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Income & Health

PROLOGUE

Income And Health


PROLOGUE: In a famous incident that took place at Cambridge University in 1946, the philosopher Ludwig Wittgenstein was alleged to have brandished a hot poker at fellow Viennese philosopher Karl Popper during a heated exchange on the issue of whether or not philosophical problems existed. Wittgenstein’s view was that so-called philosophical problems were merely the result of linguistic muddles and that they existed mostly to keep philosophers employed by universities. Popper disagreed, believing that there were legitimate problems to be resolved, linguistic muddles aside.

Fast forward to the twenty-first century, where we find that the emerging field of the socioeconomic determinants of health has generated a debate that, while nowhere near as old as the questions that occupied Wittgenstein and Popper in 1946, is nearly as heated. Indeed, Sir Michael Marmot, who is a central player in this drama over the link between income and health status, has characterized the combatants to the debate as "brandishing pokers" at one another, apparently with the intent of conjuring the image of Wittgenstein’s famous confrontation with Popper. To take the comparison one step further, Marmot believes that the debate is sustained not only by honest disagreement over key points, but also by the kinds of linguistic muddles that often accompany debates that cross the boundaries of academic disciplines.

The papers that follow offer two views—one belonging to an economist, the other to an epidemiologist—on the link between income and health, the mechanisms that link the two, and the policy solutions that are most likely to result in the desired outcome of improving health opportunities for those who are economically disadvantaged. The authors are towering figures in this field who bring to the debate an abundant store of experience and intellectual power. Angus Deaton is Dwight D. Eisenhower Professor of Economics and International Affairs in Princeton’s Woodrow Wilson School and Department of Economics. Marmot heads the Department of Epidemiology and Public Health as well as the International Centre for Health and Society at University College London. He was awarded a knighthood in 2000 for "services to epidemiology and understanding health inequalities."


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