Poverty in India

Assignment Cover Sheet
College of Health and Science
School of Biomedical and Health Science

Student name and number: | YAMINI KAPIL SETHI, 17609904 | Student contact phone number: | 0452457861 | Unit name and number: | Public Health Policy and Society 400416 | Tutorial group: | Lecture | Tutorial day and time: | Wednesday, 6 PM – 9 PM | Lecturer/Tutor: | John Macdonald | Title of assignment: | Poverty in India | Length: | 3429 words | Date due: | 10th May 2013 | Date submitted: | 10th May 2013 | Campus enrolment: | Parramatta |

Declaration: I hold a copy of this assignment if the original is lost or damaged. I hereby certify that no part of this assignment or product has been copied from any other student’s work or from any other source except where due acknowledgement is made in the assignment. No part of the assignment/product has been written/produced for me by any other person except where collaboration has been authorised by the subject lecturer/tutor concerned I am aware that this work may be reproduced and submitted to plagiarism detection software programs for the purpose of detecting possible plagiarism (which may retain a copy on its database for future plagiarism checking)

Signature:______________________________________

Note: An examiner or lecturer/tutor has the right to not mark this assignment if the above declaration has not been signed.

Choose one social determinant of health that you think is important in a context you are familiar with.

Gerald (2012) in his journal article explained the connection of an individual with his total surrounding environment and individual’s living in that particular environment. Health in its general aspect can be defined as the active interactions of people with their social, cultural, economical, physical, and emotional environment. Marmot (2005) argued that state of absolute health cannot be achieved until and unless the social determinants that affect health of a person are considered. One such social determinant of health that I will discuss in this essay is “Poverty in India”. Poverty
United Nation defined poverty as denial of choices and opportunities, violation of human dignity. It means lack of basic capacity to participate effectively in society. It means not having enough to feed and clothe a family, not having a school or clinic to go to, not having the land on which to grow one’s food or a job to earn one’s living, not having access to credit. It means insecurity, powerlessness and exclusion of individuals, households and communities. It means susceptibility to violence, and it often implies living in marginal or fragile environments, without access to clean water or sanitation (Gordon, 2005).

Poverty and poor health are inseparably connected. The ability to breast feed, attain education or attend school, make money to live or feed the whole family, work to grow food, all depends on the state of good health. Attainment of good health is a dream for poor people. Nearly 1.2 billion people globally live in extreme poverty, which is around $1 per day, and 2.7 billion live in moderate poverty, which is around $2 per day (Hossain, Goyder, Rigby, & Nahas, 2009). This income is so less that it cannot even help one to save against future costs of ill health or even to pay for health services today (Murray, 2006).

Extreme poverty interacts with health in many ways and undermines a whole range of human capabilities, possibilities and opportunities (Reading & Wien, 2009). There are various factors that are intertwined and constitutes to ill health. As we all know and understand that health inequalities that exist are the result of many overlapping and inter relating factors. Let me discuss these factors, which include social gradient, ethnicity, education, occupation, food, stress, health care services, women’s health, prenatal care, housing, mental illness, health behavior, government policies in relation to poverty and its effect on health.

In recent years, a scientific research and study indicates that human health and life expectancy are not just matter of genes and lifestyles or habits. Rather, they seem to have a lot to do with our virtual status or position in society. Poor socioeconomic condition of people affects health throughout their life. The people higher up the social ladder in each society tend to have better life expectancy and better health in comparison with people further down the social ladder. The impoverished people or people further down the social ladder have twice the risk of health ailments and premature death (Wilkinson & Marmot, 2003).

Ethnicity plays a vital role in determining health for people living in poverty. It has been observed in US that in few of its richest cities, African Americans have lower life expectancy at birth when compared with people in much more poorer countries like India and China. Studies suggest that in South Africa black people suffer worse morbidity and higher rate of mortality due to limited access to social resources. Among this population poverty is the main culprit, which causes many endemic diseases, hunger and malnutrition (Farmer, 2005). An uneven number of AIDS cases in North America are from American minorities, 72 percent of AIDS cases among women are either Hispanic or African American (Ward, 1993). Farmer (2005) mentioned that the increasing mortality differentials between the blacks and whites must be attributed to class differentials, which include recognizing race within poor population. Considering race as a factor for determining poor health without recognizing poverty has misguided people to believe race is the only factor. Hispanic women affected by AIDS are usually from poor families, hold smaller salaries than other average women and are more likely to run household (Ward, 1993).

