Introduction

2016 ◽  
Author(s):  
Rebecca L. Walker ◽  
Michele Rivkin-Fish ◽  
Mara Buchbinder
Keyword(s):  
Health Inequalities ◽  
Health Inequality ◽  
Positive Impact ◽  
Health Justice

The introduction to Understanding Health Inequalities and Justice: New Conversations Across the Disciplines describes the terrain of health justice and inequalities and the multiple disciplinary perspectives that explore it. In the introduction, the editors advance the view that how we approach health inequalities and justice is a matter of great import, and argue for the positive impact multiple disciplinary perspectives may have when engaged in conversations together on these matters. The introduction offers a substantive discussion of normative paradigms informing health justice including egalitarian, libertarian, utilitiarian, rights-based, and principles-based bioethics approaches. In addition to examining each of the three sub-headings of the volume: 1. Interrogating Normative Perspectives on Health Inequality and Justice, 2. Disrupting Assumptions and Expanding Perspectives through Cases, and 3. Rethinking Evidence and the Making of Policy, each chapter is given a detailed introduction and described in relationship to other relevant chapters in the volume.

The Politics of Global Health Inequalities

2019 ◽  
pp. 58-84
Author(s):  
Yusra Ribhi Shawar ◽  
Jennifer Prah Ruger
Keyword(s):  
Social Sciences ◽  
Critical Theory ◽  
Global Health ◽  
Health Inequalities ◽  
Health Inequality ◽  
The Political ◽  
State Of Health ◽  
Political Determinants ◽  
The Social

Careful investigations of the political determinants of health that include the role of power in health inequalities—systematic differences in health achievements among different population groups—are increasing but remain inadequate. Historically, much of the research examining health inequalities has been influenced by biomedical perspectives and focused, as such, on ‘downstream’ factors. More recently, there has been greater recognition of more ‘distal’ and ‘upstream’ drivers of health inequalities, including the impacts of power as expressed by actors, as well as embedded in societal structures, institutions, and processes. The goal of this chapter is to examine how power has been conceptualised and analysed to date in relation to health inequalities. After reviewing the state of health inequality scholarship and the emerging interest in studying power in global health, the chapter presents varied conceptualisations of power and how they are used in the literature to understand health inequalities. The chapter highlights the particular disciplinary influences in studying power across the social sciences, including anthropology, political science, and sociology, as well as cross-cutting perspectives such as critical theory and health capability. It concludes by highlighting strengths and limitations of the existing research in this area and discussing power conceptualisations and frameworks that so far have been underused in health inequalities research. This includes potential areas for future inquiry and approaches that may expand the study of as well as action on addressing health inequality.

Enhancing clinical practice: reducing health inequalities – reflections on a clinical education and training partnership

2016 ◽  
Vol 10 (6) ◽  
pp. 342-348
Author(s):  
Karina Marshall-Tate
Keyword(s):  
Intellectual Disabilities ◽  
Health Inequalities ◽  
Positive Impact ◽  
Education And Training ◽  
Health Staff ◽  
Significant Group ◽  
Content Type ◽  
Knowledge And Skills ◽  
People With Intellectual Disabilities ◽  
And Training

Purpose The purpose of this paper is to outline a two-year project designed to reduce health inequalities and improve health outcomes of people with intellectual disabilities using health services in South London by raising awareness and increasing health staff confidence and capability. Design/methodology/approach The project was conducted in two stages. In stage 1, a mapping exercise was undertaken to establish existing intellectual disabilities education and training availability. In stage 2, a network of stakeholders was formed and education and training materials were developed and delivered. Findings A formal evaluation of the project is underway and this paper seeks to share information about the project. That said prima facie data appear to indicate that health staff who attended education and training events learned new knowledge and skills that they could implement in their practice, increasing confidence and capability. Research limitations/implications Health staff who attended the events appeared to have an interest in intellectual disabilities and wanted to increase their knowledge and skills base. This means that there is a significant group of health staff that the project was unable to reach or who may not know that they need to know about intellectual disabilities. The results of the project have not yet been formally analysed. Practical implications Work-based education and training events can have a positive impact on health staff capability and confidence, however, it would appear that only those who already have an interest in the field or recognise its value to their own practice attend such events. To truly capture all health staff intellectual disabilities needs to be visibly included in all health curricula. Originality/value This project has not focussed on one profession or one aspect of healthcare and has embraced the values of inter professional and inter agency learning; this has enabled health staff to learn from each other and think in a “joined up” way replicating the realities of providing healthcare to people with intellectual disabilities.

