Potential savings from reducing inequalities in health.

BACKGROUND Numerous studies have established that socio-economic position is positively related to health status, but we know little about the real costs of these differences across an entire population. This paper estimates the potential savings in morbidity and dollars from reducing the inequalities in health among Winnipeg residents. METHODS We measure excess morbidity by examining rates of premature death, hip fracture, and heart attack according to the relative affluence of the Winnipeg neighbourhood. We also assess the total expenditures on physician and hospital care by neighbourhood of residence. We then estimate the savings that could have been achieved if 1 ) the health of the two poorest quintiles had been raised to the level of the middle quintile, and 2) the health of the poorest four quintiles had been raised to the level of the top quintile. RESULTS Thirty-seven percent of Winnipeg's premature deaths, 22% of the heart attacks, 20% of the hip fractures and 15% of total expenditures on hospitals and physicians ($62 million in 1999 dollars) could have been avoided if residents of the less wealthy 80% of neighbourhoods enjoyed health similar to those in the wealthiest neighbourhoods. CONCLUSION The potential savings from reducing the socio-economic-related differences in health are high, whether they are measured in terms of morbidity or dollars. Research is needed to determine the extent to which these potential savings are achievable.