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Poverty as Social and Economic Exclusion

Poverty is a complex phenomenon that varies with the social and economic conditions of the community or the country. Increasingly in Western countries, poverty is more accurately recognized as social and economic exclusion. This definition captures the multi-dimensional and dynamic nature of poverty and disadvantage. From this perspective, poverty is clearly interwoven with the social determinants of health.

[ …Human poverty is deprivation in multiple dimensions, not just income. Industrial countries need to monitor poverty in all its dimensions – not just income and unemployment, but also lack of basic capabilities such as health and literacy, important factors in whether a person is included in or excluded from the life of a community. ] 1

Jean-Pierre Deschamps, Director of the School of Public Health in Nancy, France, describes the profound two-way relationship between poverty and the determinants of health in the video "Poverty and Health." He points out that people with limited access to income are more likely to have poorer health, be more socially isolated, and have fewer opportunities for early childhood development and later education. At the same time, people with poorer health who are socially isolated and have fewer opportunities are more likely to live in poverty. Clearly, people are not poor because they choose to be. According to Deschamps, poverty is a result of economic and social exclusion.2 This relationship is also noted in community development documents from Ireland:

Social exclusion is seen as a process whereby individuals or groups and the environments in which they live are excluded from the resources and opportunities which are considered the norm in a society. It is not just about scarcity of material resources, but lack of opportunities, isolation, discrimination, marginalisation from decision-making and from an adequate quality of life. 3

By understanding poverty as social and economic exclusion, we begin to understand the need to address poverty through policies that foster inclusion and reduce inequalities in the determinants of health. This approach is described below:

Connected problems require joined-up solutions. This means tackling inequality which stems from poverty, poor housing, pollution, low educational standards, joblessness and low pay. Tackling inequalities generally is the best means of tackling health inequalities in particular. 4

Promoting social and economic inclusion is an approach that underlies all the work of the Public Health Agency of Canada (PHAC) Atlantic.



  1. United Nations Development Program. 1998. Human Development Report.
  2. Deschamps, J.P. 1997. Jean-Pierre Deschamps on Poverty and Health. The New Public Health Collection, NSP, Montreal, Quebec.
  3. O'Hara, P. 1998. Action on the Ground: Models of Practice in Rural Development. Published by Irish Rural Link.
  4. Our Healthier Nation. Green Paper presented to the UK Parliament. 1998.