Education level directly varies to poverty and poverty to health. It can be easily said that good education depends on income or vice versa insufficiency of education is a cause of poverty. Socioeconomic status decides whether an individual can be educated as attainment of education depends on household income, area and access to school. According to Ending illiteracy could end poverty (2012), in the whole world approximately 775 million adults and 122 million children are unable to read or write and they belong to low economic status. People with low or no level of education have greater rates of infectious diseases, self-reported poor health, numerous chronic non-infectious ailments, and shorter rate of survival when sick and have small life expectancy (Ross & Wu, 1995). It has been observed that low education level is also associated with alcohol, smoking, substance use and illicit drugs (Leskosek, 2012) as a common self-destruction habit in order to cope up with stresses of life. In poor people life, education helps them to develop usable skills, resources, and abilities so that they can reach their goals and attain better health and life.

Poor people usually have uncertain jobs or hold part time or casual jobs, are migrant workers, experience stress as a result of unemployment or unable to meet the daily need with the current income, which in turn affects health outcomes. According to WHO, working condition and employment status significantly affects health equity (Kivimaki et al., 2003). This occurs due to poor employment conditions exposes an individual to many health hazards, which are very common for low status jobs. Stansfeld and Candy (2006) gives evidence that high job demand, less control and low reward for the work in low status jobs are the risk factors for various physical and mental health problems, such as 50 percent greater risk of heart diseases. There has been an increase in job insecurity and temporary jobs in the developed countries. People are insecure about their jobs due to precarious job instability, which directly and indirectly affects health, which is magnified in impoverished people (Kivimaki et al., 2003).

In today’s world we all know that poverty affects nutrition. Many impoverished sleep hungry stomach, as they cannot afford safe food. Rise in food costs have further magnified this problem, as a consequences of which impoverished mainly children and women remain under nourished or malnourished. Improper nutrition affects their whole life-span and predisposes them to many diseases, both infectious and non-communicable, reduced physical activity, lower intellectual and learning capacity, increased susceptibility and vulnerability to environmental and lifestyle related risk, reduced social participation. Poor nutrition begins in utero and its adverse effects are more obvious in early postnatal life and linger through adolescence to adulthood in relation to higher risk, lower resistance to diseases and diminished working capacity (Pena & Bacallao, 2002).

There is an increasing evidence of a relationship between stress and the experience of poverty and deprivation. Stressful situation makes people feel anxious, worried and unable to cope with the situations, which are harmful to health. In an impoverished person’s life, social and psychological conditions can cause long term stress. Continuing anxiety, low self-esteem, lack of control over work life and home life, isolation, social exclusion, insecurity, has powerful impact on health. Such psychological dangers accumulate during life and increase the likelihood of poor mental health, suicide and premature death (Wilkinson & Marmot, 2003). Psychiatric epidemiological surveys done in the late 1930s have shown higher rates of mental illness in low-income communities. Studies showed major mental illnesses like schizophrenia, Mood disorders, suicide, common mental disorder, which were common in people living in poverty (Kuruvilla & Jacob, 2007).

Access to health care (primary, secondary and tertiary) is a very important determinant of health as it also influences other determining factor. The introduction to high cost for health treatments has immensely reduced the access to health care and most affected by it are the people with low socioeconomic status (Whitehead, Dahlgren & Evans, 2012). People’s access to health care centers, theirs experiences there and the health benefits they gain are closely associated with other social factors that determine health which includes, income, education, occupation, ethnicity and more. For poor people system barriers in the social structure are difficult, especially financing. The maternity and Medicaid coverage structures have time consuming and complex registration processes, along with long waiting and unsure eligibility (Ward, 1993). The distribution of health care is unequal across the globe, with remarkable inequality for the poor living in low and middle-income countries. A study by Agency for Health Care Research and Quality (2003) showed (as cited in Zhan & Miller, 2003) that doctors treat poor people differently, showing that they are less likely to obtain recommended diabetes treatment and are more prone to undergo hospitalization due to diabetes induced complication. In countries without proper social provisions, health care costs can cause serious threats to impoverished populations and make them the victims of many acute and chronic diseases.