Global Health Inequalities and Justice

2016 ◽  
Author(s):  
Jennifer Prah Ruger
Keyword(s):  
Health Policy ◽  
Global Health ◽  
Health Inequalities ◽  
Health Governance ◽  
Policy System ◽  
Global Institutions ◽  
Policy Goals ◽  
Global Health Policy ◽  
Health Justice ◽  
Shared Health Governance

This chapter discusses challenges of global health inequalities in the current global health policy system. It then describes provincial globalism and a shared health governance framework as approaches to these challenges. Moral philosophers have for some time argued that global poverty and associated human suffering are universal concerns and that there is a moral obligation, beyond matters of charity, for wealthier countries to do more. Being serious about addressing the problem of global health inequalities requires developing a conception of global health justice. Moreover, addressing global health inequalities requires a reexamination of the norms and principles underlying global institutions in order to offer proposals for a better global health policy. This chapter sketches analytical components of provincial globalism, a framework that takes individuals to be the moral unit in both domestic and global contexts and that improves the prospects of alleviating global health inequalities. Provincial globalism promotes the realization of individuals’ health capabilities and supports a shared health governance that enables institutions to reexamine the objectives, policy goals, and decision-making procedures of the global health architecture. Shared health governance, in turn, provides standards for regulating global and domestic institutions and practices to create the conditions for realizing individuals’ health capabilities.

scholarly journals Tackling health inequality at the local level: Some critical reflections on the future of Norwegian policies

2017 ◽  
Vol 45 (18_suppl) ◽  
pp. 56-61 ◽  
Author(s):  
Wenche Bekken ◽  
Espen Dahl ◽  
Kjetil Van Der Wel
Keyword(s):  
Public Health ◽  
Health Inequalities ◽  
Health Inequality ◽  
Social Inequalities ◽  
Local Level ◽  
Government Documents ◽  
Challenges And Opportunities ◽  
Recent Developments ◽  
Research Findings ◽  
Public Health Act

Aim: In this paper we discuss recent developments in the policy to reduce health inequalities in Norway in relation to challenges and opportunities associated with tackling health inequality at the local level. Methods: We discuss government documents and research findings on the implementation of policies to diminish health inequalities at the municipality level. Recent policy developments are briefly reviewed in relation to the 10-year strategy to reduce health inequalities passed by the Parliament in 2007. We then identify opportunities and obstacles to successful action on health inequalities at the local level. Results: The 2012 Public Health Act represented a powerful reinforcement of the strategy to reduce health inequalities at all three levels of government: the national, the regional and the local. However, some aspects of the policies pursued by the current government are likely to make local action to tackle health inequality an uphill struggle. In particular, health equity policies that have hitherto been based on universalism and had a focus on the gradient seem to be running out of fuel. Other challenges are an insufficient capacity for effective action particularly in smaller municipalities, and a rather weak knowledge base, including systems to monitor social inequalities and a general lack of evaluations of trials and new initiatives. Conclusions: We conclude that the Public Health Act opened up many new opportunities, but that a number of municipalities face obstacles that they need to overcome to tackle health inequalities comprehensively. Furthermore, local efforts need to be coupled with sustained national momentum to be efficient.

scholarly journals The Impact of Regeneration and Climate Adaptations of Urban Green–Blue Assets on All-Cause Mortality: A 17-Year Longitudinal Study

