The detrimental health effects of inequality on Americans, as noted by Nick Kristof, apply to nearly all urban populations in the world. The American dream as a cultural value has become the mainstream influence underlining all social structures from early education and family norms to corporate ladders and political administrations.
Nick's article has strong traces of Merton's sociological thought and influence. The creation of unlimited aspirations combined with differential access to fulfill them can lead to the establishing of unconventional hierarchies of power and system dropouts who eventually pull out of society totally. However, the majority of people who choose to remain in the system (or in some cases have no choice) manifest social pathologies indicative of stress levels and other psychological trauma.
In the past, most civilizations rest on monarchies and other religion-centric hierarchies, which limits aspirations (as well as imagination). The tenets of capitalism and economic globalization however, have their roots in democracy, meritocracy and equal worth, and these frameworks are now beyond the control of any one human being. Inequality challenges those tenets whilst in the contemporary context of capitalism and economic globalization, and social pathologies appear as reactions, although not necessarily corrective measures.
The toll on health is more than simply the elimination of the "unfit" in a global "strongest will survive" challenge. No human being works alone, and inequality breaks down more than just the human body but the social body as well. Persistent social inequality prevents any remedies except those invoking Old Marxist overtones. However, urban social inequality is much more complex today. No longer is it based simply on quantifiable class factors such as real estate, educational level and meritocracy. Nor can it be simply glossed over with intangible, fluid factors such as social status and prestige.
Pushing down levels of social inequality in urban areas must take be factored at an international level. Governments can only do so much by implementing policies and laws; religious institutes can only provide a limited amount of counseling and spiritual solace; families and communities are limited by the output (and burden) of each member.
The solution to social inequality must start from a conscious choice from those with much to reach out to those with the least in the very surroundings where we live and breathe in. And often, it starts with an understanding among those with much to know that there is already so much that we can give.
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