With regards to socioeconomic factors, poor organizations of public health and facilities can cause worse health in women. According to Moss (2002) components of the geopolitical system that issue gender and economic inequality, such as nation’s history, policy, geography services, policy rights, organization, and social structures, are all determinants of women’s health in poverty. These structures, like social-demographic status and culture, norms and consents, form women’s productive role in the workplace and propagative role in the household, which decides health. Also, women facing monetary strain are more likely to report chronic conditions of health, which occurs commonly in the life of impoverished. Ward (1993) found that poor women have higher rates of diabetes, cancer, heart diseases and infant mortality. Poor women significantly suffer from comorbidity, such as any psychiatric disorder along with psychoactive substance use. Poor women are also at higher risk for contracting endemic diseases like tuberculosis. Women in urban areas with low socioeconomic status are more likely to contract sexually transmitted diseases and have unplanned pregnancies.

Prenatal care also plays a role in shaping the health of women and their offspring, with increased infant mortality in poor population and nations. According to Ward (1993), poverty is the strongest predictor of deficient prenatal care, which is caused by three factors reducing access. These include socio-demographic factors (such as age, education, ethnicity, and marital status), systematic barriers, and barriers based on attitudes, life-styles and lack of knowledge. About Sixty percent of children born in poor families have at least one chronic ailment. Maternal mortality also adds to the list. The World Health Organization In 1995 estimated that maternal mortality rates were 150 times higher in developing nations than developed nations.

Housing and living condition plays a key role in framing good health. Whether a person lives in urban or rural, poor people are unhealthy than their rich neighbours. With the presence of inner city slums and ghettos across the globe there are approximately 1 billion people living in slums in the whole world (Wagstaff, 2002). According to Todd (1996) the impoverished are more likely to live in poor physical environments with poor standards, over congested housing, inadequate supply of water, sanitation and proper waste disposal, higher levels of pollution and other harmful substances which in turn causes many infectious communicable and non-communicable diseases, and premature death. Impoverished people have low and insecure income; have very few assets, and are unable to access health care due to high cost and privatization (Todd, 1996) and thus are unable to cope up the unfavorable events, including health. Addition to it is the stressful nature of their environment, which may contribute to higher levels of alcohol, tobacco and drug use, road accidents and violence (Todd, 1996). Also, few studies have stated that obesity is one of the paramount health issue in impoverished and socially disadvantaged people living in urban areas (Friel, Chopra & Satcher, 2007). The increase in the obesity counts can be blamed on the nutrition transition that explains how people have started eating high fat, salt and sugar food sources as they are cheaper in terms of availability and price (Friel et al., 2007).

Patel and Kleinman (2003) argue that their is an association between indicators of poverty and the risk of mental illness, the most consistent association being with no or low levels of education. Factors such as the feeling of insecurity and hopelessness, stress, hasty social change, threats of violence and physical ill-health may explain the greater vulnerability of the impoverished to common mental disorders. The direct and indirect costs of mental ill health impair the economic condition, setting up a cruel cycle of poverty and mental disorder.

Health risk behavior such as cigarette smoking, use of elicit drug, alcohol, physical inactivity are closely related to both socioeconomic status and health. All of these behavior are strongly related to indexes of socioeconomic status including, education, employment status, income and is linked with morbidity and mortality (Adler et al., 1994) mainly from cancer and cardiovascular diseases.

In the life of the poor people, according to WHO structure and type of government and government’s social and economic policy greatly affects health and health equity. According to Alcock and Kohler (1979) variation between countries with regards to health can be partially blamed on the type of political system, whether that is social-democratic, communist, fascist and conservative. Each and every module of government from education, housing, finance, transportation and health care policy plays a crucial role in framing good health of an individual mainly of people living in poverty (Alcock and Kohler, 1979).

Poverty in India
In India poverty is widespread. India is the home to one third of the world’s poor. According to an Oxford University study, population of India has reached beyond 1.1 billion people, out of which 55% or could say 645 million people are infected by poverty (Fabrizio & Ramsby, 2012). The total population of India falls below the international poverty line of $1 per day while 68.7% live on less than $2 per day (Gupta, 2008). India is the second fastest growing economy, but is still in-efficient in providing employment to all. The root cause of poverty in India is firstly the ever-growing population and caste system, which classifies individual based on their religion, social status and name. People who belong to lower caste and lower socioeconomic status are mostly refused jobs, so they are forced to take only jobs they can get. As these jobs begin when they are young, they never get the chance to get an education. Lack of education prevents them from having high paying jobs. Poverty in India further leads to poor sanitation and unhealthy environment where these houses are built. People dwell in slums where water borne and air borne diseases are all time fixtures. Sewages and garbage disposal are never taken care of and is sad sight to the eyes; nevertheless healthcare has been an issue in a poor country like India (Kataria, 2011).

