Definition and Concept of Health Equity
The Concern for Health Equity
(Oxford University Press 2004, 2004)
What Is Health Equity? And What Difference Does a Definition Make?
This report from the Robert Wood Johnson Foundation aims to stimulate discussion and promote greater consensus about the meaning of health equity and the implications of acting on it. The goal of the report is to identify essential elements to guide effective action rather than to encourage all practitioners to use the same words to define health equity. The report notes that definitions can matter and that, in the case of health equity, clarity is important, especially given that working towards equity is a struggle that must engage diverse st...
The political origins of health inequity: prospects for change
(The Lancet - University of Oslo Commission on Global Governance for Health, 2014)
Despite large gains in health over the past few decades, the distribution of health risks worldwide remains extremely and unacceptably uneven. Although the health sector has a crucial role in addressing health inequalities, its efforts often come into conflict with powerful global actors in pursuit of other interests such as protection of national security, safeguarding of sovereignty, or economic goals. This is the starting point of The Lancet–University of Oslo Commission on Global Governance for Health. With globalisation, health inequity i...
The Many Faces of Health Justice
(The London School of Economics and Political Science, October 20)
This paper develops the idea of health justice as a plural conception. It draws on the literature on justice from philosophy and economics, and investigates its application and reach in the space of health. Several distinctions are invoked in identifying and contrasting different facets of health justice and injustice. These include active versus passive injustice; process fairness versus substantive justice; comparative versus noncomparative justice; compensatory and distributive justice. Within distributive justice, the health implications of...
Health, Disability and the Capability Approach: An Introduction
(Journal of Human Development and Capabilities, 2015)
This special issue of the Journal of Human Development and Capabilities focuses on two areas of substantial and growing importance to the human development and capability approach: disability and health. The research on disability, health and the capability approach has been diverse in the topics it covers, and the conceptual frameworks and methodologies it uses, beginning over a decade and a half ago in health (Ruger 1998) and more than a decade ago in disability (Baylies 2002).1 We are pleased to share a set of articles in these two are...
Health Inequities and the Social Determinants of Health
(John Wiley & Sons, Ltd, 2006)
The health of individuals and populations is influenced by many variables. These include genetics and biology, but perhaps more important than these are the social determinants of health. The social, political and economic circumstances in which people live their lives are critical in determining how long they live and with what burden of ill health. These differences are very marked between countries, for example a 15-year-old boy in Lesotho has about a 10% chance of living until the age of 60, compared with a 15-year-old boy in Swede...
Health inequities and social justice: The moral foundations of public health
(Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 2008)
Recently we argued that social justice is concerned with human well-being, which is best understood as involving plural, irreducible dimensions, each of which represents something of independent moral significance. Health is one of these distinct dimensions of well-being, as is personal security, the development and exercise of cognitive capacities for reasoning, living under conditions of social respect, developing and sustaining deep personal attachments, and being able to lead self-determining lives. In this paper, we address why considerati...
HEALTH, VITAL GOALS, AND CENTRAL HUMAN CAPABILITIES
I argue for a conception of health as a person’s ability to achieve or exercise a cluster of basic human activities. These basic activities are in turn speciﬁed through free-standing ethical reasoning about what constitutes a minimal conception of a human life with equal human dignity in the modern world. I arrive at this conception of health by closely following and modifying Lennart Nordenfelt’s theory of health which presents health as the ability to achieve vital goals. Despite its strengths I transform Nordenfelt’s argument in order to ove...
The Crime of Gender Inequality in Global Health
The Normative Dimensions of Health Disparities
(Journal of Health Disparities Research and Practice, 2013)
Understanding what conditions must be satisfied for a health inequality to be a health inequity (disparity) is crucial for health policy makers. The failure to understand what constitutes a health inequity, and confusing health inequalities with health inequities threatens the successful creation of health policies by diverting needed attention and resources away from addressing health inequalities that are health inequities. More generally, the failure threatens to undercut our ability to tell what research is relevant to the creation of healt...
HEALTH DISPARITIES AND HEALTH EQUITY: Concepts and Measurement
(Annual Review of Public Health, 2006)
There is little consensus about the meaning of the terms “health disparities,” “health inequalities,” or “health equity.” The definitions can have important practical consequences, determining the measurements that are monitored by governments and international agencies and the activities that will be supported by resources earmarked to address health disparities/inequalities or health equity. This paper aims to clarify the concepts of health disparities/inequalities (used interchangeably here) and health equity, focusing on the implications of...
RESPONSIBILITY FOR HEALTH AND HEALTH CARE
(Oxford University Press 2005)
The Capability Approach and Disability
(JOURNAL OF DISABILITY POLICY STUDIES)
The definition of disability is of interest to disability policymakers and analysts because it has fundamental implications for eligibility for public programs, for the scope of legislation, and for the way disability prevalence is measured. The purpose of this article is to assess how an approach developed in economics to analyze issues related to the standard of living, the so-called capability approach, may help us understand disability at the conceptual level. The article first summarizes different theoretical models of disability (the...
Chapter 34 Equity in health care finance and delivery
(Handbook of Health Economics, 2000)
The paper surveys the economics literature on equity in health care financing and delivery. The focus is, for the most part, on empirical work, especially that involving intemational and temporal comparisons. There is, however, some discussion of the concept and definition of equity. The empirical sections cover the literature on equity in health care financing (progressivity and horizontal equity of health care financing arrangements), equity in health care delivery (horizontal equity in the sense of treating persons in equal need similarly), ...
What does Equity in Health Mean?
(Journal of Social Policy, 1993)
Up until very recently, the international debate on health inequality tended to disregard the issue of specifying equity objectives precisely. This was unfortunate, given the importance of normative analysis for understanding why people care about social justice in the field of health; the extent to which specific types of inequality are compatible with equity; how the concept should be measured; and how rational policies may be formulated and monitored. This article critically appraises six well established approaches to defining equity—egalit...
Defining equity in health
(Journal of Epidemiology & Community Health, 2003)
Study objective: To propose a definition of health equity to guide operationalisation and measurement, and to discuss the practical importance of clarity in defining this concept. Design: Conceptual discussion. Setting, Patients/Participants, and Main results: not applicable. Conclusions: For the purposes of measurement and operationalisation, equity in health is the absence of systematic disparities in health (or in the major social determinants of health) between groups with different levels of underlying social advantage/disadvantage—t...