scholarly journals Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia

2021 ◽  
Author(s):  
Matthew Fisher ◽  
Patrick Harris ◽  
Toby Freeman ◽  
Tamara Mackean ◽  
Emma George ◽  
...  
Keyword(s):  
Policy Implementation ◽  
Health Equity ◽  
Indigenous Health ◽  
Three Dimensions ◽  
Governance Structures ◽  
Access To Health ◽  
Health Related ◽  
Equity In Access ◽  
Context Specific ◽  
Equity Of Access

Background: Debate continues in public health on the roles of universal or targeted policies in providing equity of access to health-related goods or services, and thereby contributing to health equity. Research examining policy implementation can provide fresh insights on these issues. Methods: We synthesised findings across case studies of policy implementation in four policy areas of primary health care, telecommunications, Indigenous health and land use policy, which incorporated a variety of universal and targeted policy structures. We analysed findings according to three criteria of equity in access – availability, affordability and acceptability – and definitions of universal, proportionate-universal, targeted and residual policies, and devolved governance structures. Results: Our analysis showed that existing universal, proportionate-universal and targeted policies in an Australian context displayed strengths and weaknesses in addressing availability, affordability and acceptability dimensions of equity in access. Conclusion: While residualist policies are unfavourable to equity of access, other forms of targeting as well as universal and proportionate-universal structure have the potential to be combined in context-specific ways favourable to equity of access to health-related goods and services. To optimise benefits, policies should address equity of access in the three dimensions of availability, affordability and acceptability. Devolved governance structures have the potential to augment equity benefits of either universal or targeted policies.

scholarly journals Understanding vulnerability in the context of climate change – a Health impact Assessment Framework

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Haigh ◽  
B Harris-Roxas ◽  
E de Leeuw
Keyword(s):  
Health Equity ◽  
Health Impact ◽  
Poor Quality ◽  
Three Dimensions ◽  
Mitigation Measures ◽  
Sea Levels ◽  
Health Impact Assessments ◽  
Rising Sea Levels ◽  
Vulnerability Framework ◽  
Context Specific

Abstract The climate emergency is resulting in differential exposures to health risks across populations. Where the 'standard' determinants of (ill) health are already socio-economically distributed, the impacts of a changing climate will have even greater effects on the most vulnerable in society and further exacerbate health equity gaps. Building on a conceptualisation of health inequity as 'the unfair and avoidable differences in health between groups in the population' we argue that phenomena like high temperatures, extreme weather and rising sea levels do not affect everyone equally; and that policies and interventions need to be cognisant of distributed and differential patterns of health risk exposure and responses. Vulnerability can be conceptualised across three dimensions. Firstly, some populations are vulnerable because they have higher levels of exposure. Secondly, some populations have higher levels of vulnerability because they are more sensitive. The final type of vulnerability is particularly important and relates to health equity adaptive capacity - people's ability to prepare for and respond to health threats. For example, people who are economically less well-off are: more likely to live in poor quality housing and in areas with relatively less access to resources; less likely to know how to respond (health literacy), or if they do know, less likely to be able to acquire and afford mitigation measures; have less capacity to advocate; and are less likely to be listened to. These vulnerabilities tend to cluster and accumulate, reinforcing and exacerbating health inequities. These same communities also have capacities and assets that can support recovery and resilience. We can utilise Health Impact Assessments to understand context specific climate emergency vulnerabilities and to develop strategies to respond. In this presentation a climate vulnerability framework and associated tools for HIA will be described and discussed.

Risk Assessment vs. Right to Privacy: The Access to Health Information on the Insurance Candidate through Questionnaires and the Right to Privacy

2013 ◽  
Vol 20 (1) ◽  
pp. 63-78
Author(s):  
Maria Inês de Oliveira Martins
Keyword(s):  
International Law ◽  
Health Information ◽  
Personal Information ◽  
Relevant Information ◽  
Right To Privacy ◽  
The Right To Privacy ◽  
Access To Health ◽  
Health Related ◽  
Principle Of Proportionality ◽  
The Right

