Poverty is a major cause of ill health and a barrier to accessing health care when needed. This relationship is financial: the poor cannot afford to purchase those things that are needed for good health, including sufficient quantities of quality food and health care. But, the relationship is also related to other factors related to poverty, such as lack of information on appropriate health-promoting practices or lack of voice needed to make social services work for them.
Ill health, in turn, is a major cause of poverty. This is partly due to the costs of seeking health care, which include not only out-of-pocket spending on care (such as consultations, tests and medicine), but also transportation costs and any informal payments to providers. It is also due to the considerable loss of income associated with illness in developing countries, both of the breadwinner, but also of family members who may be obliged to stop working or attending school to take care of an ill relative. In addition, poor families coping with illness might be forced to sell assets to cover medical expenses, borrow at high interest rates or become indebted to the community.
Strong health systems improve the health status of the whole population, but especially of the poor among whom ill health and poor access to health care tends to be concentrated, as well as protect households from the potentially catastrophic effects of out-of-pocket health care costs. In general, poor health is disproportionately concentrated among the poor.