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 Health inequalities among middle-aged and elderly people in China: analyses of cross-sectional surveys from the China Health and Retirement Longitudinal Study 2011–2016

2020 ◽  
Author(s):  
Qinxiao Qiu ◽  
Jinfeng Zeng ◽  
Liyuan Han ◽  
Zhuo Chen ◽  
Hongpeng Sun
Keyword(s):  
Longitudinal Study ◽  
Chronic Diseases ◽  
Health Equity ◽  
Health Inequalities ◽  
Health Inequality ◽  
Gdp Per Capita ◽  
Calculated Concentration ◽  
Kendall’S Τ ◽  
Per Capita ◽  
Concentration Indices

Abstract Objectives: China has a history of striving to achieve health equity, including efforts to prevent and control infectious diseases. However, to date, there is no comprehensive assessment of inequalities in chronic diseases in China. Methods: Data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS) conducted from 2011 to 2016. A total of 50,244 Chinese adults aged 45 years and older were included (16,128 in 2011, 16,646 in 2013, and 17,470 in 2015). Principal component analysis was used to construct the socioeconomic status indicator. We calculated concentration indices and corresponding CIs for 14 chronic diseases and comorbidities. We then estimated the Kendall rank correlation coefficient for inequalities and GDP per capita among provinces. Results: For 10 of the 14 chronic diseases, prevalence rates were higher for the poorest tertiles than for the richest tertiles. The concentration indices of dyslipidaemia, diabetes or high blood sugar, and cancer or malignant tumour were, respectively, 0.1256 (95% confidence interval, 0.1052–0.151), 0.098 (0.0704–0.1244), and 0.1305 (0.0528–0.215) in 2015–2016, which indicated pro-rich inequality. Health inequality for chronic lung diseases and eight other diseases grew markedly from 2011 to 2016. Overall, health inequality was lower for urban residents (−0.035 in 2011–2012, −0.036 in 2013–2014, and −0.05 in 2015–2016) than rural residents (−0.053, −0.064, and −0.08, respectively), and inequality was twice as high among women (−0.051, −0.05, and −0.072, respectively) than among men (−0.023, −0.02, and −0.032, respectively). Provinces that were ranked higher for GDP per capita were also ranked higher in the degree to which disease prevalence was higher in people with lower income (Kendall’s τ=−0.2328, p=0.015; Kendall’s τ=−0.3545, p=0.0077; Kendall’s τ=−0.2646, p=0.0079, respectively). Conclusions: Pro-poor health inequalities for many diseases in China are large and widening. Policies associated with health equity, including free public health services and community health programmes, are needed to achieve the Sustainable Development Goals.

scholarly journals Elderly Health Inequality in China and its Determinants: A Geographical Perspective

2019 ◽  
Vol 16 (16) ◽  
pp. 2953 ◽  
Author(s):  
Chenjing Fan ◽  
Wei Ouyang ◽  
Li Tian ◽  
Yan Song ◽  
Wensheng Miao
Keyword(s):  
Health Status ◽  
Health Inequalities ◽  
Health Inequality ◽  
Elderly Population ◽  
Hot Spot ◽  
Good Health ◽  
The Elderly ◽  
Multilevel Regression ◽  
Health Differences ◽  
Elderly Health

Inter-regional health differences and apparent inequalities in China have recently received significant attention. By collecting health status data and individual socio-economic information from the 2015 fourth sampling survey of the elderly population in China (4th SSEP), this paper uses the geographical differentiation index to reveal the spatial differentiation of health inequality among Chinese provinces. We test the determinants of inequalities by multilevel regression models at the provincial and individual levels, and find three main conclusions: 1) There were significant health differences on an inter-provincial level. For example, provinces with a very good or good health rating formed a good health hot-spot region in the Yangtze River Delta, versus elderly people living in Gansu and Hainan provinces, who had a poor health status. 2) Nearly 2.4% of the health differences in the elderly population were caused by inter-provincial inequalities; access (or lack of access) to economic, medical and educational resources was the main reason for health inequalities. 3) At the individual level, inequalities in annual income served to deepen elderly health differences, and elderly living in less developed areas were more vulnerable to urban vs. rural-related health inequalities.

scholarly journals Understanding Health Equity: Key Concepts, Debates, and Developments in Canada

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Attia Khan
Keyword(s):  
Human Rights ◽  
Health Equity ◽  
Health Inequalities ◽  
Political Ideology ◽  
Review Of The Literature ◽  
The Social ◽  
Canadian Context ◽  
Key Concepts ◽  
Taking Action ◽  
Political Economy Approach

Health inequalities exist and persist due to the quality and distribution of the social determinants of health, i.e., the day to day circumstances people live in. These circumstances are determined by governing policies and practices which are influenced by the State’s political ideology and its socio-economic structures. Using a political economy approach, this paper takes a critical review of the literature on health equity in the Canadian context and clarifies key concepts pertaining to health equity and human rights. Findings of this review show that Canada has been performing poorly in addressing growing health inequalities, in part because of Canada’s increasingly neo-liberal stance on public health over the last decade. This paper will argue that a human rights framework can offer a concrete tool for restructuring public policies and for taking action against these inequalities. By placing health equity on the policy agenda, Canada can help reduce social and income inequalities and optimize the health of its populations.

