Despite the establishment of a 'health inequities knowledge base', the precise roles for municipal governments in reducing health inequities at the local level remain poorly defined. The objective of this study was to monitor thematic trends in this knowledge base over time, and to track scholarly prescriptions for municipal government intervention on local health inequities. Of the total of 1,004 journal abstracts pertaining to health inequities that were analysed, the overall quantity of abstracts increased considerably over the 20 year timeframe. 'Healthy lifestyles' and 'healthcare' were the most commonly emphasised themes, but only 17% of the abstracts articulated prescriptions for municipal government interventions on local health inequities. This study has demonstrated a pervasiveness of 'behavioural' and 'biomedical' perspectives, and a lack of consideration afforded to the roles and responsibilities of municipal governments, among the health inequities scholarly community. Thus, despite considerable research activity over the past two decades, the 'health inequities knowledge base' inadequately reflects the complex aetiology of, and solutions to, population health inequities.
Equity in Health
For this survey, school learners completed a self-administered questionnaire, in addition to having their height and weight measures taken, in 2008. The overall response rate was 71.6%. In summary, there were considerable variations across age, gender, grade, race and province for each of the risk behaviours. With regard to behaviours related to infectious diseases, 38% of learners had reported ever having had sex, with 13% of them reporting their age of initiation of sexual activity as being under 14 years old, while 63% always washed their hands before eating and 70% always washed their hands after going to the toilet. High levels of violence were indicated by the 15% of learners reported carrying weapons and 36% who reported they had been bullied in the month prior to the survey. Learners reported alcohol consumption was 50% for ever having drunk alcohol and 35% for having drunk alcohol in the past month, and 29% for having engaged in binge drinking in the month prior to the survey. The study makes specific recommendations to address the clusters of behaviours covered in this survey, based on the concept of intersectoral intervention development or solutions to limit the behaviours that place young people at risk for premature morbidity and mortality.
This book analyses the impact of social determinants on specific health conditions. It presents promising interventions to improve health equity for: alcohol-related disorders, cardiovascular diseases, child health and nutrition, diabetes, food safety, maternal health, mental health, neglected tropical diseases, oral health, pregnancy outcomes, tobacco and health, tuberculosis, and violence and injuries. Individual chapters represent the major public health programmes at WHO, reflecting the premise that health programmes must lead the way by demonstrating the relevance, feasibility and value of addressing social determinants. Each chapter is organised according to a common framework that allows a fresh but structured look at common, high burden public health problems. Levels in this framework range from the overall structure of society, to differential exposure to risks and disparate vulnerability within populations, to individual differences in health care outcomes and their social and economic consequences. Throughout the volume, an effort is made to identify entry-points, within existing health programmes, for interventions that address the upstream causes of ill-health. Possible sources of resistance or opposition to change are also consistently identified.
About 3,500 advocates, policymakers, development leaders, health care professionals, youth advocates, celebrities and media personnel from 140 countries attended the 2010 Women Deliver Conference, held from 7–9 June in Washington, DC, United States. The conference challenged the international community to dramatically reduce maternal and child mortality by committing US$12 billion in aid. Three messages emerged from the conference. First, maternal and newborn mortality rates are dropping, but the work is far from done. Second, investing in girls and women is not only the right thing to do, but it makes economic sense. Third, although solutions exist to achieve Millennium Development Goal 5, which aims to reduce maternal and infant mortality, what is lacking are the requisite political will and the equitable allocation of resources.
In her address at the 2010 World Health Assembly, Margaret Chan charted the successes and failures of public health over the past year. She underlined the importance of equity and social justice, which are central to the Millennium Declaration and its goals, as well as the primary health care approach. Principles such as universal access to services, multisectoral action and community participation form a solid basis for strengthening health systems. However, efforts to reduce maternal and newborn deaths have shown the slowest progress of all the Millennium Development Goals (MDGs) in all regions, largely, as she pointed out, because reducing these deaths depends absolutely on a well-functioning health system. She informed participants that, in preparation for the September United Nations Summit on the Millennium Development Goals, the Secretary-General’s office is finalising a joint action plan to accelerate progress in reaching the health-related MDGs, with a special focus on maternal and child health. She urges all participants to maintain a focus on building strong health systems and improving regulatory capacity. Acknowledging that WHO has not met its goals in the past, she re-iterated the organisation's commitment to improving fundamental capacities to help reach international commitments, increase efficiency and fairness, improve health outcomes in sustainable ways and move countries towards greater self-reliance.
