Individuals suffering from health anxiety are a drain on resources in every area of medical practice. There have been estimates that illness worries varying from rational concerns to constant incapacitating fears occurs in 10-20% of normal people. It has been estimated that 30-80% of patients who consult physicians present with symptoms for which there are no physical basis. Health anxiety can arise in two major situations. Patients can present to medical personnel with a preoccupation with fears of having, or the idea that they have, a serious disease based on a misinterpretation of one or more bodily signs or symptoms. The second aspect is that patients with general or serious medical conditions become dysfunctional with their preoccupations and fears with their condition. The preoccupation with bodily symptoms, whether a disease is present or not, causes clinically significant distress or impairment in social, occupational or other important areas of functioning. In addition, medical personnel frequently formulate demanding profiles of constant reassurance seeking patients whether they have or do not have demonstrable medical conditions or diseases. These attitudes may and do lead to less than optimal health care. In addition, there are cases where individuals with advanced medical conditions do not present to medical personnel because of their health anxiety.
The relationship between income inequality, socioeconomic status and population has been demonstrated across a numerous studies, both between and within countries, for most major causes of death and morbidity. The role of socioeconomic factors was highlighted in the 1998 annual report of the National Center for Health Statistics. Social factors in health risk were first noted in the Whitehall Study of British civil servants. A gradient has been reported relating morbidity and mortality to socioeconomic status. In other words, not only were the lowest groups affected, but the relationship continues up the socioeconomic ladder. Behavioural risk was found to be less important than income disparities. In addressing these areas, among the aspects to be explored are issues of governance and the role of civil society groups.
Access to health services by under-serviced groups is affected by demographic, gender and socio-economic factors. In their search to improve the health of under-serviced people, policy makers have redefined the concept of under-service to include a broad range of fundamental factors affecting population health. One possible explanation for the correlation between income inequality and health outcomes is that as the social distance between the rich and the poor widens, their interests diverge. Investment in public goods e.g. education, childcare, health, become less appealing for the better off because they are able to finance these expenditures privately. In the US, trend lines indicate that states with higher income inequality generally spend less that their more equal counterparts on education, welfare, health care and other public services.