We are often told that health inequalities are about money, that poor people cannot afford to live healthy lifestyles, but that is far too simplistic.

Health inequality goes deeper than dollars

Most of us accept the obvious part of this truth: yes, poorer people face real barriers. Fresh food costs more. Gym memberships aren't free. Time to cook properly or exercise is a luxury when you're working multiple jobs. But stopping there actually lets us off the hook too easily. It lets us think the problem is purely economic—and therefore not our problem, or only solvable through big policy shifts that feel distant.

The real insight is messier: health inequalities are also about power, information, trust, and dignity. Someone might have enough money but live in an area where they don't know anyone making different choices, or where there's no safe place to walk, or where they've learned not to trust health advice from institutions that haven't served them well. A person working two jobs has less mental bandwidth to navigate confusing health systems or make dozens of daily decisions. Stress itself—the chronic kind that comes from instability or powerlessness—damages health in ways that have nothing to do with a grocery budget.

When we reduce it all to money, we miss what we might actually change through design, community, and respect. That's both more complicated and more hopeful than throwing around statistics about income.