This is because the determinants are not limited to economic status but include a multitude of factors such as “the social gradient, stress, early life, social exclusion, work, unemployment, social support, addiction, food, transport” (Marmot 2005) and the availability of publicly funded health care. For example, Greece has only half the average individual GNP purchasing power of the US yet has a life expectancy of 78.1 years compared to the US 76.9 (Marmot 2005). One would have to study both countries in detail to assess what factors give Greece a better life expectancy than the US in spite of its’ relative poverty.
As well as extreme differences world wide between countries from Sierra Leone’s 34 years life expectancy to Japan’s 81.9 years there are also significant differences between various populations within countries. For example in Australia the aboriginal life expectancy is 20 years less than that of the dominant white population.(Marmot 2005) However, interestingly their child mortality rate is relatively low .in spite of the fact they are not considered an advanced civilization. No doubt their relative poverty, unemployment and cultural alienation from mainstream Australian society are major contributing factors. I think it would be helpful to compare health and life expectancy outcome for aboriginals and non aboriginals at the same socioeconomic level. One would expect the results for non aboriginals to be better.
In conclusion, it is clear that poverty is a major cause of poor life expectancy and health outcomes. However there are also other significant factors which must be studied on a case by case basis to assess what needs to be done to promote optimal
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