Poverty is a vice

Why can't the poor be healthy

Dmitry Spitsyn, Habr

"It's better to be poor but healthy than rich but sick," are the first words that come to mind for many of my patients, and these words have ceased to be relevant since 1946, when the charter of the World Health Organization was adopted.

Since 1946, a poor person has ceased to be considered healthy. Poverty has become as much a vice as the absence of a body part or the presence of a disability due to a chronic disease.

There has been a qualitative leap from the understanding of health according to the official definition of the concept of "health" from the WHO statute: "Health is a state of complete physical, mental and social well-being, and not only the absence of diseases and physical defects." 

The quality of life has become another measure of health. To console myself with the fact that I'm not sick, because I don't really need prosperity, it doesn't work anymore. 

Medicine is a very conservative field of activity, and paradigm changes occur slowly and gradually. The dominant concept of the biomedical model of medicine until the end of World War II only crystallized into a biopsychosocial one with the beginning of the third millennium (see the review article "Biopsychosocial model 25 years later". 

If the absence of illness or injury is enough for the biomedical model of medicine to consider the patient healthy, then quality of life factors (lifestyle of both healthy and sick people) are also important for the biopsychosocial model. 

"Healthy lifestyle", healthy lifestyle are words that are found everywhere and, as usual, are understood in context: went to the gym – ate salads and fruits. About the sleep regime and ecology are remembered less often. About the quality of working, friendly and family relationships even less often. Quality sex, as a factor of healthy lifestyle pops up from memory sometimes. But money as a factor of health is taboo. 

At the same time, physical, mental and social well-being depends on monetary prosperity. The amount of money earned does not reflect well–being - everyone needs their own level of cash flow to live in prosperity. Prosperity is a relative state. 

Here is an approximate list of questions that you should ask yourself to understand whether you live in prosperity: 

• What is your balance of expenses and income (are you accumulating, living in debt or in zero)?
• Is there a financial "safety cushion" (accumulation of cash, allowing two months to live on them in the usual mode of consumption)?
• Do you save on the quality of food, can you fully eat 2-3 times a day?
• Do you have a daily change of underwear, a full set of clothes and shoes according to the weather?
• Do you have a separate space to live in?
• How much free time do you have besides work and commuting?
• Do you have time to sleep?
• Can you afford to buy "unnecessary" things?
• Do you have the time and money to recover from work and rest?
• How safe and confident do you feel financially in your relationships (with family and friends, at work)? 
• How many sources of income do you have?
• How many hundreds of items on your wish list do you have?

Poverty is quickly identified by a list of these issues. Even well-earning people find in this list those uncomfortable questions that pose the question: "If I am so successful, then why am I bad here and here?". 

As soon as there is an understanding that prosperity implies not only the amount of money, but also the knowledge and skills of proper disposal of them, a biopsychosocial model of medicine comes on the scene. The key role in this model is to teach how to find optimal patterns of behavior for human health, to work independently on the quality of one's life, to change the social worldview to improve public and personal health. 

An example of the introduction of new principles of understanding health can be the UN programs for the elimination of poverty and destitution, the integration of disabled people into society, gender equality, decent work and sustainable growth, and the maintenance of the environment… 

National programs are fine, but what about a specific me? It is impossible to give an unambiguous answer to this question. There are a lot of individual factors that only you and financial literacy programs can take into account, helping to develop your own strategy for achieving prosperity.

Health is more than just the absence of disease or injury, and one of the components of health is a state of prosperity. The topic is painful for many, I will be glad if the article helps in understanding readers' health problems.

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