125 lines
3.9 KiB
YAML
125 lines
3.9 KiB
YAML
abstract: 'It is well known that social, cultural and economic factors cause
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substantial inequalities in health. Should we strive to achieve a more
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even share of good health, beyond improving the average health status of
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the population? We examine four arguments for the reduction of health
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inequalities.
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1 Inequalities are unfair. Inequalities in health are undesirable to the
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extent that they are unfair, or unjust. Distinguishing between health
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inequalities and health inequities can be contentious. Our view is that
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inequalities become `(unfair)'' when poor health is itself the
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consequence of an unjust distribution of the underlying social
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determinants of health (for example, unequal opportunities in education
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or employment).
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2 Inequalities affect everyone. Conditions that lead to marked health
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disparities are detrimental to all members of society. Some types of
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health inequalities have obvious spillover effects on the rest of
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society, for example, the spread of infectious diseases, the
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consequences of alcohol and drug misuse, or the occurrence of violence
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and crime.
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3 Inequalities are avoidable. Disparities in health are avoidable to the
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extent that they stent from identifiable policy options exercised by
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governments, such as tax policy, regulation of business and labour,
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welfare benefits and health care funding. It follows that health
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inequalities are, in principle, amenable to policy interventions. A
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government that cares about improving the health of the population ought
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therefore to incorporate considerations of the health impact of
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alternative options in its policy setting process.
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3 Interventions to reduce health inequalities are cost effective. Public
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health programmes that reduce health inequalities can also be cost
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effective. The case can be made to give priority to such programmes (for
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example, improving access to cervical cancer screening in low income
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women) on efficiency grounds. On the other hand, few programmes designed
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to reduce health inequalities have been formally evaluated using cost
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effectiveness analysis.
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We conclude that fairness is likely to be the most influential argument
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in favour of acting to reduce disparities in health, but the concept of
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equity is contested and susceptible to different interpretations. There
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is persuasive evidence for some outcomes that reducing inequalities will
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diminish ``spill over{''''} effects on the health of society at large. In
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principle, you would expect that differences in health status that are
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not biologically determined are avoidable. However, the mechanisms
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giving rise to inequalities are still imperfectly understood, and
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evidence remains to be gathered on the effectiveness of interventions to
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reduce such inequalities.'
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affiliation: 'Woodward, A (Corresponding Author), Wellington Sch Med, Dept Publ Hlth,
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POB 7343, Wellington S, New Zealand.
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Wellington Sch Med, Dept Publ Hlth, Wellington S, New Zealand.
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Harvard Univ, Sch Publ Hlth, Dept Hlth \& Social Behav, Boston, MA 02115 USA.'
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author: Woodward, A and Kawachi, I
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author_list:
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- family: Woodward
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given: A
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- family: Kawachi
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given: I
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da: '2023-09-28'
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doi: 10.1136/jech.54.12.923
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files: []
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issn: 0143-005X
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journal: JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH
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keywords-plus: 'SOCIAL INEQUALITIES; SOCIOECONOMIC DETERMINANTS; 5-YEAR-OLD CHILDREN;
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UNITED-STATES; NEW-ZEALAND; MORTALITY; INCOME; INTERVENTIONS;
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FLUORIDATION; ENVIRONMENT'
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language: English
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month: DEC
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number: '12'
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number-of-cited-references: '49'
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orcid-numbers: Woodward, Alistair/0000-0001-5425-6018
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pages: 923-929
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papis_id: 42541e971057ec90b4c12c6b1131db74
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ref: Woodward2000whyreduce
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times-cited: '140'
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title: Why reduce health inequalities?
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type: article
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unique-id: WOS:000165346000010
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usage-count-last-180-days: '2'
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usage-count-since-2013: '61'
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volume: '54'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2000'
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