Kawachi I, Kennedy B P
Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115, USA.
BMJ. 1997 Apr 5;314(7086):1037-40. doi: 10.1136/bmj.314.7086.1037.
Throughout the world, wealth and income are becoming more concentrated. Growing evidence suggests that the distribution of income-in addition to the absolute standard of living enjoyed by the poor-is a key determinant of population health. A large gap between rich people and poor people leads to higher mortality through the breakdown of social cohesion. The recent surge in income inequality in many countries has been accompanied by a marked increase in the residential concentration of poverty and affluence. Residential segregation diminishes the opportunities for social cohesion. Income inequality has spillover effects on society at large, including increased rates of crime and violence, impeded productivity and economic growth, and the impaired functioning of representative democracy. The extent of inequality in society is often a consequence of explicit policies and public choice. Reducing income inequality offers the prospect of greater social cohesiveness and better population health.
在全球范围内,财富和收入正变得越来越集中。越来越多的证据表明,除了穷人所享有的绝对生活水平之外,收入分配也是人口健康的关键决定因素。贫富差距大会因社会凝聚力的瓦解导致更高的死亡率。许多国家近期收入不平等现象激增,与此同时,贫困和富裕在居住方面的集中程度也显著上升。居住隔离减少了社会凝聚的机会。收入不平等对整个社会产生溢出效应,包括犯罪率和暴力事件增加、生产力和经济增长受阻以及代议制民主的运作受损。社会不平等的程度往往是明确政策和公共选择的结果。减少收入不平等有望增强社会凝聚力,改善人口健康状况。