Universal health coverage and social determinants of health

The Lancet ◽  
2013 ◽  
Vol 382 (9900) ◽  
pp. 1227-1228 ◽  
Author(s):  
Michael Marmot
The Lancet ◽  
2015 ◽  
Vol 385 (9975) ◽  
pp. 1343-1351 ◽  
Author(s):  
Luiz Odorico Monteiro de Andrade ◽  
Alberto Pellegrini Filho ◽  
Orielle Solar ◽  
Félix Rígoli ◽  
Lígia Malagon de Salazar ◽  
...  

Author(s):  
Shannon Berg

Fisher et al have provided a solid addition to health policy literature in their finding that universal health coverage supports equitable access to Australian primary healthcare (PHC), despite factors such as episodic care and poor distribution of services. Their definition of PHC was comprehensive, extending beyond medical care to include social determinants of health and public policy. However, they limited their operational definition for purposes of the study to general practice, community health and allied health. Applying a narrower definition risks lost opportunities to identify policy implications for equity beyond financial accessibility. The populations most at risk of non-communicable diseases also face significant language, culture, and individual and systemic discrimination barriers to access. Future policy research should consider using a comprehensive PHC definition in determining variables of interest and designing research methodologies, to avoid missing important knowledge that allows existing biases within primary care to continue.


2021 ◽  
Author(s):  
Eniola Olatunji ◽  
Sanam Maredia ◽  
Allen Nguyen ◽  
Natalie Freeman ◽  
David J Washburn

Background: In a push for universal health coverage, Ethiopia introduced two insurance schemes in 2010. Yet coverage rates remain very low. To encourage greater adoption, policymakers require a better understanding of who chooses to enroll and which promotional efforts are most effective in encouraging enrollment. Objective: Using nationally representative Demographic and Health Surveys, this research assessed the social determinants of health insurance coverage, including media exposure, in Ethiopia from 2011-2016. Methods: This research analyzed health insurance coverage and other sociodemographic and media exposure variables using multivariable logistic regression model. Results: Health insurance coverage increased 3.30 times from 1.48% in 2011 to 4.89% in 2016. In both years, coverage was associated with higher education, older age, higher wealth levels, and exposure to newspaper and television. Compared to those with no exposure to newspaper, those with newspaper exposure at least once a week were 1.80 times (2011) and 1.86 times (2016) more likely to be insured. Similar results were obtained for television exposure. Conclusion: Initiatives that target the poor and less educated will be necessary if Ethiopia is to achieve universal health coverage. This research suggests that, to date, newspaper and television mediums have been effective promotion mechanisms for growing enrollment.


Author(s):  
Lawrence O. Gostin

How can we keep people – wherever they live – healthy and safe? Among all global health initiatives, universal health coverage (UHC) has garnered most political attention. But can UHC (as important as it is) actually achieve the two fundamental aspirations of the right to health: keeping people healthy and safe, while leaving no one behind? There is a universal longing for health and security, but also a deep-seated belief in fairness and equity. Can UHC achieve both health and equity, or what I have called, "global health with justice?" What makes a population healthy and safe? Certainly, universal and affordable access to healthcare is essential, including clinical prevention, treatment, and essential medicines. But beyond medical care are public health services, including surveillance, clean air, potable water, sanitation, vector control, and tobacco control. The final and most important factor in good health are social determinants, including housing, employment, education, and equity. If we can provide everyone with these three essential conditions for good health (healthcare, public health and social determinants), it would vastly improve global health. But we also need to take measures to leave no one behind. To achieve equity, we need to plan for it, and here I propose national health equity programs of action. Society’s highest obligation is to achieve global health, with justice.


2019 ◽  
Vol 12 (4) ◽  
pp. 264-271
Author(s):  
Noé Atamari-Anahui ◽  
Maycol Suker Ccorahua-Rios ◽  
Mirian Condori-Huaraka ◽  
Yerika Huamanvilca-Yepez ◽  
Elard Amaya ◽  
...  

Abstract Background Chronic kidney disease (CKD) is a growing public health problem and an important cause of morbidity and mortality. Disparities in CKD may be related to social determinants and health inequalities in low- and middle-income countries. This study determined how social determinants of health influence trends in the prevalence and mortality of CKD in Peru. Methods This was an ecological study based on a secondary analysis of health care and death records obtained from the Ministry of Health of Peru for the period 2010–2016. The standardized prevalence and mortality rates of CKD were descriptively reported using geospatial exploratory analysis. We also determined the association with social determinants of health according to the domains suggested by Healthy People 2020. Results In the studied period, CKD prevalence increased by 300% and was associated with the health insurance coverage rate (β=5.9 [95% CI 0.82 to 10.92]), proportion of people with a secondary education level (β=11.4 [95% CI 1.94 to 20.93]), mean age (β=−10.7 [95% CI −19.33 to −2.12]), monetary poverty rate (β=−2.2 [95% CI −3.88 to −0.60]) and gross domestic product per capita (β=−63.2 [95% CI −117.81 to −8.52]). The standardized mortality decreased by 10% and was associated with mean age (β=−0.6 [95% CI −1.22 to −0.06]) and the proportion of people with a primary education level (β=−0.5 [95% CI −0.9 to −0.05]). Conclusions During the period 2010–2016, the prevalence of CKD increased and the mortality associated with CKD decreased. The observed changes were associated with some social determinants of health, such as increased health coverage and education. The health system of Peru must be prepared to take on the challenge.


2018 ◽  
Vol 14 (9) ◽  
pp. 98
Author(s):  
Anchana NaRanong

The Thai universal health coverage scheme (UHCS), or “30 Baht Scheme”, has played an important role in increasing the accessibility of health care services for low income earners. The objective of this paper is to study poor beneficiaries’ awareness of the UHCS. Quantitative research methods were employed. Data were collected, and multiple regression performed, to explore the determinants of health coverage awareness. The regression shows that age, education level, and number of years as card holder are significant determinants of health coverage awareness. Those with a higher age or level of education scored higher than those who were younger or with a low level of education or no education. Those who held UHCS cards for long periods of time possessed higher health coverage awareness than those who had recently received their membership cards. Greater exposure to news and information, therefore, is needed for those of a younger age and those who have less education, if awareness is to be increased. The same applies to those who have only held UHCS cards for a short period.


2017 ◽  
Vol 59 (4) ◽  
pp. 4
Author(s):  
Gboyega A Ogunbanjo

By the time, you receive this issue of the journal, the joint 5th WONCA Africa and 20th South African Academy of Family Physicians conference would have ended in Pretoria South Africa on 20 August 2017. The theme of the joint conference forms the basis of this editorial. So what is “Social Determinants of Health (SDH)”? The World Health Organization (WHO) defines it as the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The SDH are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries. It is acknowledged that “health equity and social determinants” are critical components of the post-2015 sustainable development goals (SDG) global agenda and of the push towards progressive achievement of universal health coverage (UHC). If we have to reduce health inequities, the approach will be to address both SDH and UHC in an integrated and systematic manner.1


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