Following are the poverty reduction policies that are discussed in this essay

Education and training
Education, acquisition of skills and employment opportunity is a keystone in eradicating poverty. Illiteracy rate is high in India with schooling not made compulsory. However, there are many school aged children who are not studying due to lack of resources and in most of the cases they are working in low wages sectors to financially support their families. The policy to increase education has many initiatives. There needs to be indexed budgetary allotment to schools that are located in rural and low socio-economic areas. Another option to improve opportunities for poor is to make education compulsory up to class 8. Including adult education programs would also contribute. Child labor should be completely banned, and children from poor family should be provided with free schooling with exemption from all types of school charges including bus transport and giving lunch at school. Quota system can be introduced were ever possible for students from poor families (Mirowsky & Ross, 2003).

Utilities and Government Services
The disadvantaged sector of the society is the one, which is last to acquire access services provided by government including electricity, piped water and garbage and sewage disposal. Many of peri-urban and rural areas are deprived of these services and where these services are available they are subjected to irregular supply and breakdowns. In many rural areas people suffer due to lack of access to services because of bad infrastructure and transportation. Government and public organizations need to put in place two tier pricing models instead of uniform user pay pricing models so as to allow base level consumption in the provision of. A strategy with annual targets should be set to guarantee universal coverage of water, electricity and telecommunication, services with better road and transportation in the communities that are deprived of it. Government should also promote rural regional centers so that rural people are able to access health, banking and education services (Fan, Hazell & Thorat, 2000).

Health care facilities
Availability of health care system backed up with staff should be made in the rural and other areas that are deprived of it. Also, for the poor people and whose household earnings are less than $10,000 per year, free health check-up, drugs, medical treatment, spectacles and dentures should be provided (Balarajan, Selvaraj, & Subramanian, 2011). Government in partnership with other non-governmental organization should increase the provision of counseling and information services on growing health issues such as, nutrition, maternal health, reproductive health, HIV/AIDS, sexually transmitted diseases, diabetes, teenage pregnancies and aged care (Peters et al., 2008).

Housing
Government should take into account the developing challenges to provide shelter to the people with low socioeconomic status. The policy should aim at providing housing at affordable prices with the basic services for urban and rural poor, which includes safe water, sanitation, provision for waste disposal and sewage, easy access to health care and schools. the government must reduce the building cost by lowering prices on building materials to ease the burden of constructing a house. In partnership with landowners it should be able to provide long term residential leases. Easy home loans for the poor people should be provided (Nallathiga, 2007).

Food security
In past few decades concern about food security has increased as hike in the food costs and unemployment has made health of the impoverished even more vulnerable. In order to tackle this problem the government needs to complement the provision of food security through targeted approach with both short and long-term policies. In short term, the vision to acknowledge the root cause for food insecurity is lack of opportunity. So, there is a need to make employment opportunities for at least one capable person from the poor household. Midday meal scheme for children should be implemented in the states where it is lacking (Maxwell & Slater, 2003). In long term, assurance of food security will in turn tackle poverty. Improvement in infrastructure is needed for this and time-limited targeted strategies to increase farm and non-farm productivity.

According to me the following policies should be incorporated in order to minimize the effect of poverty

Creating employment opportunities
The government, NGO, public and giant private sector companies should increase employment opportunities especially in the remote areas where there is severe poverty.

Training for employment
Skilled training should be given to uneducated people so as to earn their daily living. For example, men can be skilled in carpentry, plumbing and masonry work similarly women can be skilled in embroidery, stitching and knitting jobs. They can also be engaged in packing of goods.

Free or subsidized medical treatments
Medical treatment should be given to people who are unable to pay for their medical bills. For example people earning less than $1 and $2 per day. Vaccinations and flu shots should be given free of cost.

Measures to control population
Introducing incentives to families that adopt family planning measures to control population explosion.

Stop corruption
The existing government policies can be fruitful if a stop is put on corruption.

Conclusion
Poverty is one social determinant of health and all the other factors like people, population, education, employment, food security, are secondary factors and depend on income level/poverty. In short poverty kills the ability of a person to demand the acceptable health care facilities. A few policies to eradicate or least decrease the poverty level will get people closer to good health care.

References:
Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., & Syme, S. L. (1994). Socioeconomic status and health. American Psychologist, 49(1), 15-24.

Alcock, N., & Kohler, G. (1979). Structural violence at the world level: diachronic findings. Journal of Peace Research, 16(3), 255-262.

Balarajan, Y., Selvaraj, S., & Subramanian, S. V. (2011). Health care and equity in India. Lancet, 377(9764), 505.