Abstract The need of private insurers for information on the candidate’s health risks is recognized by the law, which places pre-contractual duties of disclosure upon the candidates. When the risks are influenced by health factors, e.g. in the case of life- and health insurances, it implies the provision of health information by the candidates, who thus voluntarily limit their right to privacy. This consent, however, often happens in a context of factual coercion to contract. Next to this, from a legal standpoint, the collection of personal information must respond to the principle of proportionality. Against this background, this article assesses the compatibility of questionnaire techniques that rely on open-ended health related questions with the right to privacy, as protected by Portuguese and international law. It then analyses the extent of pre-contractual duties of disclosure as defined by the Portuguese Insurance Act, which requires the candidate to volunteer all the relevant information independently of being asked for it. In doing so, the article also refers to some other European countries. It concludes that the relevant Portuguese legislation is incompatible both with Portuguese constitutional law and with international law.

scholarly journals Respectful Adolescent Care: A Right of Every Adolescent

2021 ◽  
Vol 07 (03) ◽  
pp. 16-19
Author(s):  
Anjali Kaushik ◽  
Keyword(s):  
Teen Pregnancy ◽  
Access To Health Care ◽  
Developmental Process ◽  
Young Person ◽  
Point Of View ◽  
Health Issues ◽  
Self Identity ◽  
Social And Emotional ◽  
Access To Health ◽  
Health Related

Adolescence is a crucial period in the life of every individual. The significance of adolescence and young adulthood is highlighted in relation to the crucial developmental process of preparing and transitioning to adulthood. During this period, the important developmental milestones are reached, and the young person develops a greater understanding about who they are and form their self-identity as per the Erikson. Adolescents become more independent and autonomous during this time. Adolescence is marked by changes that are not only physical but also psychological, social and emotional. Sometimes due to lack of proper knowledge and guidance, they end up having health related issues like teen pregnancy, STDs and other mental health issues like breakups etc. To tackle all these issues the health professionals should be sensitive and non-judgmental and should provide unbiased care. Adolescents have their own experiences and point of view that should be respected and taken into account. It is important to trust adolescents and their sense of responsibility. Adolescents are often reluctant to visit health facilities. It is therefore important to reach out to them by providing adolescent friendly services. It is their right also to have access to health care whenever they need it. It is essential to have trained and sensitive staff in these health centers so that young people access services in these centers in a confidential and non-judgmental manner.

scholarly journals Forum: equity in access to health care. Introduction

2008 ◽  
Vol 24 (5) ◽  
pp. 1159-1161 ◽  
Author(s):  
Claudia Travassos
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Systems ◽  
Care Access ◽  
Unethical Practices ◽  
Access To Health ◽  
Care Systems ◽  
Equity In Access

The Introduction outlines this issue's special Forum on equity in access to health care, including three Articles and a Postscript. The Forum represents a continuation of the debates raised during a seminar organized by the Oswaldo Cruz Foundation in the city of Rio de Janeiro, Brazil, in 2006, in collaboration with UNICEF, UNDP, World Bank, the WHO Special Program for Research and Training in Tropical Diseases, and the United Nations Research Institute for Social Development. The authors approach health care access and equity from a comprehensive and contemporaneous perspective, introducing a new conceptual framework for access, in which information plays a central role. Trust is proposed as an important value for an equitable health care system. Unethical practices by health administrators and health care professionals are highlighted as hidden critical aspects of inequities in health care. As a whole, the articles represent a renewed contribution for understating inequalities in access, and for building socially just health care systems.

scholarly journals Xpey’ Relational Environments: an analytic framework for conceptualizing Indigenous health equity

2017 ◽  
Vol 37 (12) ◽  
pp. 395-402 ◽  
Author(s):  
Alexandra Kent ◽  
Charlotte Loppie ◽  
Jeannine Carriere ◽  
Marjorie MacDonald ◽  
Bernie Pauly
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Underserved Populations ◽  
Indigenous Health ◽  
Indigenous Populations ◽  
Indigenous Research ◽  
Analytic Framework ◽  
Frontline Staff ◽  
Equity Research ◽  
Health Equity Research

