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F. Perry Wilson, MD MSCE

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It doesn’t really matter what disease you are looking at. Cancer, heart disease, dementia, drug abuse, psychiatric disorders. In every case, poverty is associated with worse disease.

But the word “associated” is doing a lot of work there. Many of us feel that poverty itself is causally linked to worse disease outcomes through things like poor access to care and poor access to medicines.

But there is an argument that the arrow goes the other way — perhaps people with worse illness are more likely to be poor because, in this country at least, being sick is incredibly expensive.

Causality is what all medical research is fundamentally about. We want to know if A causes B because if A causes B, then changing A changes B. If poverty causes bad health outcomes, then alleviating poverty should alleviate bad health outcomes.

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F. Perry Wilson, MD MSCE

Medicine, science, statistics. Associate Professor of Medicine and Public Health at Yale. New book “How Medicine Works and When it Doesn’t” available now.