Ending illiteracy could end poverty. (2012). Appropriate Technology, 39(4), 5-6.

Fabrizio, D., & Ramsby, H. (2012). Poverty in India.

Fan, S., Hazell, P., & Thorat, S. (2000). Government spending, growth and poverty in rural India. American Journal of Agricultural Economics, 82(4), 1038-1051.

Farmer, P. (2005). Pathologies of power: health, human rights, and the new war on the poor: with a new preface by the author (Vol. 4). Univ of California Press.

Friel, S., Chopra, M., & Satcher, D. (2007). Unequal weight: equity oriented policy responses to the global obesity epidemic. BMJ: British Medical Journal, 335(7632), 1241.

Gerald, L. (2012). Social determinants of health. North Carolina medical journal, 73(5), 353.

Gordon, D. (2005, December). Indicators of Poverty & Hunger. In Expert group meeting on youth development indicators (pp. 12-14).

Gupta, K. R. (2008). Poverty in India. Atlantic Publishers & Dist.

Hossain, M. P., Goyder, E. C., Rigby, J. E., & El Nahas, M. (2009). CKD and poverty: a growing global challenge. American Journal of Kidney Diseases, 53(1), 166-174.

Kivimaki, M., Head, J., Ferrie, J. E., Shipley, M. J., Vahtera, J., & Marmot, M. G. (2003). Sickness absence as a global measure of health: evidence from mortality in the Whitehall II prospective cohort study. BMJ: British Medical Journal, 327(7411), 364.

Kataria, J. R. (2011). Poverty in south Asia: An overview. Interdisciplinary Journal of Contemporary Research in Business, 3(3), 389-396.

Kuruvilla, A., & Jacob, K. S. (2007). Poverty, social stress & mental health. Indian Journal of Medical Research, 126(4), 273-8.

Leskosek, V. (2012). Social determinants of health: The indicators for measuring the impact of poverty on health. Zdravstveno Varstvo, 51(1), 21. doi:http://dx.doi.org/10.2478/v10152-012-0004-1

Marmot, M. (2005). Social determinants of health inequalities. Lancet, 365(9464), 1099-1104.

Maxwell, S., & Slater, R. (2003). Food policy old and new. Development policy review, 21(5‐6), 531-553.

Mirowsky, J., & Ross, C. E. (2003). Education, social status, and health. Aldine de Gruyter.

Moss, N. E. (2002). Gender equity and socioeconomic inequality: a framework for the patterning of women 's health. Social science & medicine, 54(5), 649-661.

Murray, S. (2006). Poverty and health. Canadian Medical Association Journal, 174(7), 923-923.

Nallathiga, R. (2007). Housing Policy in India: Challenges and Reform. Review of Development and Change, 12(1), 71-98.

Navarro, V., Muntaner, C., Borrell, C., Benach, J., & al, e. (2006). Politics and health outcomes. The Lancet, 368(9540), 1033-7.

Patel, V., & Kleinman, A. (2003). Poverty and common mental disorders in developing countries. Bulletin of the World Health Organization, 81(8), 609-615.

Pena, M., & Bacallao, J. (2002). Malnutrition and poverty. Annual Review of Nutrition, 22, 241-53.

Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Hafizur Rahman, M. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences, 1136(1), 161-171.

Reading, C. L., & Wien, F. (2009). Health Inequalities and the Social Determinants of Aboriginal Peoples ' Health. Prince George, BC: National Collaborating Centre for Aboriginal Health.

Ross, C. E., & Wu, C. L. (1995). The links between education and health. American sociological review, 719-745.

Stansfeld, S., & Candy, B. (2006). Psychosocial work environment and mental health—a meta-analytic review. Scandinavian journal of work, environment & health, 443-462.

Todd, A. (1996). Health inequalities in urban areas: a guide to the literature. Environment and Urbanization, 8(2), 141-152.

Wagstaff, A. (2002). Poverty and health sector inequalities. Bulletin of the world health organization, 80(2), 97-105.

Ward, M. C. (1993). A different disease: HIV/AIDS and health care for women in poverty. Culture, Medicine and Psychiatry, 17(4), 413-430.

Whitehead, M., Dahlgren, G., & Evans, T. (2001). Equity and health sector reforms: can low-income countries escape the medical poverty trap?. Lancet, 358(9284), 833-836.

Wilkinson, R. G., & Marmot, M. G. (2003). Social determinants of health: the solid facts. World Health Organization.

Zhan, C., & Miller, M. R. (2003). Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA: the journal of the American Medical Association, 290(14), 1868-1874.

