A 2015 report from the World Health Organization states that 36% of the world's population, or nearly 2.5 billion people, lack access to improved sanitation facilities, putting them at risk of several diseases including dysentery, cholera and typhoid. In context, however, the report also states that disadvantaged subpopulations, such as rural residents, the poor and the less educated have seen greater increases in key coverage indicators over the past decade or so than their urban, wealthier and better-educated counterparts. Access to vision care is a further example of a health issue that can impact educational attainment and earning potential. Worldwide, 80 per cent of blindness is avoidable through prevention or treatment.
In the US, access to medical care is limited more by costs than by availability of services. Costs of medical care are a significant contributor to financial stress, with more than half of personal bankruptcies explicitly tied to medical bills—even though three-quarters of those households had medical insurance at the onset of the medical condition. Analyses before the implementation of the 2010 Affordable Care Act concluded that 1.7 million Americans live in households that will declare bankruptcy due to their inability to pay their medical bills.8 Lack of access to medical care feeds back to health outcomes: uninsured adults are at least 25 per cent more likely to die prematurely than adults who have private insurance, one indicator of poorer health. Households in which individuals, and especially wage earners, experience poor health or premature death are at added risk for low income, creating a self-reinforcing cycle.