In the article Cause of Death: Inequality, by Alejandro Reuss, the author discusses how disparity in income, opportunity, and class relate directly to life expectancy and likely causes of death.  Basically, the wealthier and higher up on a social hierarchy ladder a person is, the more likely they will live a long life; the lower income and status a person is, the more likely their life will be comparatively short and have a tragic, avoidable end. 

While of course there are individual exceptions to the above generalizations, the overwhelming statistics and trends should shock and/or disturb everyone.  How is it possible that disparity and the results of disparity are basically accepted as givens?  This is nearly impossible to explain.

I have seen health care from a variety of angles here in the U.S., from free clinics, to state-sponsored care, to high-priced insurance (Kaiser-Permanente) and government employess health care; a common thread in all of these has not been quality of care, which has generally been good, but in the need for self-advocacy.  Regardless of whether a person is paying nothing, a little, or alot for health care, they MUST be able to speak up for themselves and their loved ones.  I can only imagine that it is only the truly wealthy who automatically receive the type of preventative care that we all should.  It is simply not likely to be a very personal experience in the average, super busy doctors office.  Adequate, but rarely "great".

It requires knowledge, experience, skill and will to self advocate effectively. The societal factors and personal choices (many of which are influenced by societal factors) that contribute to lower qualities of life and life expectancies need to be brought to light and discussed openly.

Reference:

Reuss, A. (2001, June). Cause of Death: Inequality. Dollars and Sense.