Pathology of poverty: the need for quality improvement efforts to address social determinants of health

A massive body of literature characterises the impact of poverty on health outcomes. In 1817, Rene Villermé, a young French surgeon (and later economist-cum-social commentator), demonstrated stark differences in life expectancy across Parisian neighbourhoods or arondissements.1 This demonstration of disparities in basic health outcomes across income levels helped configure our early understanding of the 'social determinants of health'. These determinants refer to the conditions in which people are born, grow, live, work and age, including income, housing and education, among others. Even 200 years after Villermé, with so many technological advances both within and outside of healthcare, the unequal distribution of resources across society continues to exert tremendous influence on the health outcomes of individuals and their communities.2–5

Underappreciated impacts of poverty as a cognitive impediment

In this issue of BMJ Quality and Safety, two papers draw attention...

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