The public health dimension of pension hikes and rising poverty

The 2,500 lira "update" that came after weeks of debate regarding the raise to be given to retirees was met with disappointment and anger in millions of households. 

Before the raise to be given to the lowest pension was announced the day before yesterday, a pioneering statement came from medical chambers: "Poverty is a public health issue." 

In the statements, which were based on data from official institutions and calculations by unions and which revealed the increasing inequality and deepening poverty in Turkey, it was stated: "The hunger threshold has exceeded the minimum wage. In June, the hunger threshold for a family of four rose to 19 thousand 44 lira, and the poverty threshold rose to 65 thousand 874 lira." 

Think about how meaningful the 2,500 lira increase in pensions, announced two days after this statement, is now! 

We are in times when our living standards are falling and incomes are eroding day by day. 

With the July 2024 civil servant salary increase, the salary of a 15-year teacher rose to 49 thousand 550 lira, and the base payroll salary of a 33-year academic / associate professor physician rose to 68,750 lira. In other words, the teacher is receiving a salary far below the poverty line, and the doctor is receiving a salary at the poverty line. 

HOUSEHOLDS SURVIVE ON SOCIAL ASSISTANCE 

Data from DİSK, KESK, TÜRK-İŞ, and official institutions reveal the latest situation regarding the increasing inequality and deepening poverty in Turkey. One of these data points, shared by the Ankara and Balıkesir Medical Chambers, was that the total amount of expenses for a person living alone—including healthy and balanced nutrition, housing, transportation, education, health, etc.—reached 30 thousand 604 lira. 

According to the social assistance data of the Ministry of Family and Social Services, 17 million 114 thousand 912 people in Turkey are trying to sustain their lives through social assistance.

As of June 1, 2024, the number of households in need of social assistance has jumped by 500 thousand in the last 6 months to 4 million 278 thousand. 

According to the latest data, the risk of poverty and social exclusion in Turkey is higher than in EU countries. When the rates of those under the risk of poverty and social exclusion are examined, the rate of those facing this risk in Turkey is twice the average of EU member countries. 

While the rate of those under the risk of poverty in Turkey is 34 percent, this rate is 21 percent in EU member countries. 

It is stated that 4 out of every 10 women are under the risk of poverty and social exclusion. 

CHILD POVERTY IS INCREASING 

According to TUIK data, while the rate of poor children in 2023 was 31.3 percent, the rate of children in material deprivation is stated to be 33.3 percent. When proportioned to the population, approximately 3 out of every 10 children are considered poor.

The number of children benefiting from the Social and Economic Support service rose to 170 thousand 694 as of May 2024. 

While this is the case, it should also be remembered that the additional budget proposal submitted by opposition parties for providing one free meal in schools was rejected by the votes of the AKP and MHP while the Ministry of National Education budget was being discussed in the Planning and Budget Committee.

In the proposal, where it was stated that malnutrition threatens the mental and social development of millions of children in our country, an increase in the MEB budget was requested to provide one meal a day in schools.

POVERTY EQUALS AN UNHEALTHY SOCIETY

It is known that the existence of dozens of health problems and the shortening of life expectancy are related to poverty. Poverty is described as one of the leading causes of diseases frequently seen in society. Again, high maternal and infant mortality, malnutrition, and shorter life expectancy are shown as the most important factors that negatively affect public health due to poverty. 

Another fact is that the negative effects of poverty on health become even more pronounced during economic crises. According to research, the poor contract chronic diseases earlier and die earlier. 

In recent years, it is frequently voiced in our country that children are facing the problem of stunting, which is called permanent short stature due to malnutrition, and beyond that, they are experiencing developmental delays in terms of mental health. Poverty reduces perception and learning skills in children, increases the risk of contracting infectious diseases, and makes them more prone to chronic diseases. 

The diseases and health problems caused by poverty, which the medical chambers also drew attention to in their recent statements, are summarized as follows:

**Poverty is a public health issue because in people who have to eat inadequately and unbalancedly due to financial impossibilities; the probability of seeing diseases such as fatigue and weakness, depression, hair loss due to zinc and iron deficiency, frequent illness due to a weakened immune system, constipation and edema formation, tooth decay or osteoporosis due to calcium and vitamin D deficiency, and anemias due to iron and folic acid deficiency increases.

**Due to high food prices, our people are turning to filling their stomachs with meals suitable for their budgets that are heavy in carbohydrates, high fat, and high simple sugar. There is not enough protein, fresh vegetables, and fruit on the tables. For this reason, health problems triggered by obesity such as obesity, hypertension, diabetes, and metabolic syndrome emerge. 

**According to the Obesity Combat Methods and Measures Commission report submitted to Parliament a few years ago, 1 out of every 3 people in our country is obese.

BENEFITING LESS FROM HEALTH SERVICES

The frequent illness of the poor segment means a need for doctors and medicine. However, unfortunately, the poor segment cannot access health services sufficiently either. The inverse proportion between poverty and access to health services shows that the poor segment benefits less from health services despite needing them more. 

The suggestions brought by the Medical Chambers on this issue are as follows: 

**Policies that increase inequality, place the burden of the economic crisis on the public and workers, and aim to transfer more resources to capital should be ended.

**Social policies that will prevent poverty and inequality in distribution should be implemented. Social assistance provided by the public should not be turned into a tool of political populism.

**The priority ways to reduce working poverty are to ensure justice in income and justice in taxation.

**For the development of our school-age children, 1 free healthy meal should be provided. Preventing child poverty and combating child labor should be among the government's priority duties.

THE NUMBER OF ULTRA-RICH IS INCREASING 

The population left in need of help is increasing exponentially, but on the other hand, reports from various international organizations reveal that the number of ultra-rich is increasing the most worldwide in Turkey. While the number of people with wealth over 30 million dollars in Turkey was 1 thousand 761 in 2022, it rose to 1 thousand 932 people in 2023. 

According to a Swiss bank that recently announced its global wealth report, the number of millionaires in Turkey will increase by 43 percent by 2028.  

While the share of the richest 20 percent in total income is increasing, the share received by the poorest 20 percent is decreasing. In other words, the inequality and injustice in income distribution are deepening the gap between the ultra-rich and the ultra-poor more and more every day.