wow-inequalities/02-data/intermediate/wos_sample/1bf9866d0116336f66f40f716929ac5b-woodward-a-and-kawa/info.yaml

abstract: 'It is well known that social, cultural and economic factors cause

  substantial inequalities in health. Should we strive to achieve a more

  even share of good health, beyond improving the average health status of

  the population? We examine four arguments for the reduction of health

  inequalities.

  1 Inequalities are unfair. Inequalities in health are undesirable to the

  extent that they are unfair, or unjust. Distinguishing between health

  inequalities and health inequities can be contentious. Our view is that

  inequalities become `(unfair)'' when poor health is itself the

  consequence of an unjust distribution of the underlying social

  determinants of health (for example, unequal opportunities in education

  or employment).

  2 Inequalities affect everyone. Conditions that lead to marked health

  disparities are detrimental to all members of society. Some types of

  health inequalities have obvious spillover effects on the rest of

  society, for example, the spread of infectious diseases, the

  consequences of alcohol and drug misuse, or the occurrence of violence

  and crime.

  3 Inequalities are avoidable. Disparities in health are avoidable to the

  extent that they stent from identifiable policy options exercised by

  governments, such as tax policy, regulation of business and labour,

  welfare benefits and health care funding. It follows that health

  inequalities are, in principle, amenable to policy interventions. A

  government that cares about improving the health of the population ought

  therefore to incorporate considerations of the health impact of

  alternative options in its policy setting process.

  3 Interventions to reduce health inequalities are cost effective. Public

  health programmes that reduce health inequalities can also be cost

  effective. The case can be made to give priority to such programmes (for

  example, improving access to cervical cancer screening in low income

  women) on efficiency grounds. On the other hand, few programmes designed

  to reduce health inequalities have been formally evaluated using cost

  effectiveness analysis.

  We conclude that fairness is likely to be the most influential argument

  in favour of acting to reduce disparities in health, but the concept of

  equity is contested and susceptible to different interpretations. There

  is persuasive evidence for some outcomes that reducing inequalities will

  diminish ``spill over{''''} effects on the health of society at large. In

  principle, you would expect that differences in health status that are

  not biologically determined are avoidable. However, the mechanisms

  giving rise to inequalities are still imperfectly understood, and

  evidence remains to be gathered on the effectiveness of interventions to

  reduce such inequalities.'
affiliation: 'Woodward, A (Corresponding Author), Wellington Sch Med, Dept Publ Hlth,
  POB 7343, Wellington S, New Zealand.

  Wellington Sch Med, Dept Publ Hlth, Wellington S, New Zealand.

  Harvard Univ, Sch Publ Hlth, Dept Hlth \& Social Behav, Boston, MA 02115 USA.'
author: Woodward, A and Kawachi, I
author_list:
- family: Woodward
  given: A
- family: Kawachi
  given: I
da: '2023-09-28'
doi: 10.1136/jech.54.12.923
files: []
issn: 0143-005X
journal: JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH
keywords-plus: 'SOCIAL INEQUALITIES; SOCIOECONOMIC DETERMINANTS; 5-YEAR-OLD CHILDREN;

  UNITED-STATES; NEW-ZEALAND; MORTALITY; INCOME; INTERVENTIONS;

  FLUORIDATION; ENVIRONMENT'
language: English
month: DEC
number: '12'
number-of-cited-references: '49'
orcid-numbers: Woodward, Alistair/0000-0001-5425-6018
pages: 923-929
papis_id: 42541e971057ec90b4c12c6b1131db74
ref: Woodward2000whyreduce
times-cited: '140'
title: Why reduce health inequalities?
type: article
unique-id: WOS:000165346000010
usage-count-last-180-days: '2'
usage-count-since-2013: '61'
volume: '54'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2000'