2020 ◽  
Vol 17 (12) ◽  
pp. 4577 ◽  
Author(s):  
Zoë Tieges ◽  
Duncan McGregor ◽  
Michail Georgiou ◽  
Niamh Smith ◽  
Josie Saunders ◽  
...  
Keyword(s):  
Health Inequalities ◽  
Positive Impact ◽  
Buffer Zone ◽  
Well Being ◽  
Buffer Zones ◽  
Mitigation And Adaptation ◽  
Urban Waterways ◽  
All Cause Mortality ◽  
The Impact ◽  
Health And Health Inequalities

Urban waterways are underutilised assets, which can provide benefits ranging from climate-change mitigation and adaptation (e.g., reducing flood risks) to promoting health and well-being in urban settings. Indeed, urban waterways provide green and blue spaces, which have increasingly been associated with health benefits. The present observational study used a unique 17-year longitudinal natural experiment of canal regeneration from complete closure and dereliction in North Glasgow in Scotland, U.K. to explore the impact of green and blue canal assets on all-cause mortality as a widely used indicator of general health and health inequalities. Official data on deaths and socioeconomic deprivation for small areas (data zones) for the period 2001–2017 were analysed. Distances between data zone population-weighted centroids to the canal were calculated to create three 500 m distance buffers. Spatiotemporal associations between proximity to the canal and mortality were estimated using linear mixed models, unadjusted and adjusted for small-area measures of deprivation. The results showed an overall decrease in mortality over time (β = −0.032, 95% confidence interval (CI) [−0.046, −0.017]) with a closing of the gap in mortality between less and more affluent areas. The annual rate of decrease in mortality rates was largest in the 0–500 m buffer zone closest to the canal (−3.12%, 95% CI [−4.50, −1.73]), with smaller decreases found in buffer zones further removed from the canal (500–1000 m: −3.01%, 95% CI [−6.52, 0.62]), and 1000–1500 m: −1.23%, 95% CI [−5.01, 2.71]). A similar pattern of results was found following adjustment for deprivation. The findings support the notion that regeneration of disused blue and green assets and climate adaptions can have a positive impact on health and health inequalities. Future studies are now needed using larger samples of individual-level data, including environmental, socioeconomic, and health variables to ascertain which specific elements of regeneration are the most effective in promoting health and health equity.

Health Difference, Disparity, Inequality, or Inequity—What Difference Does It Make What We Call It?

2016 ◽  
Author(s):  
Paula Braveman
Keyword(s):  
Human Rights ◽  
Empirical Evidence ◽  
Health Equity ◽  
Health Inequalities ◽  
Health Inequality ◽  
Social Disadvantage ◽  
The Past ◽  
Health Differences ◽  
Technical Issues

Over the past two and a half decades, distinct approaches have been taken to defining and measuring health inequalities or disparities and health equity. Some efforts have focused on technical issues in measurement, often without addressing the implications for the concepts themselves and how that might influence action. Others have focused on the concepts, often without addressing the implications for measurement. This chapter contrasts approaches that have been proposed, examining their conceptual bases and implications for measurement and policy. It argues for an approach to defining health inequalities and health equity that centers on notions of justice and has its basis in ethical and human rights principles as well as empirical evidence. According to this approach, health inequality or disparity is used to refer to a subset of health differences that are closely linked with—but not necessarily proven caused by—social disadvantage. The term “inequity,” which means injustice, could also be used, but arguments are presented for using it somewhat more sparingly, for those inequalities or disparities in health or its determinants that we know are caused by social disadvantage.

scholarly journals Monitoring health inequalities at the municipal level: Lithuanian experience

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 163-170 ◽  
Author(s):  
Snieguole Kaseliene ◽  
Olga Mesceriakova-Veliuliene ◽  
Jurgita Vladickiene ◽  
Ramune Kalediene ◽  
Neringa Seseikaite ◽  
...  
Keyword(s):  
Public Health ◽  
Health Inequalities ◽  
Health Inequality ◽  
Health Professionals ◽  
Health Indicators ◽  
Intersectoral Collaboration ◽  
Public Health Professionals ◽  
Positive Attitudes ◽  
Routine Monitoring ◽  
Municipal Level

