This paper documents inequality in health and education outcomes by constructing an index of human capital disaggregated by quintiles of socioeconomic status (SES) for a sample 51 mostly low- and middle-income countries. The index measures the expected future human capital of children born today, following the methodology of the World Bank Human Capital Index that was launched in October 2018. Within-country disparities in human capital outcomes across SES quintiles are large, accounting for roughly one-third of the total variation. On average,...

Income inequality is one of the most profound social, economic, and political challenges of our time. The gap between the rich and the poor has been regarded as a major concern for policy makers. This gap is at its highest level in decades for developed economies, while the inequality trend has been rising in many developing countries. In Asia, despite recent economic growth, income distribution has been worsening as well. This book contributes to the existing literature on inequality in Asia by overviewing the new trend of inequality in Asia a...

City Deals’ are new governance instruments for urban development. Vast evidence exists on the relationship between urban factors and health equity, but little research applies a health equity lens to urban policy-making. This paper does precisely that for the Western Sydney City Deal (WSCD) in Australia. We conducted a critical discourse analysis of publicly available documents and interviews with the WSCD’s main architects, applying insights from relevant theories. We find ‘pro-growth’ discourse to encourage economic investment dominates any r...

Background: This study aims to assess geographical distribution of hospitals and extent of inequalities in hospital beds against socioeconomic status (SES) of residents of five metropolitan cities in Iran. Methods: A cross-sectional analysis was conducted to measure geographical inequality in hospital and hospital bed distributions of 68 districts in five metropolitan cities during 2016 using geographic information system (GIS), and Gini and Concentration indices. Correlation analysis was performed to show the relationship between the SES and i...

WHO’s World health statistics report 2021 presents the latest data for more than 50 health-related indicators for the Sustainable Development Goals and WHO’s “Triple Billion” targets. It finds an overall increase in global life expectancy and healthy life expectancy at birth as a result of improvements in several communicable diseases, maternal, perinatal and nutritional conditions, noncommunicable diseases, injuries and their underlying determinants. Persisting inequalities also continue to impact population health in most, if not all, aspects...

The efforts chronicled in this series of case studies are not only designed to improve health outcomes, they are also poised to save the country billions in health care spending. According to one study published in 2009, more than 30 percent of direct medical costs faced by African Americans, Hispanics and Asian Americans can be tied to health inequi- ties. Because of inequitable access to care, these populations are sicker when they do find a source of care and incur higher medical costs. That 30 percent translates to more than $230 billion ov...

Background Countdown to 2015 tracks progress towards achievement of Millennium Development Goals (MDGs) 4 and 5, with particular emphasis on within-country inequalities. We assessed how inequalities in maternal, newborn, and child health interventions vary by intervention and country.

Background Universal coverage of health care is now receiving substantial worldwide and national attention, but debate continues on the best mix of financing mechanisms, especially to protect people outside the formal employment sector. Crucial issues are the equity implications of different financing mechanisms, and patterns of service use. We report a whole-system analysis—integrating both public and private sectors—of the equity of health-system financing and service use in Ghana, South Africa, and Tanzania.

This publication reviews the region's inequality trends, challenges and achievements and identifies policy gaps across the three dimensions of inequality--inequality of outcome, inequality of opportunity and inequality of impact. It also discusses the potential impact of rapid and disruptive technological advances, such as machine learning, and puts forward a broad set of policy recommendations for reducing all forms of inequality for the effective implementation of the 2030 Agenda for Sustainable Development and its core tenant of "leaving no ...

Non-communicable diseases (NCDs) are a large and rapidly-growing problem in China and other middle-income countries. Clinical treatment of NCDs is long-term and expensive, so it may present particular problems for equality and horizontal equity (equal treatment for equal need) in access to health care, although little is known about this at present in low- and middle-income countries. To address this gap, and inform policy for a substantial proportion of the global population, we examined inequality and inequity in general health care utilizati...

This chapter investigates recent advances in our understanding of the global distribution of income, and produces the first estimates of global inequality that take into account data on the incomes of the top one percent within countries. We discuss conceptual and methodological issues – including alternative definitions of the global distribution, the use of household surveys and national accounts data, the use of purchasing power parity exchange rates, and the incorporation of recently available data on top incomes from income tax records. We...

Background Coverage levels for essential interventions aimed at reducing deaths of mothers and children are increasing steadily in most low-income and middle-income countries. We assessed how much poor and rural populations in these countries are benefiting from national-level progress.

In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of the increasing financial burden of health care being met by households. Health-care expenditures exacerbate poverty, with about 39 million additional people falling into poverty every year as a result of such expenditures. We identify key challenges for the achievement of equity in service provision, and equity in financing and fi...

The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status, therefore, should be of concern to policy makers in every sector, not solely those involved in he...