Income inequality is widely assumed to be a major contributor to poorer health at national and subnational levels. According to this assumption, the most appropriate policy strategy to improve equity in health is income redistribution. This paper considers reasons why tackling income inequality alone could be an inadequate approach to reducing differences in health across social classes and other population subgroups, and makes the case that universal social programs are critical to reducing inequities in health. A health system oriented around a strong primary care base is an example of such a strategy.
Equity in Health
Income redistribution is not enough: income inequality, social welfare programs, and achieving equity in health
Starfield B, Birn AE: Journal of Epidemiology and Community Health 61:1038-1041, 2007
Malawi Health Equity Network National Health Forum
MHEN, 22-23 November 2007
MHEN held a National Forum on 22nd and 23rd November 2007 at Lilongwe Hotel. It brought together a network of policy makers and practitioners who work in the field of health services delivery. The forum explored the challenges in health services delivery in a non-industrialised country with limited resources.
Further details: /newsletter/id/32725
Shaping the world to illustrate inequalities in health
Dorling D, Barford A: Bulletin of the World Health Organisation 85(11): 821-900, November 2007
Visualizing inequalities in health at the world scale is not easily achieved from tables of mortality rates. Maps that show rates using a colour scale often are less informative than many map-readers realize. For instance, a country with a very small land area receives less attention, whereas a large, sparsely populated area on a map is more obvious. Furthermore, unlike our visual ability to compare the lengths of bars in a chart, we do not have a natural aptitude for translating different colours or shades to the magnitudes they represent. Here we introduce another approach to mapping the world that can be useful for illustrating inequalities in health. This article looks at various ways of mapping and visualising global health statistics.
Squaring the Circle: AIDS, Poverty, and Human Development
Piot P, Greener R, Russell S: PLoS Med 4(10), 23 October 2007
The relationship between AIDS and poverty has more to do with inequality than poverty per se. The relationship between socioeconomic status and HIV varies considerably from country to country, reflecting differences in culture and traditions. Effective actions to tackle AIDS must directly address these specific factors—the inequalities—that drive HIV transmission in different contexts, and must overcome the obstacles to accessing treatment in different groups. It is crucial to place AIDS squarely at the centre of all socio-economic development, and provide long-term, high-level domestic and international investment in HIV prevention and treatment in the world's poorest countries.
Equity in health and healthcare in Malawi: Analysis of trends
Zere E, Moeti M, Kirigia J, et al: BMC Public Health; 7,78, 2007
Achievement of the Millennium Development Goals is likely to be compromised if inequities in health/ healthcare are not properly addressed. This study attempts to assess trends in inequities in selected indicators of health status and health service utilisation in Malawi using data from the Demographic and Health Surveys of 1992, 2000 and 2004. The widening trend in inequities, in particular healthcare utilisation for proven cost-effective interventions is likely to jeopardize the achievement of the Millennium Development Goals and other national and regional targets. To counteract the inequities it is recommended that coverage in poor communities be increased through appropriate targeting mechanisms and effective service delivery strategies. There is also a need for studies to identify which service delivery mechanisms are effective in the Malawian context.
Gender inequity in health: why it exists and how we can change it
Sen G, Ostlin P, George A: Women and Gender Equity Knowledge Network, 2007
Gender differentials in health related risks and outcomes are partly determined by biological sex differences. Yet they are also the result of how societies socialise women and men into gender roles. The paper draws together evidence that identifies and explains what gender inequality and inequity mean in terms of differential exposures and vulnerabilities for women versus men, and also how health care systems and health research reproduce these inequalities and inequities instead of resolving them.
Research on Determinants of Health Equity
Global Forum for Health Research, 1 November 2007
The health disparities between rich and poor in the developing world are so stark that reforms premised on "equal access" are inadequate, declared Werner Christie, Counsellor, Science and Technology, Norwegian Embassy, People's Republic of China and former minister of health of Norway. To be most effective, policies should be based on "disparate access," said Christie, speaking at Forum 11, the annual meeting of the Global Forum for Health Research, which this year focuses on equitable access. Such an approach would grant priority to the disadvantaged people who need help most, he said.
UN poverty goals on health out of reach, WHO says
The World Health Organisation (WHO), 29 October 2007
The world is likely to fail to meet the United Nation's Millennium Development Goals related to health, the head of the World Health Organization said on Monday at a global forum on health research for poor nations. A rise in funding for research into communicable diseases has not been matched by the power of health systems to deliver, in part because of the failure of governments to invest in the sector, said Margaret Chan.
Equity in health and health care in Malawi: analysis and trends
Zere E, Moeti M, Jirigia J: BMC Public Health, 2007
This article in BMC public health assesses trends in inequities in health and health service utilisation in Malawi using data from the Demographic and Health Surveys (DHS) of 1992, 2000, and 2004. The paper finds that there has been an increase in the levels of pro-rich inequity in infant and under-five mortality rates. This implies that the burden of infant and under-five mortality is getting disproportionately higher among children from the poor than the non-poor households. Inequalities are also observed in the use of interventions including treatment of diarrhoea. In addition, the paper finds that the publicly provided services for some of the selected interventions including child delivery, benefit the non-poor more than the poor.
The Interim Statement of the WHO Commission on the Social Determinants of Health
The Interim Statement sets out the Commission’s vision and goals, the problems it seeks to ameliorate, and the intellectual foundation for a social determinants approach. In doing so, the Interim Statement is a resource for stakeholders concerned with social determinants of health and health equity, as they build towards a global movement. Recommendations for action, based on the evidence gathered across all the Commission’s work streams, will be made in the Final Report in May 2008.