AbstractThis study aimed to assess the attitudes of Lithuanian public health professionals towards health inequality monitoring in municipalities.The survey was conducted in public health bureaus (PHBs) and administrations of municipalities in March 2015. All employees of PHBs, all municipal doctors and all employees of health departments were invited to participate in the study (N=318; response rate, 47.2%).The study participants had positive attitudes towards the importance of health inequality monitoring at the municipal level, meanwhile systematic health inequality monitoring was assessed moderately. The majority of the interviewed professionals working at PHBs and municipalities (91.4% and 88.2%, respectively) declared that health indicators were monitored and analysed in their institutions. The respondents acknowledged the importance of routine monitoring of health indicators for assessment of inequalities, but these indicators were not monitored systematically in every municipality and PHB. Public health professionals identified the following measures for better health inequality monitoring: to strengthen intersectoral collaboration, formulate specific objectives of health programmes, promote actions in reducing health inequalities.ConclusionsPublic health professionals working at the municipal level outlined the importance of monitoring and reducing health inequalities. However, health inequality monitoring at the municipal level was considered as insufficient.

scholarly journals Measuring Geographic and Wealth Inequalities in Health Distribution as Tools for Identifying Priority Health Inequalities and the Underprivileged Populations

2018 ◽  
Vol 7 ◽  
pp. 216495611879195 ◽  
Author(s):  
Sherine Shawky
Keyword(s):  
Information Systems ◽  
Health Information ◽  
Health Inequalities ◽  
Health Inequality ◽  
Health Information Systems ◽  
Inequalities In Health ◽  
Inequality Measures ◽  
Pearson Coefficient ◽  
Wealth Inequalities ◽  
Index Of Dissimilarity

Background Currently, there is no consensus on standard measure that can be routinely part of the health information systems to alert countries to inequalities in health and identify the priority health inequality conditions. Objectives To identify the health inequality measures relevant for assessing geographic and wealth inequalities; use the measures as a demonstration to what can happen in practice to recognize the geographic and wealth-related priority health inequalities within a country; and identify the geographic and wealth underprivileged populations. Method Egypt data were used as demonstration. Pearson coefficient of correlation was calculated to compare the various geographic and wealth health inequality measures. T test was used to identify significant correlations. The relevant inequality measures were used to rank geographic and wealth health inequalities and identify the underprivileged populations. Results The wealth inequalities in health measured by the concentration index provide a familiar and perform adequately in identifying economic inequalities in health. However, the geographic health inequalities identified by the index of dissimilarity appear to provide a more comprehensive profile of health inequalities within a country. Conclusion There is a need for a feasible inequality measure in the health information systems. A country’s geographic health distribution measured by the index of dissimilarity appears to provide a feasible first-step alarm to inform and guide the uptake of equity-sensitive policies.

scholarly journals Toward an Intersectional Approach to Health Justice

2020 ◽  
pp. 002073142098185
Author(s):  
Arnel M. Borras
Keyword(s):  
Public Health ◽  
Social Justice ◽  
Health Inequality ◽  
Health Inequity ◽  
Wealth Creation ◽  
Race Ethnicity ◽  
Gender Based ◽  
And Gender ◽  
Health Justice ◽  
Ethnicity And Gender

Despite unprecedented global wealth creation, health inequity—the unjust health inequality between classes and groups among and within countries—persists, reviving the relevance of social justice as a lens to understand and as an instrument to intervene in these issues. However, the theoretical aspects and polysemous character of social justice as applied in the field of public health are often assumed rather than explicitly explained. An intersectional justice approach to understanding health inequality, inequity, and injustice might be useful. It argues that preexisting class-, race/ethnicity-, and gender-based health injustice and the socially differentiated impacts of the COVID-19 pandemic are shaped, interconnectedly, by economic maldistribution, cultural misrecognition, and political misrepresentation. Pursuing health justice requires analyses, strategies, and interventions that integrate the economic, cultural, and political spheres of redistribution, recognition, and representation, respectively. Such an intersectional approach to health justice is even more relevant and compelling in light of the COVID-19 pandemic. This article is broadly about class, race/ethnicity, and gender political economy of public health—but with a narrower focus on maldistribution, misrecognition, and misrepresentation, shaping social and health injustices.

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