The Hindu : National : Inequities in healthcare claiming millions of lives, says World Health Organisation report

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Inequities in healthcare claiming millions of lives, says World Health Organisation report

Aarti Dhar

Evidence suggests that the poor are worse off than those less deprived

Distribution of services especially in low-income countries is unfair
Wealth alone does not determine the health
of a nation

NEW DELHI: A toxic combination of bad policies, economics and politics is largely responsible for a majority of the people in the world being deprived of good health that is biologically possible. Millions of people die globally due to lack of healthcare facilities, according to a World Health Organisation (WHO) report.

In the report on “Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health,” the WHO’s Commission on the Social Determinants of Health says that health inequities – unfair, unjust and avoidable causes of ill health – have long been measured between countries.

Health gradients

It documents “health gradients” within countries as well. The Commission found evidence that suggests that in general the poor people are worse off than those less deprived. It also found that the less deprived are in turn worse than those with average incomes, and so on.

“This slope, linking income and health, is the social gradient, and is seen everywhere – not just in developing countries, but all countries, including the richest. This slope may be more or less steep in different countries, but the phenomenon is universal.”

While there has been an enormous increase in global wealth, technology and living standards in recent years, the distribution of services and institution-building, especially in low-income countries, is unfair. But wealth alone does not determine the health of a nation’s population. Some low-income countries such as Cuba, Costa Rica, China and Kerala in India and Sri Lanka have achieved levels of good health despite relatively low national income. But, the Commission points out, wealth could be wisely used.

Water-borne diseases

Much of the work to redress health inequities lies beyond the health sector. According to the report water-borne diseases are not caused by lack of antibiotics but by dirty water and by the political, social and economic forces that fail to make clean water available to all.

“We rely too much on medical intervention as a way of increasing life expectancy. A more effective way of increasing life expectancy and improving health would be for every government policy and programme to be assessed for its impact on health and health equity.”

Recommendations

Based on the evidence, the Commission makes three recommendations to tackle the “corrosive effects of inequality of life chances.” These are, improving the daily living conditions, including the circumstances in which people are born, grow, live and work; tackling the inequitable distribution of power, money and resources –the structural drivers of these conditions, and measuring and understanding the problem and assess the impact of action.

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