How does the operation of PHARMAC's 'Community Exceptional ...

They claim that health inequities count and that they are avoidable,
unnecessary and unfair. Similarly, the Marmot Review published in England in
2010 (Strategic Review of Health Inequalities in England Post - 2010)
demonstrated the link between social opportunities, equality, fairness and life
expectancy. This position emphasises the connection between the social
conditions and predictable biological pathways (Marmot, 2010).
New Zealand has been criticised for the high levels of income inequity by
Wilkinson and Pickett (2007) in their book The Spirit Level. They have shown
that at the macro-level, unequal levels in income distribution within countries (or
within cities) are linked to social pathologies. They have draw a correlation
between income inequity and relative rates of morbidity and mortality, obesity,
teenage birth rates, mental illness, homicide, low trust, low social capital,
hostility, and racism (Wilkinson & Pickett, 2007). The theory presented linked
individual health status to deep-seated social problems associated with poverty,
poor formal education, relative deprivation and low social status. They also
made the claim that income inequality is related to communities lacking in
cohesion, social relationships and bedevilled by mistrust. In these
circumstances of high levels of social inequality, increasing access to health
care will make no difference to poor health outcomes because their research
has concluded the aetiologies of ill health lie in the perpetuating inequalities.
Wilkinson and Picket (2007) also wrote an article on health inequities titled The
problems of relative deprivation: Why some societies do better than others. In
this article, they reported on a review of 186 studies where a correlation existed
between income inequality and population health. The review showed that
more egalitarian societies were healthier. They have identified New Zealand,
along with the USA, as countries with very wide levels of income disparity and
increasing social inequity.
There has been considerable debate about the accuracy of Wilkinson and
Pickett’s work on social inequity. Snowden challenged The Spirit Level in his
book The Spirit Level Delusion: Fact-checking the Left's new theory of
everything, contending that the inequality model proposed is selective because
it excludes some richer countries which are more socially equitable and
includes a greater number of less equitable countries. He argues that this has
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