Health, Wealth, and Well-Being

(PCD) joins Morbidity and Mortality Weekly Report, Emerging Infectious Diseases, and scientific journals around the world in publishing on the topic of poverty and human development. This joint effort is sponsored by the Council of Science Editors (1), and the global partnership of more than 200 journals represents both developed and developing countries. PCD is honoring this commitment with a special addition to our October 2007 issue on society and health. The association of poverty and poor health has been recognized for centuries. However, as Waitzkin has observed, researchers currently studying the effects of social determinants on health rarely credit previous generations for making similar observations and reaching similar conclusions (2). Waitzkin's essay explores the work of 19th-century Prussian pathologist and public health visionary Rudolf Virchow. One of the most remarkable aspects of Virchow's career was his ability to span the divide between cellular pathology (the essence of medical bench science) and public health (the discipline of population wellness). Medical students are still taught principles elucidated in his comprehensive text, Cellular Pathology, but Virchow also studied health differences across social classes. " The improvement of medicine, " Virchow said, " would eventually prolong human life, but improvement of social conditions could achieve this result even more rapidly and successfully " (3). In this issue of PCD, Braveman discusses highlights of the most recent investigations into the poverty–health link; these investigations have led to consensus that the link is causal (4). That poverty leads to poor health is an established fact, but what are the associated questions for practice and policy? Members of the public health community may ask, " How shall we address this problem? " but a significant portion of the U.S. public asks, " Does society have a responsibility to address it? " Put another way, it is not a universally held belief in the United States that all citizens have inherent rights to good health. This aspect of the political will to support health rights is not subject to scientific argument; it represents the values of a society. The California Endowment recently commissioned several studies that examined the beliefs of California citizens about health and society. The first of these studies was described in Health Individualism: Findings From Cognitive Elicitations Among Californians (5) and was derived from interviews with men and women of all ages and income levels, representing diverse cultures and political beliefs. Regardless of their …