Honorary Chair and Patron of the Africa Public Health Alliance and 15% Plus Campaign, Desmond Tutu, has called on African Heads of State and Ministers of Health and Finance to work urgently towards meeting their Abuja commitments before the 2011 High Level Progressive Review of Africa's commitment to health financing. He pointed out that, in the past nine years, only six out of 53 African Union member states have met their 2001 Abuja commitment to pledge 15% of their budgets to health. He attributed shortfalls on meeting health Millennium Development Goals (MDGs)to a combination of low per-capita investment in health and low investment in social determinants of health, such as clean water, improved sanitation, poor nutrition and gender equity in health, as well as a lack of pharmaceutical capacity and access to medicines. He urged the education and labour sectors to train and retain the necessary numbers of health workers, and double per capita investment in health.
This statement was made after a meeting of Commonwealth Health Ministers (CHMM), which was held on 16 May 2010 in Geneva, Switzerland. The theme of the meeting was 'The Commonwealth and the Health MDGs by 2015'. The Meeting noted that only 5% of Commonwealth developing countries have met Millennium Development Goal (MDG) 4 targets or are on track to do so. At least 19 countries have high maternal mortality rates, and only 36% of developing Commonwealth countries have achieved or are on track to achieve the targets for births attended by skilled staff. The Meeting also noted the major challenges facing the world, and Commonwealth countries in particular, if the MDGs are to be met. Ministers were optimistic that many of the 2015 MDG targets could be met by Commonwealth countries. They, however, noted that this would require greater technical co-operation; attention to enabling environments, including legal frameworks, and where appropriate free healthcare to mothers and children; and an integration of preventative and curative services in the context of strengthening health systems through primary healthcare. Ministers called on the global community, especially the G8 and G20, to support maternal and newborn health programmes, and to meet MDGs 4 and 5. While acknowledging the tremendous achievements in access to anti-retroviral treatment, the Ministers noted that two thirds of those needing treatment did not receive it. Ministers pledged support for the greater alignment of non-communicable disease issues with the MDGs.
The International Conference on Dynamics of Rural Transformation in Emerging Economies was held from 14 to 16 April 2010 in New Delhi, India. Up to 300 participants with over 70% from emerging economy countries and 30% from other developing countries, including those in the Organization for Economic Co-operation and Development, joined the discussions. Debates during the conference suggested that food security policies could be further explored as an important field for South-South knowledge sharing. The Conference offered an opportunity for stakeholders to discuss concepts and policies concerning rural development . The discussions raised areas that participants agreed would be explored in further dialogue, such as the increase in urban-rural disparities, the expansion of rural non-farm income-generation options, migration and environmental concerns, as well as persisting issues of food insecurity, land tenure and rural poverty.
This report provides an overview of progress in implementing the action plan for the global strategy for the prevention and control of non-communicable diseases since its endorsement by the Sixty-first World Health Assembly in May 2008. The action plan aims to: map the emerging epidemics of non-communicable diseases and analyse their social, economic, behavioural and political determinants; reduce the level of exposure of individuals and populations to the common modifiable risk factors; and strengthen health care for people with non-communicable diseases by developing evidence-based norms, standards and guidelines for cost-effective interventions and by orienting health systems to respond to the need for effective management of diseases of a chronic nature. The plan covers six objectives, each with two sets of proposed actions, for member states and international partners, and one set of actions for the WHO Secretariat. Its implementation is to be reviewed at the end of the first biennium.
The 63rd World Health Assembly, which brought together Health Ministers and senior health officials from the World Health Organization's (WHO) Member States, concluded on 21 May 2010. The delegates adopted resolutions on a variety of global health issues including: a global strategy and plan of action for public health, innovation and intellectual property; convening an intergovernmental working group to deal with counterfeit medical products; developing a comprehensive approach to the prevention and control of viral hepatitis; monitoring the achievement of the health-related Millennium Development Goals; enforcing the global code of practice for the international recruitment of health personnel; ensuring food safety; implementing the global strategy for the prevention and control of non-communicable diseases; implementing strategies to reduce the harmful use of alcohol; global eradication of measles by 2015; increasing availability, safety and quality of blood products; new guidelines on human organ and tissue transplantation; intensifying efforts to improve treatment and prevention of pneumonia; increased political commitment and a global strategy for better infant and young child nutrition; redressing the limited focus to date on preventing and managing birth defects; sharing of influenza viruses and access to vaccines and other benefits with regard to pandemic influenza preparedness; and implementing the International Health Regulations of 2005.