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BMJ. 2007 November 3; 335(7626): 909.
PMCID: PMC2048893
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An unhealthier future for most Americans

Most Americans are getting poorer. Incomes are going down and the proportion of families below the poverty line is going up. Only the rich are getting richer, says one public health expert from Virginia. Chief executives of US corporations earn 245 times more than their employees. Apart from the obvious injustice of this situation, worsening poverty means worsening health. Future generations of all but the richest Americans will have more cardiovascular disease, diabetes, and cancer than the generations alive today. The current healthcare system is already under strain and is unlikely to cope with the extra burden, he writes.

Training more health professionals and building more hospitals and other facilities is one option. But it won't be enough, even if it were possible. Policy makers must instead tackle economic hardship head on. Changing tax policy, increasing the minimum wage, promoting new job sectors, and setting up initiatives to get people into jobs with prospects could all help increase incomes across the board.

Education may be even more important. If all US adults had college degrees, the prevalence of heart disease could fall by 40%, and the prevalence of diabetes and stroke by 50%, he writes. The economy would be healthier too.

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