scholarly journals Socioeconomic inequalities in health in the post-Soviet Russia

POPULATION ◽  
2019 ◽  
Vol 22 (1) ◽  
pp. 61-78
Author(s):  
Pavitra Paul ◽  
Hannu Valtonen ◽  
Natalia Kovtun
Keyword(s):  
Health Inequalities ◽  
Health Inequality ◽  
Random Effect ◽  
Generalized Least Squares ◽  
Perceived Health ◽  
Individual Characteristics ◽  
Determinants Of Health ◽  
Health Differences ◽  
Monitoring Survey ◽  
Soviet Russia

Individual characteristics and socioeconomic position (SEP) are important determinants of health differences. We (1) examine the association of demography and SEP, with perceived health of the Russian population, and (2) quantify the magnitude of health inequalities ascribed to SEP in the Russian Federation. We apply a random effect Generalized Least Squares model on the datasets of the Russian Longitudinal Monitoring Survey (RLMS: 1994–2013). Our measure of health inequality is concentration index (CI), which we decompose into the determinants of health inequalities. Further, a balanced sample of 1,496 individuals extracted from the 1994 wave of RLMS is followed over 19-year period. The degree of aversion to inequalities in perceived health between the worseoff and the better-off is measured with achievement index. Being employed matters in perceiving a better health. Although the perceived health differences between the better-off and the worse-off are reduced, health inequality index indicates a change for better health for the better-off Russians.

scholarly journals Joint Action Health Equity Europe - turning knowledge on health inequality monitoring into actions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Olsson ◽  
G Henriksson
Keyword(s):  
Health Equity ◽  
Health Inequalities ◽  
Health Inequality ◽  
Joint Action ◽  
Social Inequalities ◽  
National Level ◽  
Health Agency ◽  
Monitoring Systems ◽  
Specific Objective ◽  
The Status

Abstract Growing social inequalities in health challenge a sustainable development. To reduce health inequalities, it will be necessary to provide relevant data to policymakers on how health inequalities and the social determinants of health are distributed within populations over time, i.e. it will be necessary to form appropriate health inequality monitoring systems (HIMS). One of the aims with Joint Action Health Equity Europe (JAHEE) and the specific objective of work package five (WP5) is to advance partner countries ability to monitor national health inequalities. Country assessments has been conducted to assess the status of the HIMS in the participating countries, and a joint framework has been developed, describing the core components of an “ideal” HIMS. All partners have committed to the overall objective of the WP5 through the identification and implementation of concrete actions, which is now ongoing. The countries in JAHEE WP5 are Cyprus, Finland, Germany, Italy, Lithuania, Netherlands, Poland, Romania, Serbia, Slovenia, Spain and Sweden, where The Public Health Agency Sweden is the lead. The aim of this presentation is to present the experiences from JAHEE WP 5, and what they imply is needed to build coherent health inequality monitoring systems at a national level. More specifically, the JAHEE project in general, the WP5 project in particular will be presented, the structured work process described, and some general results and conclusions discussed

scholarly journals Health Inequalities in the Time of COVID-19: The Globally Reinforcing Need to Strengthen Health Inequalities Research Capacities

2021 ◽  
pp. 002073142199393
Author(s):  
Lucinda Cash-Gibson ◽  
Juan M. Pericàs ◽  
Eliana Martinez-Herrera ◽  
Joan Benach
Keyword(s):  
Social Capital ◽  
Empirical Evidence ◽  
Health Equity ◽  
Health Inequalities ◽  
Unmet Needs ◽  
Evidence Based ◽  
Critical Research ◽  
Early Results ◽  
Cognitive Social Capital ◽  
Strong Capacity

The full impact of coronavirus disease 2019 (COVID-19) is yet to be well established; however, as the pandemic spreads, and early results emerge, unmet needs are being revealed, and pressing questions are being asked about who is most affected, how, where, and in what ways government responses might be exacerbating inequalities. A number of scholars have called for more in-depth critical research on COVID-19 and health inequalities to produce a strong empirical evidence based on these issues. There are also justifiable concerns about the scarcity of health-equity actions oriented analyses of the situation and calls for more empirical evidence on COVID-19 and health inequalities. A preliminary condition to establish this type of information is strong capacity to conduct health inequalities research. Worldwide, however, this type of capacity is limited, which, alongside other challenges, will likely hinder capacities of many countries to develop comprehensive equity-oriented COVID-19 analyses, and adequate responses to present and future crises. The current pandemic reinforces the pending need to invest in and strengthen these research capacities. These capacities must be supported by widespread recognition and concern, cognitive social capital, and greater commitment to coordinated, transparent action, and responsibility. Otherwise, we will remain inadequately prepared to respond and meet our society’s unmet needs.

