This paper notes that inequalities in health arise at a number of
levels: in the economic, social and environmental determinants
of health, in the policies that influence the distribution of these
determinants and in the political and economic interests that
shape these policies. It argues that these conditions are being
powerfully transformed by a process of globalization in which
the interests of transnational capital dominate public health
and national authority. Any research process that seeks to explain
and understand the sources and drivers of this inequality
would need to take account of these determinants, and of the
policies, interests and imperatives that influence them. More
importantly, a research process driven by values of equity and
goals of justice, would need to generate knowledge that can be
used to confront these trends and promote public, population
health interests in a way that preferentially benefits the worst
off members of society.
This has implications for both the type of research questions
we ask, and the way we seek to address them. In this paper
we propose some research priorities and also discuss the need
for such questions to be addressed in ways that strengthen social
action for health equity and reinforce policy actors promoting
health equity.
The global community has set itself targets such as the
achievement of the Millennium Development Goals. In the
coming year we may see a great deal of research that describes
the gap between these targets and the current lives of many
people in the world. This is necessary but not sufficient in the
face of a growing unmet demand for health equity and justice.
We need to do more with our research. We need to choose the questions and generate the knowledge and analysis that explains
the drivers of unacceptable gaps between our social aspirations
and our economic and social practice. More importantly, we
need to generate the knowledge and analysis that informs
public policy-making and the economic and social processes
that influence it.