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Health equity

Health gap in England and Wales, 2011 Census

Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige.[1] Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources.[2][1] It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.[1]

According to the World Health Organization, "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".[3] The quality of health and how health is distributed among economic and social status in a society can provide insight into the level of development within that society.[4] Health is a basic human right and human need, and all human rights are interconnected. Thus, health must be discussed along with all other basic human rights.[1]

Health equity is defined by the CDC as "the state in which everyone has a fair and just opportunity to attain their highest level of health".[5] It is closely associated with the social justice movement, with good health considered a fundamental human right. These inequities may include differences in the "presence of disease, health outcomes, or access to health care"[6]: 3  between populations with a different race, ethnicity, gender, sexual orientation, disability, or socioeconomic status.[7][8]

Health inequity differs from health inequality in that the latter term is used in a number of countries to refer to those instances whereby the health of two demographic groups (not necessarily ethnic or racial groups) differs despite similar access to health care services. It can be further described as differences in health that are avoidable, unfair, and unjust, and cannot be explained by natural causes, such as biology, or differences in choice.[9] Thus, if one population dies younger than another because of genetic differences, which is a non-remediable/controllable factor, the situation would be classified as a health inequality. Conversely, if a population has a lower life expectancy due to lack of access to medications, the situation would be classified as a health inequity.[10] These inequities may include differences in the "presence of disease, health outcomes, or access to health care". Although, it is important to recognize the difference in health equity and equality, as having equality in health is essential to begin achieving health equity.[1] The importance of equitable access to healthcare has been cited as crucial to achieving many of the Millennium Development Goals.[11]

  1. ^ a b c d e Braveman P, Gruskin S (April 2003). "Defining equity in health". Journal of Epidemiology and Community Health. 57 (4): 254–8. doi:10.1136/jech.57.4.254. PMC 1732430. PMID 12646539.
  2. ^ Goldberg DS (2017). "Justice, Compound Disadvantage, and Health Inequities". Public Health Ethics and the Social Determinants of Health. SpringerBriefs in Public Health. pp. 17–32. doi:10.1007/978-3-319-51347-8_3. ISBN 978-3-319-51345-4.
  3. ^ Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, 19 June – 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of WHO, no. 2, p. 100) and entered into force on 7 April 1948. The definition has not been amended since 1948.
  4. ^ Marmot M (September 2007). "Achieving health equity: from root causes to fair outcomes". Lancet. 370 (9593): 1153–63. doi:10.1016/S0140-6736(07)61385-3. PMID 17905168. S2CID 7136984.
  5. ^ "What is Health Equity?". www.cdc.gov. 2023-01-09. Retrieved 2023-04-25.
  6. ^ Goldberg J, Hayes W, Huntley J (November 2004). Understanding Health Disparities. Health Policy Institute of Ohio.
  7. ^ U.S. Department of Health and Human Services (HHS), Healthy People 2010: National Health Promotion and Disease Prevention Objectives, conference ed. in two vols. (Washington, D.C., January 2000).
  8. ^ Fujishiro, Kaori; Ahonen, Emily Q.; Gimeno Ruiz de Porras, David; Chen, I.-Chen; Benavides, Fernando G. (2021). "Sociopolitical values and social institutions: Studying work and health equity through the lens of political economy". SSM – Population Health. 14: 100787. doi:10.1016/j.ssmph.2021.100787. ISSN 2352-8273. PMC 8056461. PMID 33898729.
  9. ^ Braveman P (January 2014). "What are health disparities and health equity? We need to be clear". Public Health Reports. 129 (Suppl 2): 5–8. doi:10.1177/00333549141291S203. PMC 3863701. PMID 24385658.
  10. ^ Kawachi I, Subramanian SV, Almeida-Filho N (September 2002). "A glossary for health inequalities". Journal of Epidemiology and Community Health. 56 (9): 647–52. doi:10.1136/jech.56.9.647. PMC 1732240. PMID 12177079.
  11. ^ Vandemoortele, Jan (2011). "The MDG Story: Intention Denied: The MDG Story: Intention Denied". Development and Change. 42 (1): 1–21. doi:10.1111/j.1467-7660.2010.01678.x.

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