What Does Economic Inequality Have to Do with Women’s Health Equity?

Matthew Desmond pulls no punches. 

He speaks as he writes: clear, compelling, and with dry, poignant humor.

I sat in the mid-back row of Town Hall’s auditorium this past March to hear him speak about his latest book, Poverty, by America. Though less story-oriented than his Pulitzer Prize winner, Desmond’s latest cites fact after fact to illustrate how we perpetuate poverty. 

(Yes, we.)

As he spoke, charts and graphs illustrated with startling clarity the stark divide between the haves and have-nots in our country and how impossible it can be for those without resources to gain any foothold. 

I looked around the room more than once throughout his talk: a majority white audience (myself included), with likely enough capital to make a significant dent in our city’s housing crisis. Heads nodded as Desmond spoke, and we collectively gasped as he played clips from various zoning and city council meetings. Meeting attendees were none too pleased, it seemed, to host a purveyor of economic equity in their midst. 

One off-hand comment was made about Seattle’s progressive policies by the moderator, to which the older gentleman sitting next to me and I snorted. 

But toward the end, you could feel a palpable charge to do something. 

Desmond made our marching orders clear: attend neighborhood council meetings to advocate for low-income housing, access resources like Union Plus before making purchases, and tell stories about what causes the proverbial fires, not only why people are jumping from burning buildings (an analogy he used throughout the talk). 

People leapt from their seats to send him off with a standing ovation and buzzed out of the room, energy flowing. If you’d kept us there, we may have solved all of Seattle’s social issues in one fell swoop.

Yet we all left. 

To our homes. 

To our beds.

To our jobs. 

I cannot speak for everyone, though I can hazard a guess as to what followed. 

We woke up the next morning, minds still abuzz, albeit muted. 

We opened emails and found more urgent matters demanding our attention. 

We picked up kids from school, called parents, and made dinner. 

And, though we’d bookmarked Desmond’s resources or mentally promised to go to the next council meeting, we’d lost the urgency of the night before. 

Lower and lower they’d fall among our priorities until the next time we attend a similarly charged presentation. 

Traps of Inaction, Private Affluence, and Public Squalor

I find myself falling into this same trap time and time again. 

Reading a compelling book, planning to make big changes, only to find the next day arrives sooner than expected, with responsibilities in tow. 

It takes intention to transform the way we see our habits, our communities, our cities.

To admit where we perpetuate inequitable systems. 

To crawl out of our comfort zones. 

To speak up for our unhoused neighbors. 

To call out inequitable policies. 

To be kind, generous, and gracious to everyone who crosses our paths. 

Desmond says we often settle for lonely, stingy affluence. 

The wealthier we become, the higher our walls grow. He told a story of his former lower-income neighborhood, where communal gatherings were plenty, and people knew each other’s names, struggles, and joys. But as he moved on and “up,” so to speak, the higher the fences, the less and less he knew his neighbors. 

It harkens to images of Tolkien’s Smaug, sitting alone, guarding his gold. 

And the more wealth we hold, the fewer resources are available to others, thus leading to what Desmond calls “private affluence and public squalor.” 

When the wealthy leave communities, outcomes worsen for everyone. Less investment in public schools. Public parks fall by the wayside. 

And on and on it goes.

We must remember it’s not only the 1%; we all play a role in perpetuating poverty. 

How do anti-poverty initiatives relate to women’s health?

Following Desmond's presentation, I spent some time mulling over this question in particular. 

Lower economic status often equates to poorer health. 

Lack of health insurance, high deductibles, and confusing systems form significant barriers for the poor to access healthcare. 

And for women, who are often in charge of their family’s health and wellbeing, their health gets put on the back burner even more, leading to worse outcomes or overlooked conditions. 

Unhoused women also face particular health challenges, such as accessing menstrual products, safe, hygienic places to care for their health needs, and healthcare options outside of emergency services. 

And on it goes until women find themselves living 25% of their lives in poorer health than men. 

Equitable economic policies and pay and parental leave and reproductive rights improve women’s health tenfold. We’re missing out on a trillion dollars each year due to women’s unpaid labor and poor health. 

Melinda French Gates’ continued announcements give me hope, though, that the tide may shift all the more rapidly toward improving women’s health and reproductive rights. But that remains to be seen. 

Disrupting the Cycle of Inaction to Further Economic and Health Equity

So, what to do? 

How can we, average people, begin to make a dent in this enormous, inequitable system we’re a part of?

In my mind, we can start small. 

Such as writing down one change you can make in the next year.

You could go to one council meeting and listen. 

You could invite your neighbors over for a meal. 

You could choose one women’s health nonprofit or anti-poverty organization to support with your time or your funds.

You could give Desmond’s books to a friend. 

Use your imagination, and be honest with yourself, your time, and your capabilities. 

Pro Tip: It may help to tell your partner or a friend about your commitment. I’ve found that f you keep it to yourself, you’re more likely to put it off until it falls entirely off your list. 

Desmond closed his talk with the opening line from Oscar Wilde’s “The Soul of a Man Under Socialism,” though I found a quote within the essay I believe sums up my thoughts quite well (with my own edits): 

“For what [woman] has sought for is, indeed, neither pain nor pleasure, but simply Life. [Woman] has sought to live intensely, fully, perfectly. When [she] can do so without exercising restraint on others, or suffering it ever, and [her] activities are all pleasurable to [her], [she] will be saner, healthier, more civilised, more [herself].”

Stopping inequitable systems requires people like you and me to point out its blatant disregard for the poor so that we all may have the opportunity to live fully and freely. 

We must all have the opportunity to thrive.