What is health equity?

Farmer selling carrots at Lusulu Market, Malawi & Mozambique Border, March 2011. Photo credit: Sheridan Jones McCrae © 

Farmer selling carrots at Lusulu Market, Malawi & Mozambique Border, March 2011. Photo credit: Sheridan Jones McCrae © 

Health equity is about the fair achievement and capability for good health, and not simply the equal distribution of health care. It means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives. To achieve health equity, we must treat everyone equally and eliminate avoidable health inequities and health disparities. Health equity is a multidimensional concept that is a central concern of social equity and justice – it cannot be viewed in isolation. 

Sources:

  • Sen A (2002). Why Health Equity? Health Econ. 11: 659–666
  • Health Equity Institute https://healthequity.sfsu.edu/content/defining-health-equity

Determinants of Health

Social, economic, and environmental conditions affect health in a number of ways.

  • Social Conditions - Social inequities occur when a person or group is treated unfairly because of race, gender, class, sexual orientation, or immigration status.
  • Economic Conditions - Institutions such as governments, churches, corporations, or schools use their authority to create unequal opportunities among groups of people.
  • Environmental Conditions - Where you live affects your health. Lower income neighborhoods tend to be in poor social, economic, and physical conditions.
  • Health Behaviors - Smoking, poor nutrition, and lack of exercise are all behaviors that may lead to poor health. Social, economic, and environmental conditions affect health knowledge and health behaviors.
  • Disease or Injury - Chronic disease or injury can result from inequities and health behaviors. Genetics also affect health differences.
  • Mortality -Your social status, economic opportunities, where you live, and health behaviors all affect life expectancy

Why Focus on Improving Healthy Equity?

Health equity is an ambitious goal for global health. A key challenge of global health is to raise the health, nutrition and wellbeing of the world’s poorest people.

Social, economic, and environmental conditions affect health in a number of ways. Inequities in the social determinants of health – including socioeconomic status, education, the physical environment, employment, and social support networks – have wide-ranging effects on people’s health and survival. (Marmot M. et al. (2008). Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Lancet 372 (9650):1661–1669)

Growing inequities in health, both between and within countries, threaten the community development gains made over the past decades.

Health inequities typify a so-called “wicked problem” that is seemingly intractable, complex, and difficult to solve. Different stakeholders have conflicting values, and multiple explanations and interventions are possible.

 

Examples

  • Efforts to enhance economic opportunity in disadvantaged communities can also produce hazardous waste that damages air, water, and soil, and harms human health, particularly for marginalized populations.
  • Market forces incentivize the development of medicines that provide benefits for those who can afford them, at the expense of preventive measures and new drug development for conditions that primarily affect the poor.
  • Improving access to antimicrobials has led to widespread use in animals and humans that improve food supplies and human health, but also contribute to anti-microbial resistance and its deadly consequences.

 

Achieving health equity requires not only health professionals, but also specialists from a wide range of other disciplines to analyze the patterns and propose and test innovative solutions. It also requires active participation and leadership from governments, business, and civil society, and particularly those who are most disadvantaged.