Wagstaff Adam
The World Bank, Washington, DC 20433, USA.
Bull World Health Organ. 2002;80(2):97-105.
Poverty and ill-health are intertwined. Poor countries tend to have worse health outcomes than better-off countries. Within countries, poor people have worse health outcomes than better-off people. This association reflects causality running in both directions: poverty breeds ill-health, and ill-health keeps poor people poor. The evidence on inequalities in health between the poor and non-poor and on the consequences for impoverishment and income inequality associated with health care expenses is discussed in this article. An outline is given of what is known about the causes of inequalities and about the effectiveness of policies intended to combat them. It is argued that too little is known about the impacts of such policies, notwithstanding a wealth of measurement techniques and considerable evidence on the extent and causes of inequalities.
贫困与健康状况不佳相互交织。贫穷国家往往比富裕国家的健康状况更差。在一个国家内部，贫困人口的健康状况也比富裕人口更差。这种关联反映了两个方向的因果关系：贫困导致健康状况不佳，而健康状况不佳又使贫困人口陷入贫困。本文讨论了穷人与非穷人在健康方面的不平等证据，以及与医疗费用相关的贫困化和收入不平等后果。文中概述了关于不平等原因以及旨在消除这些不平等的政策有效性的已知情况。尽管有大量测量技术以及关于不平等程度和原因的大量证据，但人们对这些政策的影响了解甚少。
