Skip to main content

Public awareness of poverty as a determinant of health: survey results from 23 countries

Abstract

Objectives

We aim to examine (1) variations in the public awareness of poverty as a determinant of health and (2) associations of individual and macro level factors with awareness.

Methods

Analyses are based on the International Social Survey Programme. Data stem from 23 countries (N = 37,228) that were assigned to six welfare states. Sociodemographic, socio-economic, and health-related factors were considered as individual level characteristics. Gross domestic product, relative poverty rate, Gini coefficient, and magnitude of health inequalities were additionally introduced as macro level factors.

Results

About 47% of the respondents in all countries agreed with the statement that people suffer from severe health problems because they are poor (range 30–77%). Multilevel analyses reveal that awareness was least pronounced in Liberal, East European, and East Asian welfare regimes. Moreover, women, older adults, respondents with low education and income, as well as poor health were more likely to show awareness.

Conclusions

There is a need to raise public awareness of the adverse health effects of poverty as the public opinion can be an important driver of political will on health and social issues.

This is a preview of subscription content, access via your institution.

References

  1. Abdul Karim S, Eikemo TA, Bambra C (2009) Welfare state regimes and population health: integrating the East Asian welfare states. Health Policy 94:45–53

    Article  PubMed  Google Scholar 

  2. California Newsreel (2008) Unnatural causes: is inequality making us sick? http://www.unnaturalcauses.org. Accessed 11 July 2017

  3. Cavelaars AE, Kunst AE, Geurts JJ, Helmert U et al (1998) Differences in self-reported morbidity by educational level: a comparison of 11 Western European countries. J Epidemiol Community Health 52:219–227

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  4. Central Intelligence Agency (CIA) (2017) The world factbook. https://www.cia.gov/library/publications/the-world-factbook/. Accessed 11 July 2017

  5. Commission on Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Final report of World Health Organisation. WHO, Geneva

    Google Scholar 

  6. Eikemo TA, Bambra C (2007) The welfare state: a glossary for public health. J Epidemiol Community Health 62:3–6

    Article  Google Scholar 

  7. Eikemo TA, Bambra C, Joyce K et al (2008) Welfare state regimes and income-related health inequalities: a comparison of 23 European countries. Eur J Public Health 18:593–599

    CAS  Article  PubMed  Google Scholar 

  8. Esping-Andersen G (1990) The three worlds of welfare capitalism. Polity, London

    Google Scholar 

  9. Fenger HJM (2007) Welfare regimes in Central and Eastern Europe: incorporating post-communist countries in a welfare regime typology. Contemp Issues Ideas Soc Sci 3:1–30

    Google Scholar 

  10. Ferrera M (1996) The southern model of welfare in social Europe. J Eur Soc Policy 6:17–37

    Article  Google Scholar 

  11. GESIS Leibniz Institute for the Social Sciences (2017) International Social Survey Programme (ISSP). http://www.gesis.org/issp/home. Accessed 11 July 2017

  12. Gollust SE, Lantz PM, Ubel PA (2009) The polarizing effect of media messages about the social determinants of health. Am J Public Health 99:2160–2167

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hochmann O, Skopek N (2013) The impact of wealth on subjective well-being: a comparison of three welfare-state regimes. Res Soc Stratif Mobil 37:127–141

    Article  Google Scholar 

  14. Jaeger MM (2006) Welfare regimes and attitudes towards redistribution: the regime hypothesis revisited. Eur Sociol Rev 22:157–170

    Article  Google Scholar 

  15. Kawachi K, Subramanian SV, Almeida-Filho N (2002) A glossary for health inequalities. J Epidemiol Community Health 56:647–652

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  16. Knesebeck Ovd, Vonneilich N, Kim TJ (2016) Are health care inequalities unfair? A study on public attitudes in 23 countries. Int J Equity Health 15:61

    Article  Google Scholar 

  17. Lee Y-J, Ku Y-W (2007) East Asian welfare regimes: testing the hypothesis of the developmental welfare state. Soc Policy Adm 41:197–212

    Article  Google Scholar 

  18. Macintyre S, McKay L, Ellaway A (2006) Lay concepts of the relative importance of different influences on health; are there major socio-demographic variations? Health Educ Res 21:731–739

    Article  PubMed  Google Scholar 

  19. Marmot M, Allen JJ (2014) Social determinants of health equity. Am J Public Health 104:S517–S519

    Article  PubMed  PubMed Central  Google Scholar 

  20. Marmot M, Friel S, Bell R et al (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 372:1661–1669

    Article  PubMed  Google Scholar 

  21. Niederdeppe J, Bu QL, Borah P et al (2008) Message design strategies to raise public awareness of social determinants of health and population disparities. Milbank Q 86:481–513

    Article  PubMed  PubMed Central  Google Scholar 

  22. Organisation for Economic Co-operation and Development (OECD) (2017) Statistic. http://stats.oecd.org. Accessed 11 July 2017

  23. Robert SA, Booske BC (2011) US opinions on health determinants and social policy as health policy. Am J Public Health 101:1655–1663

    Article  PubMed  PubMed Central  Google Scholar 

  24. Shankardass K, Lofters A, Kirst et al (2012) Public awareness of income-related inequalities in Ontario, Canada. Int J Equity Health 11:26

    Article  PubMed  PubMed Central  Google Scholar 

  25. United Nations Educational, Scientific and Cultural Organization (UNESCO) (2017) Poverty. http://www.unesco.org/new/en/social-and-human-sciences/themes/international-migration/glossary/poverty/. Accessed 11 July 2017

  26. United Nations Educational, Scientific and Cultural Organization (UNESCO) (1997) International standard classification of education. UNESCO, Geneva

    Google Scholar 

  27. Van de Velde S, Bambra C, Van der Bracht K et al (2014) Keeping it in the family: the self-rated health of lone mothers in different European welfare regimes. Sociol Health Illn 36:1220–1242

    Article  PubMed  Google Scholar 

  28. Wikinson RG (1997) Socioeconomic determinants of health. Health inequalities: relative or absolute material standards? BMJ 314:591–599

    Article  Google Scholar 

  29. World Health Organization (WHO) (2017a) Poverty. http://www.who.int/topics/poverty/en/. Accessed 11 July 2017

  30. World Health Organization (WHO) (2017b) Social determinants of health. http://www.who.int/social_determinants/en/. Accessed 11 July 2017

  31. Wu S, Crespi CM, Wong WK (2012) Comparison of methods for estimating the intraclass correlation coefficient for binary responses in cancer prevention cluster randomized trials. Contemp Clin Trials 33:869–880

    Article  PubMed  PubMed Central  Google Scholar 

  32. Zambon A, Boyce WF, Currie C et al (2006) Do welfare regimes mediate the effect of SES on health in adolescence? A cross-national comparison in Europe, North America and Israel. Int J Health Serv 36:309–329

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Olaf von dem Knesebeck.

Ethics declarations

Funding

The authors received no external funding for this project.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

von dem Knesebeck, O., Vonneilich, N. & Kim, T.J. Public awareness of poverty as a determinant of health: survey results from 23 countries. Int J Public Health 63, 165–172 (2018). https://doi.org/10.1007/s00038-017-1035-9

Download citation

Keywords

  • Public awareness
  • Poverty
  • Social determinants of health
  • International Social Survey Programme