Posted: March 10th, 2024

Inequalities in the Healthcare arena

Inequalities in the Healthcare arena

Healthcare is a fundamental human right that should be accessible and affordable for everyone, regardless of their social or economic status. However, in reality, there are significant inequalities in the healthcare arena that affect the health and well-being of millions of people around the world. These inequalities are manifested in various forms, such as disparities in access to healthcare services, health outcomes, and healthcare resources among different population groups. These disparities can be based on various factors, such as socioeconomic status, race, ethnicity, gender, geographic location, and age.

According to the World Health Organization (WHO), health inequities are systematic differences in the health status of different population groups, arising from the social conditions in which people are born, grow, live, work and age. Health inequities are unfair and could be reduced by the right mix of government policies . The WHO also states that there is ample evidence that social factors, including education, employment status, income level, gender and ethnicity have a marked influence on how healthy a person is. In all countries – whether low-, middle- or high-income – there are wide disparities in the health status of different social groups. The lower an individual’s socio-economic position, the higher their risk of poor health .

Some examples of health inequalities are:

– Every day 16 000 children die before their fifth birthday. They die of pneumonia, malaria, diarrhoea and other diseases. They are 14 times more likely to die before the age of five in sub-Saharan Africa than the rest of the world. Furthermore, children from rural and poorer households remain disproportionately affected. Children from the poorest 20% of households are nearly twice as likely to die before their fifth birthday as children in the richest 20% .
– Maternal mortality is a key indicator of health inequity. Maternal mortality is a health indicator that shows the wide gaps between rich and poor, both between and within countries. Developing countries account for 99% of annual maternal deaths in the world. Women in Chad have a lifetime risk of maternal death of 1 in 16, while a woman in Sweden has a risk of less than 1 in 10 000 .
– Tuberculosis (TB) is a disease of poverty. Around 95% of TB deaths are in the developing world. These deaths affect mainly young adults in their most productive years. Contracting the disease makes it even harder for these adults to improve their personal economic condition and that of their families .
– Noncommunicable diseases (NCDs) such as cardiovascular diseases, cancers, diabetes and chronic respiratory diseases are the leading causes of death and disability worldwide. They disproportionately affect low- and middle-income countries, where nearly three quarters of global NCD deaths – 31 million – occur . In low-resource settings, health-care costs for NCDs can quickly drain household resources, driving families into poverty. The exorbitant costs of NCDs are forcing millions of people into poverty annually, stifling development .

These examples show that health inequalities are not only a matter of justice and human rights, but also a threat to social and economic development. Health inequalities have significant social and economic costs both to individuals and societies . Therefore, addressing health inequalities is a priority for achieving the Sustainable Development Goals (SDGs), especially SDG 3 on good health and well-being for all .

To measure and monitor health inequalities, various indicators and topics have been used by different countries and organisations. A systematic review by Albert-Ballestar and García-Altés identified 691 indicators used in the study of health inequalities. The indicators were grouped into 120 topics, 34 of which were selected for having five indicators or more. The most commonly found topics in the list include “Life expectancy”, “Infant mortality”, “Obesity and overweight (BMI)”, “Mortality rate”, “Regular smokers/tobacco consumption”, “Self-perceived health”, “Unemployment”, “Mental well-being”, “Cardiovascular disease/hypertension”, “Socioeconomic status (SES)/material deprivation” . These topics cover various aspects of health determinants, outcomes and resources.

However, measuring health inequalities is not enough to reduce them. There is also a need for effective interventions that address the root causes of health inequalities and promote equity-oriented policies and practices . Some examples of interventions that have been proven to reduce health inequalities are:

– Universal health coverage (UHC), which ensures that all people have access to quality essential health services without facing financial hardship . UHC can reduce health inequalities by improving access to preventive, curative and palliative care, especially for the most vulnerable and marginalized groups .
– Social protection, which provides income security and access to essential services for all, especially for those who are poor, unemployed, sick, disabled, elderly or children . Social protection can reduce health inequalities by alleviating poverty, enhancing social inclusion and empowerment, and improving health and nutrition .
– Health promotion, which empowers individuals and communities to take control of their own health and well-being, through education, awareness, advocacy and participation . Health promotion can reduce health inequalities by addressing the social and environmental determinants of health, such as education, employment, housing, sanitation, water, food and air quality .

In conclusion, inequalities in the healthcare arena are a major challenge for global health and development. They are unfair, avoidable and costly. They can be reduced by implementing equity-oriented policies and interventions that address the social determinants of health and ensure universal access to quality healthcare services for all.

Bibliography/References

: World Health Organization. Health inequities and their causes. 2018. Available from: https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes
: World Health Organization. Health equity. 2020. Available from: https://www.who.int/topics/health_equity/en/
: Albert-Ballestar S, García-Altés A. Measuring health inequalities: a systematic review of widely used indicators and topics. International Journal for Equity in Health. 2021;20:73.
: World Health Organization. Reducing health inequities through action on the social determinants of health. 2010. Available from: https://www.who.int/publications/i/item/reducing-health-inequities-through-action-on-the-social-determinants-of-health

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