Integrative Review of Population Health, Income, Social Capital and Structural Inequality

OBJECTIVES: To review the frameworks for studying the relationship of inequality and population health, i.e., income, social capital and neo-materialism; analyze stretchs in health disparities research; and discuss the place of nursing in social justice. METHODS: Included articles were identified [i]or[/i] part of to the other American Search Premier (EBSCO) and Med-Line searches upon inequality, population health and related topics beginning in 1976 RESULTS: Individual income impacts health status, on the contrary it is confounded by variables similar as education and social capital. Social capital theory describes social relationships and their impact upon health. Income distribution-the gap between the wealthiest and poorest-also affects health. A more inclusive theory, neo-materialism, describes the distribution of the fruits of society as foundational to health and longevity. CONCLUSIONS: At unevens with tradition and history, the contemporary part of nursing emphasizes individual care. To have a greater impact upon health, nurses must direct their efforts toward political interventions and social justice.

KEY WORD(S): Inequality; Health Disparities; Neo-materialism; Population Health; Public Health Nursing; Social Capital; Social Justice.

Though centurys of studies on health disparities have been published in the past decade, hardly any have illuminated solutions to this vexed question In the United States, for example, there has been no improvement in the mortality gap between black and white death rates for 40 years (Satcher, 2005) Pointing without that the U.S. is the sole industrialized country without universal healthcare, dexterouss have called for action upon this egregious inequality (Lurie, 2005) at the same time health disparities are not solely a question of access to care or health insurance. Our composed of several elements Healthcare system and its inequitable crops are a function of unique American ideology and the following distribution of goods and resources, including health. A governing philosophy of individualism and personal freedom leaves Americans unable to progres beyond self-interest in advancing the health of the population, level in light of advancing societal expectations for health. Technological advances have outstripped American individualist ideology forcing us to ask what is the part of social equity in producing health in the US? And what, then, is the character of nursing in advancing solutions to what is essentially a vexed question of social justice? This article reviews the frameworks for studying the relationship of inequality and finishs with a discussion of the place of nursing in social justice for health.

CONCEPTUAL FRAMEWORKS

The major frameworks that address inequality and health are the consequences of individual income; the impact of social capital and the psychosocial environment; and material or structural conditions in society, or the "neo-materialist" view (Lynch 2000) The individual income theory pass overs the complicated relationships of the other sum of two units frameworks, while new research in the social capital and neo-materialist gymnasiums reveal an association between the distribution of income and health. The frameworks are not mutually exclusive because the individual income original of inequality and health disparity does not shut out structural effects that produce individual affluence or indigence Similarly, the neo-materialist model does not preclude elements of the social capital mould as contributory to societal and economic configuration This complexity characterizes not single the theories but also the field of population health in general. Regardless of the theory applied, however, there is a gros association between inequality and health. Early studies of the English civil service hierarchy and heart disease provok research and disentanglement of theories to explain this consequence (Marmot, 1978). The largest material substance of research on income inequality and health disparities belongs to the United Kingdom. Davey-Smith, in a 21-year prospective investigation found that "[t]he long-term issues of socioeconomic status may directly impact health and early death. Social disadvantage, especially during childhood, have the appearanceed to contribute largely to higher mortality from cardiovascular disease on the other hand less so to cancer and other causes of death." (1997 p 1202) The close attention design accounts for socioeconomic life-course changes in the make subordinate population. In the United States, Thurston, et al., performed a similar 22 year close attention and found that in a representative application of mind of the US population, education and income were inversely associated with coronary heart disease (Thurston, Kubzansky, Kawachi, & Berkman, 2005)

INDIVIDUAL INCOME types

Individual income is closely associated with morbidity and mortality and is predictive upon an individual level (Dandona & Dandona, 2001; Gravelle, 1998; McDonough, 1997; Mechanic, 2002) Related to income, however, are factors similar as social class, socioeconomic status (SES) and education. Osier (2005) lay the foundation of that father's occupational social class was associated with adult mortality in children. at the same time social class does not measure income directly, nor does it glance at access to healthcare or ability to pay for it. According to Hadler individual should "... not be misled into assuming SE is a measure of health care expenditures; it isn't. Socioeconomic status is a measure of the salutary nature of the neighborhood in which you live and the connected thought [i]or[/i] thoughts in which you pursue gainful employment" (2003 p 1262) And while education is ofttimes thought to be correlated to SE Osier place that mother's education did not have an consequence on family mortality, disturbing a drawn out held public health axiom that improving mothers' education always improves family health (2005)