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.
Equity in Health
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.
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.
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.
Equity, defined primarily as equality of opportunities among people, should be an integral part of a successful poverty reduction strategy anywhere in the developing world, says the World Bank's annual 2006 World Development Report. Equity and Development, produced by an eight-member team of authors led by economists Francisco Ferreira and Michael Walton, makes the case for equity, not just as an end in itself, but because it often stimulates greater and more productive investment, which leads to faster growth. The report shows how wide gulfs of inequality in wealth and opportunity, both within and among nations, contribute to the persistence of extreme deprivation, often for a large proportion of the population. This wastes human potential and, in many cases, can slow the pace of sustained economic growth. More information on the report is available at: http://econ.worldbank.org/wdr/wdr2006/
Heavy rains have exacerbated a cholera outbreak in Zambia, where at least six people have died and more than a thousand cases have been recorded. Zambia's ministry of health confirmed that 1,144 cases of cholera have been reported since the outbreak began in August.
The government of President Bingu wa Mutharika has made strides in improving Malawi's health care system. IRIN spoke to World Health Organisation (WHO) representative Matshidiso Moeti about the remaining challenges.
QUESTION: What is your general impression of the health system in Malawi?
ANSWER: The health system in Malawi is in a very dynamic process of improvement right now. But I know there are a number of challenges: these ... include shortage of staff, and there is need to recruit more to meet these challenges; the other challenge facing the health system is the supply and management of drugs.
* Click on the link for the full interview.
Manto Tshabalala-Msimang, the South African health minister, and Paulo Ivo Garrido, the Mozambican health minister, have signed an agreement ensuring co-operation in tackling health issues affecting the two countries. South African citizens and their Mozambican counterparts will from now on have easier access to health care at both countries' public hospitals. The agreement was signed at Tonga Hospital in Mpumalanga, an area plagued by malaria. To prevent the spread of the disease, local households were sprayed with insecticides. South Africa has also donated ten tons of DDT, an anti malaria insecticide, to Mozambique.
Each year, over 1.6 million people worldwide die as a result of violence. Violence is among the leading causes of death for people aged 15-44 years, accounting for 14% of deaths among men and 7% of deaths among women worldwide. For every person who dies, many more are injured and suffer from a range of physical, sexual, reproductive and mental health problems. Violence can be prevented. Through the Global Campaign for Violence Prevention, WHO and its many partners are contributing to a new way of thinking about violence prevention.
Four people died of dysentery last month in northern Zimbabwe in what appears to be the first outbreak of the disease outside the capital, reports said. An outbreak of the highly contagious diarrhoeal disease was reported earlier this month in Harare and its satellite town of Chitungwiza. Two hundred people were taken to hospital.
