What can be done to remove inequality in healthcare services?
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Many of today’s public health issues – diabetes, cancer, obesity, cardiovascular disease – are strongly associated with social inequalities. Literature from across the world shows that gaps in income, employment, education and access to acute and preventative health care worsen health outcomes for disadvantaged populations. When the inequalities are avoidable and based on unjust distributions of resources, for example, it then becomes an issue of health inequity.
This means that public health professionals must address the factors that people are born into – where they grow, live and work – at a population level to alleviate health inequities. The World Health Organization points out that these conditions are “shaped by the distribution of money, power and resources at global, national and local levels.”
Research in action
Increasingly, researchers are looking at ways to implement and measure programs to reduce health inequities. This is the goal of what the WHO calls the “third wave” of health inequity research. To understand health inequities, first we need to know what they are. Around the world, public health agencies monitor health inequality trends, provide the basis of understanding which inequalities are equity issues, and create evidence for policy approaches to improve health for entire communities.
US Centers for Disease Control and Prevention (CDC) integrates public health and census data and it publishes a yearly health inequality report. Year after year, they’ve found that many social determinants are associated with poor health outcomes, and are thus equity issues.
Race is a factor as well. The 2013 CDC report shows many adverse health outcomes related to the social determinants of health were associated with race. For example, deaths by stroke and coronary heart disease, drug-induced deaths and HIV incidence were more likely in non-Hispanic blacks, American Indian/Alaskan Natives and non-Asian racial/ethnic minorities, respectively, than in whites. But, there are not yet any sure-fire solutions to help reduce these inequities.
In the UK, health inequality data is integrated into Public Health England’s tool called “Public Health Profiles”. The interactive tool allows users to view several sources of area-based data that can be linked to social determinants like homelessness, unemployment, and deprivation of neighborhoods, to various negative health outcomes. It is through the use of this kind of data that has caused the UK Department of Health to set their goals of seeing action on reducing cardiovascular disease, cancer and infant mortality inequalities for 2015.
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