Scientific Solutions to Health Inequality

Wealth inequality leads to big disparities in healthcare outcomes. To tackle the problem, researchers are looking beyond the hospital.

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When patients leave the hospital, not all of them have homes to go back to. Addressing the root causes of illness requires solutions that extend beyond doctors and medicine. Dr. Stephen Hwang, professor of medicine at the University of Toronto, focuses on improving the health of people who are homeless and marginalized. The environment and circumstances for these patients outside the clinic has a huge negative impact on their health outcomes. Housing and healthy neighbourhoods are essential to help citizens thrive.

These social determinants of health are gaining influence in medicine and healthcare as we recognize poverty as more than just a social issue; the World Health Organization has defined poverty as the single strongest predictor of whether people are well or ill.

“The challenge in Toronto, and the challenge in many Canadian cities, is the fact that even when we have relative prosperity, we have huge disparities in wealth and income, and we have increasingly marginalized groups of people living in our cities who suffer from really severe health problems and disadvantage. So the goal of our research is to see how we can first of all, improve the health of these marginalized individuals, but also attack the root problem, which is really the inequalities of opportunity and social determinants of health,” Hwang explains.

Some of Hwang’s research tackles practical problems, such as defining the outdoor temperatures below which a city needs to make special effort to get the homeless off the streets and into shelters.

His work is also often bridges into the political, encouraging social services not to allow people to fall through the cracks because it’s the right thing to do, and not just because of the cost benefits to the healthcare system. His research also looks at minimum standards for living conditions and government housing to ensure mental wellness.

Want to learn even more about the effect of poverty on health? Read more in our blog.

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Dr. Stephen Hwang is a practicing physician in general internal medicine at St. Michael’s Hospital and a research scientist at the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael’s Hospital. He holds the Chair in Homelessness, Housing, and Health at St. Michael’s Hospital and the University of Toronto. Dr. Hwang has worked in the community as a physician for people who are homeless for more than 20 years. Dr. Hwang’s research studies have focused on health problems and access to health care among people experiencing homelessness, the connections between housing and health, and interventions to improve the health of people who are homeless. He is Professor of Medicine and Director of the Division of General Internal Medicine at the University of Toronto. Dr. Hwang received his M.D. from the Johns Hopkins School of Medicine and his Master of Public Health degree from the Harvard School of Public Health.