Introduction Both health equity research and Indigenous health research are driven by the goal of promoting equitable health outcomes among marginalized and underserved populations. However, the two fields often operate independently, without collaboration. As a result, Indigenous populations are underrepresented in health equity research relative to the disproportionate burden of health inequities they experience. In this methodological article, we present Xpey’ Relational Environments, an analytic framework that maps some of the barriers and facilitators to health equity for Indigenous peoples. Methods Health equity research needs to include a focus on Indigenous populations and Indigenized methodologies, a shift that could fill gaps in knowledge with the potential to contribute to ‘closing the gap’ in Indigenous health. With this in mind, the Equity Lens in Public Health (ELPH) research program adopted the Xpey’ Relational Environments framework to add a focus on Indigenous populations to our research on the prioritization and implementation of health equity. The analytic framework introduced an Indigenized health equity lens to our methodology, which facilitated the identification of social, structural and systemic determinants of Indigenous health. To test the framework, we conducted a pilot case study of one of British Columbia’s regional health authorities, which included a review of core policies and plans as well as interviews and focus groups with frontline staff, managers and senior executives. Conclusion ELPH’s application of Xpey’ Relational Environments serves as an example of the analytic framework’s utility for exploring and conceptualizing Indigenous health equity in BC’s public health system. Future applications of the framework should be embedded in Indigenous research methodologies.

The west wind vs the east wind: instructional leadership model in China

2017 ◽  
Vol 55 (2) ◽  
pp. 186-206 ◽  
Author(s):  
Haiyan Qian ◽  
Allan Walker ◽  
Xiaojun Li
Keyword(s):  
Instructional Leadership ◽  
Leadership Practices ◽  
School Principals ◽  
Social Contexts ◽  
Three Dimensions ◽  
The West ◽  
Content Type ◽  
West Wind ◽  
East Wind ◽  
Context Specific

Purpose The purpose of this paper is to develop a preliminary model of instructional leadership in the Chinese educational context and explore the ways in which Chinese school principals locate their instructional-leadership practices in response to traditional expectations and the requirements of recent reforms. Design/methodology/approach In-depth interviews were conducted with 22 selected primary school principals in Shenzhen and Guangzhou. A qualitative analysis was conducted to categorize the major leadership practices enacted by these principals. Findings An initial model of instructional leadership in China with six major dimensions is constructed. The paper also illustrates and elaborates on three dimensions with the greatest context-specific meanings for Chinese principals. Originality/value The paper explores the ways in which Chinese principals enact their instructional leadership in a context in which “the west wind meets the east wind”; that is, when they are required to accommodate both imported reform initiatives and traditional expectations. The paper contributes to the sparse existing research on principals’ instructional leadership in non-western cultural and social contexts.

Measuring and Combatting Health-Related Inequalities

2021 ◽  
pp. 184-204
Author(s):  
James Wilson
Keyword(s):  
Public Health ◽  
Lived Experience ◽  
Health Systems ◽  
Health Equity ◽  
Power Structures ◽  
Health Related ◽  
Break Up ◽  
Pluralist Approach

This chapter examines how health systems should measure, and respond to, health-related inequalities. Health equity is often taken to be a core goal of public health, but what exactly health equity requires is more difficult to specify. There are indefinitely many health-related variables that can be measured, and variation in each of these variables can be measured in a number of different ways. Given the systemic interconnections between variables, making a situation more equal in some respects will tend to make it less equal in others. The chapter argues for a pluralist approach to health equity measurement, which takes its cue from the lived experience of individuals’ lives. Reflection on the deepest and most resilient causes of health-related inequalities shows that they are often the result of intersecting structural concentrations of power—structures which it is vital, but very difficult, to break up.

scholarly journals Health Equity Lens Embedded in the Public Health Policies of Saudi Arabia: A Qualitative Document Analysis

SAGE Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 215824402096277
Author(s):  
Leena Eklund Karlsson ◽  
Anne Leena Ikonen ◽  
Kothar Mohammed Alqahtani ◽  
Pernille Tanggaard Andersen ◽  
Subash Thapa
Keyword(s):  
Public Health ◽  
Saudi Arabia ◽  
Health Equity ◽  
Policy Development ◽  
Health Policies ◽  
Future Health ◽  
Public Health Policies ◽  
The People ◽  
The Social ◽  
Health Related

In the Kingdom of Saudi Arabia (KSA), no studies have been documented to analyze the equity aspects of public health policies. The aims of the study were to identify policy documents in the KSA relevant to public health and to explore whether these include an equity approach. Twenty health-related documents were identified from various ministries’ websites and analyzed through directed content analysis. The results showed that the term “equity” was neither defined nor explained in the documents and suggestions on how to tackle health inequities were lacking. None of the suggested measures communicated an explicit focus on promoting health equity or the social gradient. Several upstream, midstream, and downstream measures were suggested to improve justice and public health for the people. The study reveals that there is a need for an in-depth assessment of the policy measures across sectors and their influence on health equity to inform future health policy development and action in the KSA.

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