Principles of health equity

This chapter shows how informal normative concerns about health equity raised by decision makers can be translated into formal health equity objectives that are amenable to quantitative analysis using distributional cost-effectiveness analysis (DCEA). It also clarifies the kinds of ethical concerns that can and cannot be addressed by DCEA. Four ways of thinking about ethics are distinguished: value maximizing, moral rights, fair shares, and fair processes. When considering whether and how DCEA can be used to address a specific equity concern raised by decision makers, it is important to clarify which of these four ways of thinking underpins the concern. DCEA methods for evaluating distributions are based on the value maximizing way of thinking, but the information provided by DCEA about the distributional consequences of decisions can also help to address equity concerns relating to moral rights, fair shares, and fair processes.

Strategies for Achieving Health Equity: Concern about the Whole Plus Concern about the Hole

Health equity is a process, assurance of the conditions for optimal health for all people, which requires valuing all individu­als and populations equally, recognizing and rectifying historical injustices, and providing resources according to need. At the heart of health equity is concern about the whole of society, not just a single individual or group. Also, at the heart of health equity is concern about the holes in society, about gaps of op­portunity and gaps of being valued that are experienced by many. Strategies to achieve health equity that reflect concern about the w(hole) require the examination of a practical roadmap that combines citizenship (WHOLE) with a gap analysis (HOLE). This shorthand of operationalizing health equity as concern about the (w)hole may prove to be useful in generating further strate­gies for achieving health equity.Ethn Dis. 2019;29(Suppl 2): 345-348. doi:10.18865/ed.29.S2.345

What about the men? Gender parity in occupational therapy

Background. Gender parity is frequently raised as an equity issue in occupational therapy, with strategies proposed to recruit more men. Purpose. This article explores whether this is a legitimate equity concern. Key Issues. Most employment is gender segregated; when gender balances change, the field either re-genders feminine or creates gender-segregated internal divisions. Men avoid feminized jobs because they pay less and hold less social status. They are a “step down” for men. In such jobs, men are disproportionately pushed into management positions, with better pay, more prestige, and less hands-on care. Equity issues concern structural barriers to success in particular employment fields. Though they may feel discomfort in a feminized field, men do not face structural barriers in occupational therapy. Implications. Broader challenges to traditional gender norms are needed, but there is no evidence that gender parity is an equity concern or that recruitment targeting masculinity would make a difference.

5. Attitudes on Investment in Descendants: Products of Evolution?

This study aims to examine intergenerational equity (concern for future generations) from a human evolutionary ecology perspective. The extent to which males and females differ in their concern about the welfare of future generations can be interpreted as a product of natural selection. We hypothesized that reproductive advantage is conferred upon males by discounting future generations and focusing on their immediate well being. Given that males potentially have many children, and do not invest the same resources in raising children, it is to their reproductive advantage to focus on the present and their own wellbeing, so that they can continue to reproduce. It is hypothesized that reproductive advantage would be conferred upon females who are concerned about future generations. Females potentially have fewer children and invest more in raising children. It is therefore more to their reproductive advantage to ensure that children survive to adulthood. Using a between‐subjects design online survey, emailed to individuals in the Queen's Community (Students, Staff, Faculty, and Alumni), we asked participants to indicate what proportion of available money ($10, 000 they received by chance) they would allocate to mitigating a hypothetical food crisis (collectivist option) versus to three “individualist” options. Participants were randomly assigned to hypothetical scenarios where the food crisis affected: the participant's generation, their children's generation, their grandchildren's generation, or their great‐ grandchildren's generation. In all four scenarios, we found that males invested significantly less in mitigating the food crisis than females. Additionally, we found that neither males nor females differed significantly between scenarios in the amount they invested in mitigating the food crisis.

Teaching for Gender Justice

Since the mid 1990s ‘boys' as an equity concern have come to dominate the gender and education agenda in many countries. This has been particularly the case in Australia where substantial funding has been invested in research to investigate boys' issues, into a federal parliamentary inquiry into boys' education and into schools that have a particular focus on improving boys' education. The discourses that work to construct boys as an equity concern have had differing impacts upon teachers' philosophies and practices in relation to boys' education. In this paper we locate two teacher stories within the context of broader gender equity discourses in Australia. Against a backdrop that attempts to articulate the primary concerns of two secondary teachers in relation to effectively teaching boys, the stories explore implications for gender justice that can be associated with, on the one hand, an affirmative approach, and on the other, a transformative approach to issues of boys and schooling.