the functioning of the sympathetic and parasympathetic nervous systems, the neuroendocrine system and the metabolic system allowing for a fight-or-flight reaction to be made and after this reaction is made and the person is safe the stress levels will go down and their systems will go back to their normal functioning (Raphael, 2010). The problem for people of low income is that they are under the constant threats that accompany low income, such as insecure employment and food insecurity (Raphael, 2010). This results in their bodily systems to always be functioning whilst under

stress and never returning to their normal functioning which is where the severe health impacts come from. With this increase in stress levels one’s brain development and heart health can be at risk (Picard, 2013). Individual’s exposed to increased stress levels over prolonged periods of time can also end up altering their own DNA often leading to the development of cancer (Kaur et al. 2013). The effects of stress on an individual’s health can be seen in a tribe of monkeys in captivity. The monkeys closely resemble humans biologically and have a very complex social system. They all consume the same diet and perform the same daily exercise as each other yet it can be seen in this tribe that there are large differences in the health of each monkey (Adelman & Smith, 2008). These differences are solely caused by the social hierarchy in the tribe. The monkeys at the bottom of the social hierarchy live much more stressful lives than the monkeys at the top of the hierarchy as they are constantly harassed by the monkeys above them (Adelman & Smith, 2008). This increase in stress levels causes the buildup of atherosclerosis on the arteriole walls in the monkeys which restricts blood flow and in turn increases the likelihood of the monkey experiencing cardiac associated health problems, thus decreasing their life-expectancy (Adelman & Smith, 2008). With the biological similarity of monkeys and humans, the same physical reaction to stress can be seen in humans who are on the lower end of the socioeconomic scale and are under continuous increased levels of stress.
The early childhood experiences of a person influences their coping abilities, resistance to health problems and their overall health and well-being for the rest of their life (Advisory Committee on Population Health, 1996). This is very important for people to understand because children who are born into low-income families often have negatively impacted lives due to health problems they became susceptible to through their childhood experiences which they had absolutely no control over. The government in Quebec has provided a system to give low income pregnant women coupons for weekly eggs, milk and oranges to provide them with the nutrition necessary to give birth to a baby that is of a healthy weight. This system has worked well to reduce the amount of low birth weight babies being born in Quebec but it does not accommodate the problems that child will face during their early years in the low-income family. In order to begin to fix this problem the government must make policies to ensure affordable housing for low-income families, provide certain foods or food coupons to ensure that the parents can provide a nutritious diet for their child when they are going through the years of their life which will determine their future health.
As low-income people encounter health problems they are often unable to work and therefore they have lost their societal productivity and the government no longer receives their tax dollars which go towards the health care that these people need. This creates a downward spiral as more people become ill and place a larger financial burden on the health care system whilst removing any money that they once did provide the system with. The financial burden that this places on the health care system causes the problem of potential extreme debt which would have negative impacts on our already hurting economy.
Conclusion
Even with universal medical care there is an apparent relationship between poor health and low-income.

This is because of the stress associated with living a low-income lifestyle. The stress which someone is constantly under if they are living in poverty causes their sympathetic and parasympathetic nervous systems, their neuroendocrine system and their metabolic system to function as if they are in a fight-or-flight scenario all the time and this wears down their body and makes them susceptible to illness and disease as well as thickening of the arteriole walls. The lives of children born into low-income families are put at risk due to the unfortunate likelihood that they will not receive the proper foods or environment to facilitate proper development which will impact their health for the rest of their lives. The Canadian government is also under financial stress as the amount of low-income people who need medical care increases and the money they would have provided the government ceases. The health of Canadians is largely determined by income, even though every level of income has the same access to medical

care.