scholarly journals Misdiagnosing the Human Rights Malaise

2019 ◽  
pp. 153-164
Author(s):  
Jacques Hartmann
Keyword(s):  
Human Rights ◽  
Empirical Evidence ◽  
Fundamental Rights ◽  
The Public ◽  
The Past ◽  
The People ◽  
Human Rights Movement

Contemporary populism is antagonistic towards human rights. As a result, the challenges now facing the human rights movement are fundamentally different from those of the past. Yet, proposed remedies to this malaise often seem ill-conceived. Populists tend to claim that the institutions charged with the protection of fundamental rights not only limit the capacity of the people to exercise their rightful power but are also the source of a growing discontent with the system itself. This narrative is often uncritically accepted and leads to suggestions that human rights must be fundamentally reformed. Although intuitively appealing, such suggestions commonly lack support from empirical evidence. In addition, much of the debate seemingly starts from the premise that the public is fully informed. Using Denmark as a case study, this Note shows that existing assumptions may be questioned. It further suggests that it may be dangerous to propose a cure before the malaise has been properly diagnosed.

Socially Shared Regulation of Learning: A Review

2015 ◽  
Vol 20 (3) ◽  
pp. 190-203 ◽  
Author(s):  
Ernesto Panadero ◽  
Sanna Järvelä
Keyword(s):  
Empirical Evidence ◽  
Learning Theory ◽  
Qualitative Data ◽  
Social Regulation ◽  
Observation Data ◽  
Optimal Form ◽  
Self Regulated Learning ◽  
The Past ◽  
Recorded Observation ◽  
Socially Shared Regulation

Abstract. Socially shared regulation of learning (SSRL) has been recognized as a new and growing field in the framework of self-regulated learning theory in the past decade. In the present review, we examine the empirical evidence to support such a phenomenon. A total of 17 articles addressing SSRL were identified, 13 of which presented empirical evidence. Through a narrative review it could be concluded that there is enough data to maintain the existence of SSRL in comparison to other social regulation (e.g., co-regulation). It was found that most of the SSRL research has focused on characterizing phenomena through the use of mixed methods through qualitative data, mostly video-recorded observation data. Also, SSRL seems to contribute to students’ performance. Finally, the article discusses the need for the field to move forward, exploring the best conditions to promote SSRL, clarifying whether SSRL is always the optimal form of collaboration, and identifying more aspects of groups’ characteristics.

Provision of Remedies for Violation of Economic, Social and Cultural Rights: A Comparative Study of the United Nations, Inter-American and African Human Rights Systems

2020 ◽  
Vol 28 (2) ◽  
pp. 298-318
Author(s):  
Roman Girma Teshome
Keyword(s):  
Human Rights ◽  
United Nations ◽  
Comparative Study ◽  
Economic Rights ◽  
Regional Monitoring ◽  
Cultural Rights ◽  
The Past ◽  
The United Nations ◽  
To Receive

The effectiveness of human rights adjudicative procedures partly, if not most importantly, hinges upon the adequacy of the remedies they grant and the implementation of those remedies. This assertion also holds water with regard to the international and regional monitoring bodies established to receive individual complaints related to economic, social and cultural rights (hereinafter ‘ESC rights’ or ‘socio-economic rights’). Remedies can serve two major functions: they are meant, first, to rectify the pecuniary and non-pecuniary damage sustained by the particular victim, and second, to resolve systematic problems existing in the state machinery in order to ensure the non-repetition of the act. Hence, the role of remedies is not confined to correcting the past but also shaping the future by providing reforming measures a state has to undertake. The adequacy of remedies awarded by international and regional human rights bodies is also assessed based on these two benchmarks. The present article examines these issues in relation to individual complaint procedures that deal with the violation of ESC rights, with particular reference to the case laws of the three jurisdictions selected for this work, i.e. the United Nations, Inter-American and African Human Rights Systems.

Les héritages chrétiens: quel avenir?

Moreana ◽  
2009 ◽  
Vol 46 (Number 176) (1) ◽  
pp. 175-190
Author(s):  
Bernard Bourdin
Keyword(s):  
European Union ◽  
Human Rights ◽  
Middle Ages ◽  
Critical Analysis ◽  
Religious Affiliation ◽  
The European Union ◽  
Modern Times ◽  
The Past ◽  
Religious Significance ◽  
Politics And Religion

The legacy from Christianity unquestionably lies at the root of Europe, even if not exclusively. It has taken many aspects from the Middle Ages to modern times. If the Christian heritage is diversely understood and accepted within the European Union, the reason is essentially due to its political and religious significance. However, its impact in politics and religion has often been far from negative, if we will consider what secular societies have derived from Christianity: human rights, for example, and a religious affiliation which has been part and parcel of national identity. The Christian legacy has to be acknowledged through a critical analysis which does not deny the truth of the past but should support a European project built around common values.

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