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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.
At a time when social inequalities are increasing at an alarming rate, this new edition of Mel Bartleys popular book is a vital resource for understanding the extent of health inequalities and why they are proving to be persistent despite decades of growing knowledge and policies on the issue. As in the first edition, by examining influences of social class, income, culture and wealth as well as gender, ethnicity and other factors in identity, this accessible book provides a key to understanding the major theories and explanations of what lies behind inequality in health. Bartley re-situates the classic behavioural, psycho-social, and material approaches within a life-course perspective. Evaluating the evidence of health outcomes over time and at local and national levels, Bartley argues that individual social integration demands closer attention if health inequality is to be tackled effectively, revealing the important part that identity plays in relation to the chances of a long and healthy life. Health Inequality will be essential reading for students taking courses in the sociology of health and illness, social policy and welfare, health sciences, public health and epidemiology and all those interested in understanding the consequences of social inequality for health.
Evidence indicates that actions within four main themes (early child development fair employment and decent work social protection and the living environment) are likely to have the greatest impact on the social determinants of health and health inequities. A systematic search and analysis of recommendations and policy guidelines from intergovernmental organizations and international bodies identified practical policy options for action on social determinants within these four themes. Policy options focused on early childhood education and care; child poverty; investment strategies for an inclusive economy; active labour market programmes; working conditions; social cash transfers; affordable housing; and planning and regulatory mechanisms to improve air quality and mitigate climate change. Applying combinations of these policy options alongside effective governance for health equity should enable WHO European Region Member States to reduce health inequities and synergize efforts to achieve the United Nations Sustainable Development Goals.
"The Handbook on health inequality monitoring: with a special focus on low- and middle-income countries is a resource that enables countries to do just that. It presents a comprehensive yet clear overview of health inequality monitoring in a user-friendly manner. The handbook succeeds in giving those involved in health inequality monitoring an appreciation of the complexities of the process, as well as building the practical knowledge and skills for systematic monitoring of health inequalities in low- and middle-income countries. The use of the handbook will enable countries to better monitor and evaluate their progress and performance with a high degree of accountability and transparency, and allow them to use the results to formulate evidenced-based policies, programmes and practices to tackle inequalities in an effective manner."--Publisher's description.
This series of books brings together results of an extensive research programme on aspects of the national systems of innovation (NSI) in the five BRICS countries — Brazil, Russia, India, China, and South Africa. It provides a comprehensive and comparative examination of the challenges and opportunities faced by these dynamic and emerging economies. In discussing the impact of innovation with respect to economic, geopolitical, socio-cultural, institutional, and technological systems, it reveals the possibilities of new development paradigms for equitable and sustainable growth. This volume analyses the co-evolution of inequality and NSI across the BRICS economies. It reveals the multi-dimensional character of inequality, in going beyond its income aspect to include assets, access to basic services, infrastructure, knowledge, race, gender, ethnicity and geographic location. In advancing valuable policy recommendations, the book argues that inequalities must be factored in development strategies given that benefits of innovation are not automatically distributed equally. Original and detailed data, together with expert analyses on wide-ranging issues, make this book an invaluable resource for researchers and scholars in economics, development studies and political science, in addition to policy-makers and development practitioners interested in the BRICS countries.
New Horizons in Health discusses how the National Institutes of Health (NIH) can integrate research in the social, behavioral, and biomedical sciences to better understand the causes of disease as well as interventions that promote health. It outlines a set of research priorities for consideration by the Office of Behavioral and Social Sciences Research (OBSSR), with particular attention to research that can support and complement the work of the National Institutes of Health. By addressing the range of interactions among social settings, behavioral patterns, and important health concerns, it highlights areas of scientific opportunity where significant investment is most likely to improve nationalâ€"and globalâ€"health outcomes. These opportunities will apply the knowledge and methods of the behavioral and social sciences to contemporary health needs, and give attention to the chief health concerns of the general public.
Have gaps in health outcomes between the poor and better off grown? Are they larger in one country than another? Are health sector subsidies more equally distributed in some countries than others? Are health care payments more progressive in one health care financing system than another? What are catastrophic payments and how can they be measured? How far do health care payments impoverish households? Answering questions such as these requires quantitative analysis. This in turn depends on a clear understanding of how to measure key variables in the analysis, such as health outcomes, health expenditures, need, and living standards. It also requires set quantitative methods for measuring inequality and inequity, progressivity, catastrophic expenditures, poverty impact, and so on. This book provides an overview of the key issues that arise in the measurement of health variables and living standards, outlines and explains essential tools and methods for distributional analysis, and, using worked examples, shows how these tools and methods can be applied in the health sector. The book seeks to provide the reader with both a solid grasp of the principles underpinning distributional analysis, while at the same time offering hands-on guidance on how to move from principles to practice.
An essential text for courses in public health, health policy, and sociology, this compelling book is a vital teaching tool and a comprehensive reference for social science and medical professionals.
Good health is a key component of people's well-being. It is a value in itself but - through its influence on social, education and labour market outcomes - being in good or bad health has also wider implications on people's chances of leading a fulfilling and productive life. Yet, even in the OECD countries, health inequality persists with severe consequences on the goal of promoting inclusive growth. This report documents a comprehensive range of inequalities in health and health systems to the detriment of disadvantaged population groups in a large set of OECD and EU countries. It assesses the gaps in health outcomes and risk factors between different socio-economic groups. When it comes to health systems, the report measures inequalities in health care utilisation, unmet needs and the affordability of health care services. For each of these different domains, the report identifies groups of countries that display higher, intermediate, and low levels of inequality. The report makes a strong case for addressing health-related inequalities as a key component of a policy strategy to promote inclusive growth and reduce social inequalities. It also provides a framework for more in-depth analyses on how to address these inequalities at country level.