ABSTRACT
A growing literature supports the notion that our social environment-our incomes, our work, our social networks-in large part determines why some people are healthy and others not (Evans et al., 1994). Health-care systems play a significant role in why we get well when we are sick; social environments play a significant role in why we are healthy or why we become sick in the first place. There is an emerging consensus that societies with a more equitable income distribution, more employment and better working conditions, and more social cohesion are healthier and generate a virtuous cycle of prosperity and health (Evans et al., 1994; Amick et al., 1995; Blane et al., 1996; Wilkinson, 1996). In the past, experts viewed health as being largely separate from state policies to redistribute the rewards of a productive economy, create employment and ensure good working conditions, and build social cohesion. Many experts no longer hold this view and see health reform as one of the principal avenues redefining the boundaries between states, markets, and civil society (Dahrendorf, 1995).
