Equity in Health

WHO called to return to Alma-Ata Declaration
World Health Organisation

At the 59th World Health Assembly, Dr Serag challenged WHO to return to the principles of the Alma Ata Declaration in "Managing the Politics of Equity and Social Determinants of Health". The briefing drew sharper focus on the necessity of major health stakeholders to step up action on the social causes of ill-health. High-level policy makers, civil society members and WHO staff attended the briefing, proclaimed as a "historical moment" by a floor delegate. Among the attendees was Dr Halfdan Mahler considered to be the father of the Alma Ata Declaration and former WHO Director-General from 1973 to 1988.

Social capital and health: Does egalitarianism matter?
International Journal for Equity in Health 5:3: Islam MK, Merlo J, Kawachi L, et al

The aim of the paper is to critically review the notion of social capital and review empirical literature on the association between social capital and health across countries. Findings of this literature review led to the tentative conclusion that an association between social capital and health at the individual level is robust with respect to the degree of egalitarianism within a country.

Global Health Watch and Global Health Action
GEGA

The Global Health Watch for 2005-2006 looks at some of the most important problems, suggests solutions, and monitors the efforts of institutions and governments concerned with promoting health world-wide. This report arises out of many civil society and professional campaigns and struggles for better health, and has been released to coincide with the Second People's Health Assembly, held in Cuenca, Ecuador, at which two thousand people from across the world have gathered to discuss and debate strategies to overcome the political, economic and social barriers to better and fairer health.

Priorities for resarch to take forward the health equity policy agenda
WHO Task Force on Research Priorities for Equity in Health and the WHO Equity Team: Bulletin of the World Health Organisation; December 2005, 83 (12)

Despite impressive improvements in aggregate indicators of health globally over the past few decades, health inequities between and within countries have persisted, and in many regions and countries are widening. Our recommendations regarding research priorities for health equity are based on an assessment of what information is required to gain an understanding of how to make substantial reductions in health inequities. We recommend that highest priority be given to research in five general areas; described in detail in this article.

Further details: /newsletter/id/31457
The developing world in The New England Journal of Medicine
Lown BB, Banerjee AA: Globalization and Health 2006, 2:3

Rampant disease in poor countries impedes development and contributes to growing North-South disparities; however, leading international medical journals underreport on health research priorities for developing countries. The medical information gap between rich and poor countries as judged by publications in the NEJM appears to be larger than the gap in the funding for research. Under-representation of developing world health issues in the medical literature is a global phenomenon. International medical journals cannot rectify global inequities, but they have an important role in educating their constituencies about the global divide.

What evidence is there about the effects of health care reforms on gender equity, particularly in health?
Östlin P: Health Evidence Network, World Health Organization

In the last two decades, powerful international trends in health care reform have been observed around the world. Although health care reform is a global phenomenon driven by common financial and political actors, adopted reforms vary by country and region. Albeit from a European perspective, this article discusses how, regardless of the national and regional contexts in which health care reforms are implemented, the changes have fundamental consequences for many people's day-to-day lives and well-being.

Income inequality and population health: A review and explanation of the evidence
Social Science & Medicine

Whether or not the scale of a society's income inequality is a determinant of population health is still regarded as a controversial issue. We decided to review the evidence and see if we could find a consistent interpretation of both the positive and negative findings. We identified 168 analyses in 155 papers reporting research findings on the association between income distribution and population health, and classified them according to how far their findings supported the hypothesis that greater income differences are associated with lower standards of population health.

Social determinants of health inequalities

This paper studies the key issues underlying inequalities in health between and within countries as well as poverty and inequality. These include social determinants (poverty, inequality, and the causes of the causes). The paper emphasises that action is not only possible but also necessary. It further highlights the importance of meeting human needs.

Concerns for equity and the optimal co-payments for publicly provided health care
Social Science Research Network

In countries where health care is publicly provided and where equity considerations play an important role in policy decisions, it is often argued that an increase in co-payments is unacceptable as it will be particularly harmful to the less well-off in society. The present paper derives socially optimal co-payments in a simple model of health care where people differ in income and in severity of illness. Increased concern for equity may increase optimal co-payments for illnesses with homogeneous severity across the population. For illnesses where the severity varies strongly across the population, optimal co-payments go down as a response to increased concern for equity, provided income differences in the society are sufficiently small.

Effectiveness of primary health care evaluated by a longitudinal ecological approach
Journal of Epidemiology and Community Health 2006

Brazil is the country with the third worst income distribution in the world and, as a consequence of the unequal distribution of its main determining factors (income, education, living conditions, sanitation, and health service), the health indicators also present broad inequalities by regions and social classes. The expansion of primary health care in Brazil has been thought to be shaping the agenda for health care policy in the Latin American region. This editorial discusses the importance of a study which performed a longitudinal evaluation, at a national level, of a broad primary health care strategy.

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