References: Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., & Syme, S. L. (1994). Socioeconomic status and health. American Psychologist, 49(1), 15-24. Alcock, N., & Kohler, G. (1979). Structural violence at the world level: diachronic findings. Journal of Peace Research, 16(3), 255-262. Balarajan, Y., Selvaraj, S., & Subramanian, S. V. (2011). Health care and equity in India. Lancet, 377(9764), 505. Ending illiteracy could end poverty. (2012). Appropriate Technology, 39(4), 5-6. Fabrizio, D., & Ramsby, H Fan, S., Hazell, P., & Thorat, S. (2000). Government spending, growth and poverty in rural India. American Journal of Agricultural Economics, 82(4), 1038-1051. Farmer, P. (2005). Pathologies of power: health, human rights, and the new war on the poor: with a new preface by the author (Vol. 4). Univ of California Press. Friel, S., Chopra, M., & Satcher, D. (2007). Unequal weight: equity oriented policy responses to the global obesity epidemic. BMJ: British Medical Journal, 335(7632), 1241. Gerald, L. (2012). Social determinants of health. North Carolina medical journal, 73(5), 353. Gordon, D. (2005, December). Indicators of Poverty & Hunger. In Expert group meeting on youth development indicators (pp. 12-14). Gupta, K. R. (2008). Poverty in India. Atlantic Publishers & Dist. Hossain, M. P., Goyder, E. C., Rigby, J. E., & El Nahas, M. (2009). CKD and poverty: a growing global challenge. American Journal of Kidney Diseases, 53(1), 166-174. Kataria, J. R. (2011). Poverty in south Asia: An overview. Interdisciplinary Journal of Contemporary Research in Business, 3(3), 389-396. Kuruvilla, A., & Jacob, K. S. (2007). Poverty, social stress & mental health. Indian Journal of Medical Research, 126(4), 273-8. Leskosek, V. (2012). Social determinants of health: The indicators for measuring the impact of poverty on health. Zdravstveno Varstvo, 51(1), 21. doi:http://dx.doi.org/10.2478/v10152-012-0004-1 Marmot, M Maxwell, S., & Slater, R. (2003). Food policy old and new. Development policy review, 21(5‐6), 531-553. Mirowsky, J., & Ross, C. E. (2003). Education, social status, and health. Aldine de Gruyter. Moss, N. E. (2002). Gender equity and socioeconomic inequality: a framework for the patterning of women 's health. Social science & medicine, 54(5), 649-661. Murray, S. (2006). Poverty and health. Canadian Medical Association Journal, 174(7), 923-923. Nallathiga, R. (2007). Housing Policy in India: Challenges and Reform. Review of Development and Change, 12(1), 71-98. Navarro, V., Muntaner, C., Borrell, C., Benach, J., & al, e. (2006). Politics and health outcomes. The Lancet, 368(9540), 1033-7. Patel, V., & Kleinman, A. (2003). Poverty and common mental disorders in developing countries. Bulletin of the World Health Organization, 81(8), 609-615. Pena, M., & Bacallao, J. (2002). Malnutrition and poverty. Annual Review of Nutrition, 22, 241-53. Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Hafizur Rahman, M. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences, 1136(1), 161-171. Reading, C. L., & Wien, F. (2009). Health Inequalities and the Social Determinants of Aboriginal Peoples ' Health. Prince George, BC: National Collaborating Centre for Aboriginal Health. Ross, C. E., & Wu, C. L. (1995). The links between education and health. American sociological review, 719-745. Stansfeld, S., & Candy, B. (2006). Psychosocial work environment and mental health—a meta-analytic review. Scandinavian journal of work, environment & health, 443-462. Todd, A. (1996). Health inequalities in urban areas: a guide to the literature. Environment and Urbanization, 8(2), 141-152. Wagstaff, A. (2002). Poverty and health sector inequalities. Bulletin of the world health organization, 80(2), 97-105. Ward, M. C. (1993). A different disease: HIV/AIDS and health care for women in poverty. Culture, Medicine and Psychiatry, 17(4), 413-430. Whitehead, M., Dahlgren, G., & Evans, T. (2001). Equity and health sector reforms: can low-income countries escape the medical poverty trap?. Lancet, 358(9284), 833-836. Wilkinson, R. G., & Marmot, M. G. (2003). Social determinants of health: the solid facts. World Health Organization. Zhan, C., & Miller, M. R. (2003). Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA: the journal of the American Medical Association, 290(14), 1868-1874.