Feeling like you have a place in the world influences biology and health
By Paul Bolger. Chartered Physiotherapist at Nano Physiotherapy, Kilkenny (www.nanophysio.ie).
Our inner biology is influenced by how fair the world around us is. This is not an alternative idea – this statement is backed by science. Equality is healthy.
Inequality has been growing globally since the 1980s. This was a time when there was a shift in western economic policy, implemented by politicians like Margaret Thatcher in the UK and Ronald Regan in the US. Inequality in Ireland has followed this trend, while our tax and social support policies have helped to steady the decline somewhat. According to the Central Bank, at the end of 2024, Ireland’s wealthiest 10% of households owned approximately 50% of all wealth, while the bottom 50% of households owned just 8.7%.
How might this steady decline in economic inequality be impacting on health?
Equal Countries are Healthier
The more economically equal a country is, the more physically and socially healthy its citizens (based on things like life expectancy, mental health issues, crime and social mobility). This is independent of how wealthy the country is – wealthy countries like the UK and US score significantly lower on these health scores than countries with greater income equality such as Sweden and Belgium.
These differences can only partially be explained by things like access to care and reduced risk of danger. Researchers have shown that less than half of health issues associated with inequality are explained by risky habits like smoking and unhealthy food choices, or protective factors like access to quality healthcare and exercise clubs. It goes deeper than this – into the mind and body.
Feelings of Fairness Matter
Inequality causes biological changes in people. These changes are driven by the stressful psychosocial (i.e. psychological and social) consequences of low socioeconomic status (i.e. being poor in an unequal society).
This isn’t just about how poor you are – it’s just as much about how poor you feel. Being poor amid plenty is worse for health on just about every measure (infant mortality, life expectancy, obesity, murder rates, etc) as just being poor.
Changes in Biology
While there are many ways that the body responds to an unfair world, there are three key areas that scientists have identified: chronic inflammation, chromosomal ageing and impaired brain function.
Chronic Inflammation
There is nothing wrong with inflammation in small doses – it helps us to heal from injuries and fight off infections. But prolonged, chronic inflammation has widespread negative effects throughout the whole body. The persistent stress associated with growing up and living in poverty in an unequal society upregulates the body’s pro-inflammatory response.
DNA Damage
Chromosomes contain DNA, which holds instructions for the development of proteins – the building blocks of the body. Long-term, persistent stress is associated with faster ageing of these chromosomes within the body’s cells. Children who grow up in poverty show more rapid aging of chromosomes – leaving them more vulnerable to health problems throughout life.
Brain Function
Brain function is impacted by poverty, particularly in children. Key brain areas associated with emotional response and mood regulation (limbic system), memory (hippocampus) and planning and impulse control (pre-frontal cortex) are all impacted by poverty.
These changes likely make it harder for people to drag themselves out of poverty and up the social ladder.
Signing Off
As a healthcare professional, I feel it is important to share this information. I hope that this small nation of ours a strives to be a fair, just place to live and grow in. Human choices are made every day that shape the society we live in. What choices will push our society towards greater inequality? And what choices might offer all children, no matter their background, the opportunity to lead a healthy, fulfilling life?
This will be my final article for the Kilkenny Observer (perhaps there will be one-offs to come down the line…). I feel so grateful to have had the opportunity to offer my articles to you each week.
Thank you for reading – Paul.
