Social Determinants of Health - Social Exclusion

Given that absolute poverty is a major determinant of ill-health, the resultant social exclusion is ‘psychologically damaging, materially costly and harmful to health’ (WHO, ibid). The suggested path to cope with this is minimum wage legislation and labour market policies to reduce social stratification. Minimum wages set at a realistic level do little harm during times of prosperity. However, when the economy is slowing down, employers first of all shed marginal workers (e.g. unskilled workers, those with disabilities, etc.).

Austerity measures taken may also be by way of reduced holidays, rest breaks, pensions and other work place benefits. This will have the effect of adding to the work related stress. The suggestion made to deal with situations of social exclusion includes expansive welfare provision. However, there is evidence that such provisions created unemployment and poverty (in U.K.) contributing to breakdown of family structures (Bartholomew, 2004). Social exclusion can instead be addressed by introducing public policies that empower the poor and the marginalised. For instance, state financed educational vouchers give the poor the choice of attending any school forcing providers of education to compete to attract the students and their vouchers.